bluuebunny/crossref_metadata_2025 huggingface dataset:
Study of neurological manifestations in patients of falciparum malaria
Authors: Murmu Malati , Kar Ayaskanta , KP Karun Mahesh , Naik Manoranjan , Kumar Meher Rajesh
Published: January 2018

Background: Several types of neurological manifestations are associated with falciparum malaria. Cerebral malaria is one of the most dreaded complications. A significant number of survivors are left with disabling neurological sequelae, most of which are self-limiting. Neurological involvement is more frequent with falciparum malaria because of its unique characteristics leading to micro-vascular involvement.Methods: Present study was conducted at department of General Medicine, VIMSAR, Burla (Odisha). This observational study included in total 110 patients, who were confirmed cases of falciparum malaria. Clinical profile including detailed neurological examination with relevant investigations was done. Spectrum of neuropsychiatric manifestations were observed.Results: Out of 110 patients male and female ratio was 1:1 (M 55 and F 55). The mean age of presentation in male was 36.09 + 14.85 yrs. and in female was 31.85 + 14.00 yrs. The major presenting symptoms were fever, headache, vomiting, altered sensorium, altered behaviour and convulsions in their decreasing order of frequency. On neurological evaluation, diminished level of consciousness was found in 56.4% cases. 14% cases had GCS score ≤ 7 and 63% had GCS score ≥ 11. Convulsion was found in 31% cases, cranial neuropathy in 10.9%, cerebellar dysfunction in 12.7%, neck rigidity in 22.7%, speech abnormality in 3.6%, peripheral neuropathy in 8.2%, fundoscopic changes suggestive of retinal involvement in 44.5% cases. Atypical manifestation like; Intracerebral haemorrhage, subarachnoid haemorrhage, cortical venous sinus thrombosis were also found in few cases. 32.72% patients had Neuropsychiatric manifestations at discharge in the form of focal neurological deficits, psychosis, depression, speech disorder, memory loss, cerebellar abnormality & peripheral neuropathy.Conclusions: Neurological manifestations in falciparum malaria patients are common and encompass a wide spectrum of clinical presentation. In an endemic area, falciparum malaria should be kept as a differential diagnosis in patients presenting with atypical neurological manifestations.
The double burden of tuberculosis and diabetes prevalance of diabetes melitus in tuberculosis
Authors: Khare Rajesh Kumar , Katiyar Vivek
Published: January 2018

Background: The burden of diabetes mellitus is increasing worldwide. The prevalence of TB has been rising in recent years globally. Aging, changes in life style, socioeconomic factors, and population growth have lead to an increased prevalence of DM, particularly, type 2 DM. Diabetes Mellitus (DM) almost triples the risk of developing tuberculosis (TB). India, the nation with the highest number of TB cases in the world, is also undergoing epidemic growth in DM rates. With the demographic transition underway globally, increase in life expectancy, improvements in provision of health services and a subsequent increase in the elderly population, the absolute numbers of cases of diabetes will increase exponentially. As a result, DM and TB are increasingly present together, and this calls for renewed interest in this topic. Various studies done in different parts of India and in other parts of globe where TB is endemic have shown a higher prevalence of DM among PT infected with tuberculosis. We in our study undertaken in Department of medicine in IIMS&R Lucknow UP found a high prevalence of DM amongst TB patients. Routine screening of TB patients for DM will help detect cases of diabetes and pre-diabetes early, so that primary prevention methods may be initiated early and effectively.Methods: This hospital-based cross-sectional study was undertaken in Department of medicine in IIMS and R Lucknow UP. All TB cases more than 18 years of age, including new and re-treatment cases, sputum positive, sputum negative and extra-pulmonary cases currently on treatment in the were included in the study.Results: Using the diagnostic criteria, as mentioned in the methodology, the prevalence of diabetes among TB patients in this study was found to be 24.5% of which 18.5% were known DM cases and 5.9% were newly diagnosed.Conclusions: The burden of diabetes mellitus is increasing worldwide. The association between diabetes and tuberculosis is the next challenge for global tuberculosis control. Improved understanding of the bidirectional relationship of the two diseases is necessary for proper planning and collaboration to reduce the dual burden of diabetes and TB. In people with TB, it may be appropriate to actively screen for DM. Prevention, screening, and treatment of both diseases together is more effective.
Characterization of adrenal masses with non-enhanced CT and 18F FDG-PET in patients with primary malignancies
Authors: S. Prasanth P. , Kandanga Indu , P. Ambooken Robert , P. Sankaran Priya
Published: January 2018

Background: Characterizing adrenal lesions in patients with a known primary malignancy has a vital role in treatment and prognostication. A study by Gufler et al proposed a scoring system based on density, contour, homogeneity and size and found a high accuracy in differentiating adrenal adenomas from metastasis in patients with a known malignancy. This study evaluates the sensitivity and specificity of this NECT scoring system and comparing it with that of 18F FDG PET.Methods: The study was conducted on patients with diagnosed malignancies with adrenal mass, referred for 18F-FDG PET-CT scanning as a part of work up or follows up between October 2014 and March 2016. Whole-body CT and PET images were obtained using standard protocol. NECT scoring and quantitative analysis of FDG uptake in the adrenal lesions (SUVavg analysis) is done separately.Results: Of the 50 patients studied, 33 patients had benign adrenal lesions and the rest had metastatic lesions. Most common site of primary was lung. NECT score yielded a sensitivity of 88.2%, specificity of 100% and positive predictive value of 100%. SUVavg analysis yielded a 100% sensitivity, specificity and positive predictive value. Comparison of the predictive power of the two tests showed a z score of 2.5 and p value of 0.0124.Conclusions: 18-FDG PET can be considered as a gold standard for differentiating between metastasis and benign lesions of adrenal glands in patients with known primary. NECT has a comparable specificity as that of FDG PET, however with lower sensitivity.
The advantage of PCR for MTB in comparison to ADA in diagnosing tubercular pleural effusion
Authors: Agarwal Abhishek , Hussain Ahbab , Prasad Rajendra , Verma Anand , Banka Amitabh , Raza Tasleem
Published: January 2018

Background: Tuberculosis continues to be an important health problem globally. The bacteriological confirmation of diagnosis in extrapulmonary tuberculosis patients is more difficult because most of the cases of extrapulmonary tuberculosis are paucibacillary in nature. In this study we have compared the pleural fluid ADA levels with PCR for MTB in pleural fluid to confirm the diagnosis of tuberculosis in the pleural fluid.Methods: The study was done over two years and a total of 106 patients with a clinico-radiological diagnosis of pleural effusion were enrolled for the study. The pleural fluid was aspirated and examined for total cell count, differential cell count, protein, sugar, ADA and PCR for MTB.A CT Thorax was done in all the 106 patients of pleural effusion and underlying consolidation along with pleural effusion was found in 60 patients.Results: The pleural fluid was exudative in nature in all the patients. 90 patients (84.9%) had lymphocyte predominant pleural effusion while 16 patients (15.1%) had neutrophil predominant pleural effusion. The overall sensitivity of ADA in all the cases of pleural effusion was 85.2% while the overall sensitivity of PCR for MTB in all the cases of pleural effusion was 51.1%. However, in the 60 patients of pleural effusion with underlying lung consolidation, the overall sensitivity of ADA was 69.1% while the overall sensitivity of PCR for MTB was 92.8% for diagnosing tubercular pleural effusion.Conclusions: PCR for MTB is a useful test along with ADA for diagnosing tubercular pleural effusion. PCR for MTB is especially useful in the diagnosis of tubercular pleural effusion in patients with underlying lung consolidation.
Incidence of tuberculosis in nondialysis-requiring CKD patients
Authors: Narain Upma , Gupta Arvind
Published: January 2018

Background: Tuberculosis is a common infection of chronic kidney disease patients in developing countries.Methods: A retrospective study of 2960 non-dialysis requiring chronic kidney disease patients was made to determine the incidence and understand the demographic features of patients that lead to the development of tuberculosis on the basis of cell count, routine, ADA estimation, ZN stain, culture and PCR.Results: Between Jan 2000 and March 2017, the incidence of tuberculosis in no dialysis-requiring chronic kidney disease group was 10.3% in which pulmonary tuberculosis was 3.9% while extrapulmonary tuberculosis was 6.4%. Among extrapulmonary tuberculosis, 52% positivity was seen in pleural effusion, 16.40% in ascetic fluid, 10.10% in lymphnodes, 7.4% in urinary tract, and 3.7% in CSF, 2.6% in pericardial fluid, 1.6% in adrenal tissue and 1.1% in spine. ZN stain was positive in 48.6%, culture isolated mycobacterium 98.3%, PCR 93.4%, the mean ADA levels was 22.90+11.24 IU/ml and 60.49+07.24 IU/ml in CSF and body fluids respectively. Outcome analysis revealed 15.4% mortality rate in diagnosed tuberculosis cases while maximum loss of life was seen in diabetic patients.Conclusions:In the present study we observed 10.3% incidence of tuberculosis among nondialysis-requiring chronic kidney disease patients. Extrapulmonary form of tuberculosis predominates over pulmonary form. Unusual presentation and lococalization of symptoms should not be overlooked. Prompt and early diagnosis of tuberculosis is especially required in endemic areas.
Clinicopathological study of cervical lymphadenopathy at rural tertiary health care centre
Authors: M. Paikrao Yogesh , M. Deshpande Prashant , N. Chintale Kailas
Published: January 2018

Background: The term lymphadenopathy refers to nodes that are abnormal in size, consistency or number. Cervical lymphadenothy is one of the common and important presentations of the underlying pathology of the head and neck region which has large number of differential diagnosis like neoplasms, infections (specific and non-specific) and in immune deficiency disorders and also, the rare disorders like Inflammatory pseudotumour (Plasma cell granuloma) and Kikuchi-Fujimoto diseases. Etiological profile of cervical Lymphadenopathy varies from region to region, in developing countries like India, acute respiratory infection, suppurative skin infection and tuberculosis are the main causes for cervical lymphadenopathy while in developed countries secondary carcinoma are the most frequent causes for cervical lymphadenopathy.Methods: This hospital based cross sectional study was carried out in the Department of Otorhinolaryngology in Rural Tertiary Health Care Centre. The period of the study was from January 2014 to June 2016.Results: In our study of 176 patients the youngest patient was 13year of age and oldest patient was 68 years old. The majority of patients affected were in the age group of 21 to 30 years (30.68%) followed by 13 to 20 years (23.86%). The least affected age group was 60 to 70 years (5.8%). There were 80 men and 96 women. The male to female ratio in present study was 1:1.2 The frequently affected age group was 21 to 30 years in men (26.25%) as well as women (34.38%). In our study Neck swelling was present in all cases (100%). fever was the second most common symptom in 54 cases (30.68%) followed by cough in 45 cases (25.56%). In our study most frequently involved lymph node group was posterior cervical in 68 cases (38.39%), followed by upper deep cervical in 66 cases (37.50%).Conclusions: In the present study it was found that tuberculosis was the most frequent cause of cervical Lymphadenopathy in 48.29% of patients, followed by reactive Lymphadenopathy in 17.34%, metastatic lymphadenopathy in 15.34% chronic nonspecific Lymphadenopathy in 14.77% and primary lymphoreticular malignancy in 4.35%. In our study out of 176 cases of cervical lymphadenopathy 141 cases (80.11%) were non neoplastic and 35 cases (19.88 %) were neoplastic.
Correlation of serum-ascites albumin concentration gradient and endoscopic parameters of portal hypertension in chronic liver disease
Authors: I Suresh , Prasad Jagini Shiva
Published: January 2018

Background: In many studies Serum ascitic albumin gradient (SAAG) was found to be an independent predictor of PHTN and EV especially in alcoholic cirrhosis. Objectives of this study was to study correlation of level of “Serum-Ascites Albumin Concentration Gradient” (SAAG) and complications of “Portal hypertension” (PHTN), manifested by “Esophageal Varices” (EV).Methods: Present study was hospital based cross sectional study. The sample (100) was of patients with ascites. SAAG was measured in all subjects. EV was assessed by endoscopy in all. Data was analyzed using proportions and appropriate statistical tests.Results: High SAAG value was seen in 79% of the patients. EV incidence was 84.5%. “child-pugh score” and size of the portal vein was found to be associated with EV. The incidence of EV among patients with high “SAAG value of 1.1 to 1.44 g/dl” was 50%. The size of the EV was found to be significantly associated with SAAG level.Conclusions: Patients having ascites with EV were also having high levels of SAAG. Thus, we conclude that value of SAAG more than or equal to 1.2±0.05 g/dl can be used as a predictor of EV presence among ascites patients.
Clinical profile of patients with acute ischemic stroke receiving intravenous thrombolysis (rtPA-alteplase)
Authors: Prasad Jagini Shiva , I. Suresh
Published: January 2018

Background: Stroke patients are at highest risk death in the first few weeks after the event, and between 20-50% die within first month depending on type, severity, age, co-morbidities and effectiveness of treatment of complications. Objective of this study was to clinical profile of patients with acute ischemic stroke receiving intravenous thrombolysis (rtPA-alteplase).Methods: Prospective Observational study of 26 cases of acute ischemic stroke receiving IV thrombolysis using rtPA-alteplase at Kovai Medical Centre Hospital, Coimbatore over a period of 1 year 9 months.Results: 21 cases had NIHSS score of range 10 to 22. The mean NIHSS score at admission is 13.5. 15 subjects (57.7%) had achieved primary outcome in this study. MRS Score of 0 to 2 is considered as favorable outcome. In this study 20 subjects (76.92 %) had favorable outcome at the end of 3 months.Conclusions: Majority of the patients receiving rtPA-alteplase had favorable outcome.
Effectiveness of DOTS regime in terms of cure, failure, default and relapse in the treatment of TB patients
Authors: K. Jahnavi , Sreenivasulu T.
Published: January 2018

Background: DOTS has given very good results in terms of cure and satisfaction among tuberculosis patients. But still some failure and relapse cases occur. Hence studies on effectiveness of DOTS are required. The objectives of research were to study the effectiveness of DOTS regime in terms of cure, failure, default and relapse in the treatment of TB patientsMethods: A hospital based prospective follow up observational study was undertaken in the department of general medicine at a tertiary care medical college and hospital. The present study was conducted among the 60 eligible subjects as per the inclusion and exclusion criteria laid down for the present study.Results: 41 were pulmonary cases and 19 were extra pulmonary patients. At the end of intensive phase only 7 cases were sputum positive out of 37 which reduced to three at the end of extended intensive phase of treatment which further reduced to two at the end of two months of continuation phase. But by the end of completion of continuation phase, one case again became sputum positive i.e. failure case making a final tally to three. It was seen that there was significant weight gain over the period of time in both pulmonary and extra pulmonary cases. The cure rate was 78%. One patient died. Two defaulted and three were failure cases.Conclusions: The DOTS was found to be 78% effective in terms of cure rate. Still there is a huge gap of 22% found in the present scenario which needs to be addressed seriously and by all to prevent multi drug resistant tuberculosis.
A cross sectional study on factors affecting treatment outcome among TB patients
Authors: T. Srinivasulu , K. Jahnavi
Published: January 2018

Background: Many factors affect treatment outcome negatively. Study of these factors is essential to prevent relapse and treatment failure. The objective of the research was to study the factors affecting the treatment outcome among TB patients.Methods: Patients diagnosed to have tuberculosis who are attending the DOTS centre at a tertiary care hospital, and fulfilling the inclusion and exclusion criteria were included in the present study. 50 patients who were being treated under DOTS regime were included in the present study. The study was conducted for a period of two years. The patients were followed for a period of six months to observe the treatment outcome among them.Results: Maximum patient were in the age group of 21-40 years (50%) followed by 41-60 years (28.3%). Cough was present in 76.7% of the cases and was the most common presenting symptom of the cases. The cure rate was significantly more among non alcoholics compared to alcoholics. The cure rate was only 60% among smokers compared to 88.5% among non smokers. The non cure rate was high among smokers i.e. 40% compared to only 11.5% among those who never smoked. This difference was found to be statistically significant.Conclusions: Smoking and alcohol were found to be important risk factors for treatment failure in the present study.
Prevalence of asymptomatic bacteriuria among antenatal women and its effects on maternal and perinatal outcome in northern Andhra Pradesh population
Authors: V. Prabhavathi , B. Krishnamma , G. Krishna Murthy , DKV Prasad
Published: January 2018

Background: The pregnant women are more commonly affected with asymptomatic bacteriuria (ASB) than non-pregnant women and its progression could lead to adverse maternal and perinatal outcomes. The study was designed with an aim to know the prevalence of ASB and its effects on maternal and perinatal outcome.Methods: In this prospective study, 300 antenatal women attending Anil Neerukonda Hospital were screened for ASB. Urine culture was performed using standardized Kirby-Bauer disc diffusion method on blood agar, Mac Conkey’s agar for antibiotic sensitivity testing. The screened antenatal women were divided into two subgroups viz. asymptomatic bacteriuria positive (Group I) and asymptomatic bacteriuria negative (Group II) depending on the culture study and were followed till delivery for maternal and perinatal outcomes.Results: The prevalence of ASB was 11.33%. Out of 34 cases of ASB positive, 8 cases (23.5%) were delivered with birth weight <2500 grams as compared to 11 cases (4.1%) in unexposed cases (RR 5.68, 95% CI; 2.46-13.15; p<0.05). Preterm low birth was noticed in 5 (14.7%) cases of ASB positive pregnant women with compared to unexposed cases (RR 1.5, 95% CI; 0.61-3.65, p=0.36). Regarding maternal outcomes, premature labour was observed in 8 cases (23.5%) of ASB exposed women whereas 22 (8.3%) in non-exposed cases (RR 2.84, 95% CI; 1.37-5.88, p=0.004). A significant number of women have developed hypertension (17.6%) and preeclampsia (8.8%) in ASB positive cases as compared to ASB negative cases (4.9% and 2.3% respectively).Conclusions: The prevalence of ASB was 11.33% in the present study. As one third of the cases were identified in early and late trimesters, regular and trimester wise screening need to be incorporated in routine antenatal screening for safe motherhood and new born health.
Complicated malaria: relationship of complications and parasite load to outcome
Authors: Anand G. Keshava , Sanda Mallikarjun Rao
Published: January 2018

Background: The incidence of complicated malaria cases is increasing day by day. Complicated malaria present in different ways in different places globally. If malaria is diagnosed and treated immediately, then the death rate is less than one percent. The objective was to study the relationship of complications and parasite load to outcome (mortality) among patients with complicated malaria.Methods: The present hospital based Prospective Observational study was carried out among 100 cases of “Complicated malaria.” The present study was carried out at Department of General medicine, Kamineni hospitals, L. B. Nagar, Hyderabad.Results: 71% patients were infected with Plasmodium falciparum, 25% with Plasmodium vivax and 4% with both Plasmodium falciparum and vivax. 12% patients deceased and 88% survived. The relationship between GCS, convulsions, pH, bicarbonate, lactate, hemoglobin, creatinine, SBP, PaO2/FiO2 ratio, PT, INR, aPTT, and outcome was statistically highly significant (p=0.000). The relationship between Total Bilirubin, RBS and outcome was statistically not significant (p=0.351). Multivariate analysis using logistic regression model, to determine the effect of studied variables on the final outcome, revealed no significant influence of studied variables in predicting the outcome (p>0.05). The relationship between increasing parasite load and outcome was studied, and it showed it was statistically highly significant (p=0.000).Conclusions: The prognosis and outcome of patients with complicated malaria worsen as the parasite load increases and the probability of death increases markedly in such patients. The presentation of inappropriate parameters at admission, aid us in predicting poor outcome and appropriate treatment plan.
Morphologic features in cystic lesions of pancreas-a retrospective analysis
Authors: P. J. Cicy , Gopinathan Jeji , P Lekshmi Devi , Ulahannan Sansho Elavumkal
Published: January 2018

Background: Cystic lesions of pancreas consist of a broad spectrum of reactive, benign and malignant conditions. The most common among cystic pancreatic lesions is pseudocyst of pancreas. Cystic tumours of pancreas are less common than solid one’s accounting for less than 1% according to some studies. Literature review showed only a few extensive studies on cystic lesions of pancreas, especially from South India.Methods: Our research is a descriptive histopathological analysis of 38 cases of cystic lesions of pancreas, done in the department of pathology of our institution, over a period of 5 years.Results: We received a total of 38 cases of cystic lesions of pancreas. The age distribution ranged from 17 to 77 years. Male to female ratio was 24: 14. There were neoplastic and non neoplastic entities. Pseudocyst of pancreas was the most common cystic lesion (12 cases). Benign neoplasms included serous cystadenomas, mucinous cystadenomas and lymphangiomas. Ductal adenocarcinomas with cystic degeneration and adenocarcinomas with mucinous component were some of the malignant cystic lesions.Conclusions: Cystic pancreatic lesions accounted for 24% of all the pancreatic lesions received in our institution during the period of this study. 24 cases (63%) were benign lesions and 14 cases (37 %) were malignant. Though cystic lesions of pancreas especially neoplasms are less frequent than solid neoplasms, it is important to study their diagnostic features since the management differs. Imaging studies may be similar in some cystic lesions. A proper clinicoradiological correlation and detailed investigational work up will aid in the correct diagnosis.
Pattern of dermatologic manifestations in polycystic ovarian disease cases from a tertiary care hospital
Authors: Jain Preeti , Jain Shailendra , Singh Abhishek , Goel Shewtank
Published: January 2018

Background: Dermatologists often play a significant role in its management. Cutaneous features of hyperandrogenism in Polycystic ovarian syndrome (PCOS) have varied presentation. Aim of this study was the pattern of dermatologic manifestations in polycystic ovarian disease in northern Indian females.Methods: Patients registering for treatment of polycystic ovarian disease at Dermatology outpatients department during April 2016 to March 2017 formed the study population. Residents interviewed the study subjects at the OPD. General physical examination, systemic examination, breast and pelvic examination, along with detailed dermatological examination were conducting after taking the history. Hormonal analysis was performed after an overnight fasting using enzyme immunoassay.Results: FSH and LH levels were 5.05±1.86 IU/L and 8.14±5.21 IU/L respectively. Testosterone levels were found to be 61.01±25.32 ng/dl. DHEAS levels among them were 130.05±41.21μg/dl. Two commonest cutaneous manifestations were hirsutism and acne seen in 83.8% and 59.5% of subjects. Female pattern hair loss was seen in 45.6% females. Three most frequent hormonal abnormalities noted in our study subjects were raised L/H ratio, testosterone and LH levels seen in approximately 45%, 35% and 21% cases.Conclusions: The cutaneous manifestations of PCOS reserve a major role in its management by dermatologists. A lifestyle modification along with systemic treatment remains mainstay of treatment. Monitoring for the foreseen cardiovascular risks should start early to downgrade the morbidity.
A study of clinical profile of patients with Dengue fever at a tertiary care hospital
Authors: T. Sreenivasulu , K. Jahnavi
Published: January 2018

Background: Dengue is the most common fever. Among all flavi-viruses, it is the most common. It can cause around 50-100 million infections. Every year 2-5 lakh cases of Dengue hemorrhagic fever occur. The objective of the research was to study clinical profile of patients with Dengue fever at a tertiary care hospital.Methods: Present study was cross sectional study. The patients were interviewed and examined at one point of time and later they were never followed which is similar to the cross-sectional study design. Present study was carried out in the hospital. This was done in the department of General Medicine of a tertiary care hospital. Present study was carried out over a period of one year.Results: In the present study, there were 78 males and 22 females. The sex ratio was 3.5:1. Maximum number of males (29.5%) was in the age group of 15-25. Among females, the maximum (40.9%) were in the age group of 26-35 years and 46-55 years (9%). The most common presenting symptom was fever in all cases followed by headache in 90%. Among bleeding manifestations, epistaxis, gum bleeding and hematuria (15%) were the common symptoms. Most patients presented with generalized lymphadenopathy in 52%. 56 patients showed only hepatomegaly and 46 splenomegaly, and 30 patients showed hepato splenomegaly. 99 showed leucopenia and 10 were anemic and 25 showed platelet count less than 1,50,000cells/cumm.Conclusions: Males were commonly affected. Younger age group of 15-25 was most commonly affected and fever and headache were the most common presenting symptoms. These findings help physicians in early diagnosis of dengue by suspecting these features as of dengue and can prevent morbidity and mortality associated with dengue.
Risk factors associated with chronic low back pain: an analysis of Turkey health survey data
Authors: Cinaroglu Songul
Published: January 2018

Background: Turkey, a developing country has low back disorders as the most common symptom among adults with 33% prevalence in 2014. The patient’s self reports are important to determine the condition as chronic low back pain (CLBP) is a symptom rather than the disease. However, there is a scarcity of knowledge about self-reported CLBP among adults from developing countries. Methods: A community-based cross-sectional population survey study conducted by face-to-face interviews. To identify socio-demographic factors, health, behavior, and comorbidities associated with (CLBP). 6729 adults (≥15 years) with self-reported CLBP and 12400 non-CLBP adults who participated 2014 Turkey Health Survey (THS) were included. Data on smoking, alcohol consumption, physical activity, healthy eating behavior, muscle strengthening activities, and kinesitherapist and psychotherapist visits were collected. Socio-demographic characteristics, comorbidities, and health of CLBP and non-CLBP adults were compared using logistic regression analysis. Results: Age, gender, marital status, occupational status and health insurance were associated with a higher likelihood to report CLBP (p<0.001). The likelihood of diabetes and hypertension was higher in patients with CLBP (p<0.001). Visiting a psychotherapist, smoking and healthy eating were associated with a higher likelihood of CLBP (p<0.001) whereas, alcohol consumption, physical activity, muscle strengthening activities and visiting kinesiotherapist were associated with a lower likelihood of CLBP (p<0.001). Conclusions: Reduced smoking and alcohol consumption, healthy eating, increased physical activity, kinesitherapy and psychotherapy can be employed to manage CLBP.
Clinical evaluation of purified chick embryo cell rabies vaccine administered intradermally in animal exposures
Authors: Hardanahalli Ravish S. , V. Veena , Holla Ramesh , Annadani Rachana R. , M. R. Sathish Chandra
Published: January 2018

Background: In India, presently there are two purified chick embryo cell culture vaccines (PCECV) viz., Rabipur (Flury LEP strain) and Vaxirab – N (Pitman Moore strain) which are commonly used both in public as well as private sectors. The present study was conducted to assess the clinical efficacy in terms of safety, immunogenicity and survival status of both the PCECV administered animal exposures taking complete PEP at the anti-rabies clinic.Methods: A longitudinal study was conducted at the anti-rabies clinic, Kempegowda Institute of Medical Sciences (KIMS), Bangalore, India. 86 suspect rabid dog bite cases attending clinic were enrolled and followed up for 1year. All the animal bite cases were given post exposure prophylaxis of full course of PCECV i.e. Rabipur or Vaxirab - N as per schedule intradermally using updated Thai Red Cross regimen. The rabies virus neutralizing antibody (RVNA) concentrations on days 14, 28, 90, and 180 were tested by modified rapid fluores­cent focus inhibition test.Results: Out of 86 study subjects, 43 subjects received Rabipur and another 43 subjects received Vaxirab –N vaccines. The incidence of adverse drug events (ADEs) was found to be 9.3%. All subjects had protective RVNA titers of ³0.5 IU/ml from day 14 till day 180. All the study subjects were healthy and alive after 6 months of completing PEP.Conclusions: The currently available purified chick embryo cell culture rabies vaccines are safe, immunogenic and clinically effective for post exposure prophylaxis in animal bite cases, which will help in eliminating human rabies by 2020.
Knowledge and practices pertaining to menstruation among the school going adolescent girls of UHTC/RHTC area of Government Medical College, Kota, Rajasthan
Authors: Gupta Preeti , Gupta Jini , Singhal Govind , Meharda Bharat
Published: January 2018

Background: To achieve the goal of Millennium Development Goal 2 (universal education), 3 (gender equality and women empowerment) and, 5 (improving maternal health), it is important that there is effective menstrual hygiene and knowledge among adolescent girls since it has direct and indirect effects both to achieve the MDG and to promote the reproductive health. A study was carried out among the school going adolescents in UHTC (Urban Health Training centre) and RHTC (Rural Health Training centre) area of Department of Community Medicine, Government Medical College, Kota, Rajasthan with the following aims and objectives, Status of knowledge of school going adolescent girls about menstruation and their practice during menstruation. The objective of the study was to assess the knowledge and practices regarding menstruation among school going adolescents.Methods: It was a school based descriptive cross sectional study conducted from November 2016 to March 2017. The school was selected randomly in RHTC and UHTC area of GMC, Kota. A pretested and structured questionnaire was used. Data was entered, processed and analyzed using SPSS version 20. Results: In this study there were 300 girl students (150 each from RHTC and UHTC area schools), of which 55.33% had menarche at the age of 13 years, 66.00% of girls were aware about menstruation before the menarche whereas 91.67% of girls heard about the sanitary napkins, most of the girls (81.00%) had got the knowledge about menses from their mother, 62.67% of girls heard about the menstrual hygiene and for practices observed, 65.67% girls were using sterilized sanitary napkins and 42.00% of girls burn the waste material. Conclusions: Traditional beliefs regarding menstruation still persist and menstrual hygiene among the adolescents was found to be unsatisfactory. It highlights the need of targeted interventions to raise awareness and provision of family health education package to all girls. Menstrual hygiene is an issue that needs to be addressed at all levels.
A study of adolescent obesity and hypertension in urban school in Mumbai
Authors: Patil Anita D. , Shejul Sonali , Bhandarkar Prashant , Kattimani Ashok , Mudassir Ansari , Bantwal Kanchan
Published: January 2018

Background: Obesity and high blood pressure is increasingly prevalent, not only in adults but also in children. Initially thought to be disease of high income countries (HIC), this disease is now increasing across low middle income countries (LMIC). This study aims to estimate the prevalence of obesity and hypertension among urban school children in Mumbai.Methods: Guidelines of Indian Academy of Pediatrics were used to calculate BMI Z Score and identify the overweight and obese adolescents. Children from the age group of 9 to 15 years were selected from schools in Mumbai. Standard guidelines of blood pressure measurement using Sex height specific blood pressure percentile charts were used. Normotensive, pre-hypertensive and hypertensive adolescents were recognized. Associations among both groups were checked using chi-square test of significance and gender wise differences were studied.Results: Among 1486 adolescents studied prevalence of overweight and obesity was found to be 20.18% and 16.01% respectively. While the prevalence of pre-hypertension and hypertension was found to be 7.5% and 5.4% respectively. Gender wise significant difference was found; boys had blood pressure slightly higher than that of girls.Conclusions: Study documents scenario of increasing obesity and hypertension among urban school children of India. Strong association exists between both obese/ overweight and hypertensive disorder.
A descriptive study of aetiopathological evaluation of hoarseness: our experience
Authors: B. S. Sindhu , S. Jayaprabha
Published: January 2018

Background: Hoarseness is a quality of voice that is rough, grating, harsh, more or less discordant and lower than normal in pitch for the individual. Besides affecting useful communication leading to tremendous alterations in daily living, voice problem may also signify the presence of more serious medical illnesses; such as malignancy or airway compromise. Hence this study is undertaken to determine the relative incidence of cases presented at a tertiary hospital, to analyse the hoarseness population based on age, sex, occupation etc, to find out the pathogenesis of hoarseness in the cases and to postulate the risk factors implicated in each.

Methods: Descriptive cross sectional study was conducted on patients with hoarseness reported at Government Medical College, Trivandrum for a period of twelve months. Detailed history regarding duration, onset, nature of hoarseness, aggravating and relieving factors, voice fatiguability, diurnal variation, associated symptoms and history of upper respiratory infection were taken.

Results: Being the tertiary hospital, the incidence was noted to be 0.7%. Majority of patients are in 4th to 7th decades and the most commonly affected age group was 50-59 years. Male preponderance with 4:1 ratio was observed in which manual labourers constitute the single largest group. Smoking, alcohol intake and vocal abuse are found to be the major etiological factors. Majority of lesions were malignant in nature, commonest being Carcinoma Glottis. In benign lesions, majority was vocal cord polyp.

Conclusions: Early detection of pathology and awareness is very important in the management of hoarseness.

 
Tips for optimizing organ preservation solutions
Authors: Ostróżka-Cieślik Aneta , Dolińska Barbara , Ryszka Florian
Published: January 2018

Organ injury during ischemia is one of the clinical problems of today's transplantation. It occurs during warm ischemia time (WIT) when the blood flow is cut off and during cold ischemia when a graft is chilled in situ until the circulation is restored to the recipient organism. Fast cooling of the organ slows metabolism and activates intracellular enzymes, which minimizes the effects of warm ischemia. Unfortunately, hypothermia also results in inhibition of ATP synthesis, cell swelling and intracellular acidity. That is why research is continually being conducted to develop new fluids for rinsing and storing organs as well as to optimize the composition of those that are already in use, which will allow for longer and more effective graft storage and restoration of its optimal functions after transplantation. The article provides current information on rinsing and storage fluids available on the global market. It also discusses the directions of fluid modification with hormones and micronutrients.
Effect of growth factor on in-vitro maturation of porcine oocyte
Authors: Mahanta N. , Bhuyan D. , Kumar Suresh , Biswas R. K. , Dutta D. J. , Deka B. C. , Das A. , Dewry R. K. , Hazarika G.
Published: January 2018

The present study was aimed to evaluate the beneficial effect of different growth factors on in-vitro maturation of porcine oocytes. Ovaries were collected from a local abattoir immediately after slaughter of the animals and transported to the laboratory. A total of 618 type A and type B oocytes were cultured in TCM-199 containing additives with PMSG and hCG for the first 22 hrs and without hormones for subsequent 22 hrs of incubation at 39o C under 5 per cent CO2 level and 90-95 per cent humidity. The effects of supplementation of different growth factors viz., EGF, IGF-I and EGF + IGF-I in the medium were studied. The rate of oocytes with cumulus cells expansion was significantly higher (P less than 0.01) when growth factors were added as compared to control but it did not differ significantly between growth factors. The rate of nuclear maturation of oocytes was significantly higher (P less than 0.01) as compare to control for EGF and EGF + IGF-I but not for IGF-I. There was no significant difference in the rate of oocytes with nuclear maturation between the growth factors studied. It can be concluded from the present study that addition of EGF, IGF-I or EGF + IGF and additives along with hormones (PMSG and hCG for first 20-22 hrs) in TCM-199 Medium gives optimum in-vitro maturation rates in porcine oocytes.
Gross anatomy of scapula in Tiger (Panthera tigris)
Authors: Tomar M.P.S. , Taluja J.S. , Vaish Rakhi , Shrivastav A.B. , Shahi Apra , Sumbria Deepak
Published: January 2018

The present study was conducted on the scapula of five adult tigers to record the characteristic features of scapula bone. It was placed on lateral aspect of thorax, directed downward and forward. It was in the form of wide plate having scapular spine on lateral aspect. The height of spine increased gradually towards the distal end. The acromian process was subdivided into hamate process and suprahamate process. Hamate process overhanged the glenoid cavity. The suprahamate process was in the form of thin triangular plate directed backwards. The supraspinous fossa presented undulating surface in its middle. The infraspinous fossa was triangular and more or less flattened. Subscapular fossa was shallow and presented two prominent ridges. The caudal angle of the scapula was terminated in to glenoid cavity which was oval to quadrangular in shape. Cranial and proximal to the glenoid cavity prominent supraglenoid tubercle was observed which had hook shaped coracoid process. Scapula of both the sides were morphologically similar but the morphometrical values for the right scapula were non-significantly higher than the left counterpart (t less than 0.05), which may be of some biomechanical importance.
Preservation of Black Bengal buck semen in soybean lecithin based chemically defined extender
Authors: Konyak Pangdun , Mandal Ajoy , . Mohan , Bhakat C. , Das S. K. , Rai Saroj , Ghosh M. K. , Karunakaran M.
Published: January 2018

This experiment was conducted with the aim to study the effect of replacing egg yolk with soybean lecithin (SL) for cryopreservation of Black Bengal buck semen. Sexually matured Black Bengal buck (n = 5) were used and the ejaculates were obtained using an artificial vagina method. The semen samples were pooled and diluted in Tris extender with 5% Glycerol containing either 15% egg yolk (control group) or SL at different concentrations (1% SL, 1.5% SL and 2% SL). The semen samples were filled in straws and cooled gradually to 5 °C. Semen straws were equilibrated for 3 hours at 5°C and were frozen in static liquid nitrogen vapor and stored in liquid nitrogen. Semen samples were evaluated after initial dilution, after completion of equilibration and after freeze thawing for in vitro sperm characters such as sperm motility, functional membrane integrity and malondioldehyde (MDA) concentration. Semen samples preserved in extender containing 1% SL was able to maintain in vitro sperm characters similar to the extender containing egg yolk. However, significant (P less than 0.05) reduction in all semen parameters was observed as the concentration of soybean lecithin increased above 1% level. It is concluded that an extender containing soybean lecithin @ 1% with 5% Glycerol can be used for replacing egg yolk for cryopreservation of Black Bengal buck semen.
An unusual case of nutritional Secondary hyperparathyroidism in a Mare- A case report
Authors: Turkar Sujata , Randhawa C.S. , Preet Gurpreet Singh , Uppal S.K.
Published: January 2018

A case of nutritional secondary hyperparathyroidism in a mare was diagnosed on the basis of history, clinical signs, radiography and reduced calcium excretion in urine.
Comparative histochemical studies of lacrimal gland in Ruminants
Authors: Triveni T. , Pawar Ashok , Girish M. H. , Kumar D. Dileep
Published: January 2018

The present study was carried out to observe the histochemical details of the lacrimal gland in ruminants. The lacrimal gland located at the dorsolateral aspect of the eyeball which helps to nourish the cornea. In the present study a strong PAS positive reaction were seen in the secretory units of lacrimal gland in cattle, sheep and goat whereas, few secretory units showed strong PAS positive reaction and few secretory units showed weak PAS positive reaction in buffalo. Few secretory units and few secretory cells in some secretory units showed positive reaction for Alcian blue at (pH 2.5) in cattle, buffalo, sheep and goat. Intralobular and interlobular lipids were observed in buffalo, sheep and goat.
Gastrointestinal parasitic infections in cattle and swamp buffalo of Guwahati, Assam, India
Authors: Das M. , Deka D. K. , Sarmah A. K. , Sarmah P. C. , Islam S.
Published: January 2018

The objective of the present study was to determine the prevalence of gastrointestinal (G.I.) parasitic infections in cattle and swamp buffalo of Assam, India. A total of 3597 fecal samples of cattle (2339) and buffaloes (1258) were examined for presence of parasitic infections. Examinations revealed an overall prevalence of 58.35% and 29.80% infections in cattle and buffalo, respectively. In cattle, Strongyle sp. (18.76%) was predominant followed by Eimeria sp. (11.97%), Amphistome sp. (8.72%), Strongyloides sp. (3.76%), Moniezia sp. (2.65%), Toxocara vitulorum (1.32%), Buxtonella sulcata (0.81%), Trichuris sp. (0.72%), Fasciola gigantica (0.47%) and Bunostomum sp. (0.38%). In buffalo, Amphistome sp. (8.90%) was predominant followed by T. vitulorum (5.64%), Strongyle sp. (5%), Eimeria sp. (4.53%), Strongyloides sp. (1.35%) and Trichuris sp. (0.47%). Mixed infections with more than one species were recorded in 8.76% and 3.89% cattle and buffalo, respectively. The egg per gram (EPG) of feces in cattle and buffalo was 582.44±8.13 and 475.86±11.29, respectively while oocyst per gram (OPG) of feces was 425.00±20.37 and 251.75±22.35, respectively. Correlation of rainfall and temperature with EPG/OPG of cattle and buffalo was highly significant (P less than 0.01) while correlation of relative humidity (Av.) with EPG of cattle and buffalo was significant (P less than 0.05). Multiple linear regressions explained about 98.10% of total variance in EPG of cattle with environmental variables. 89.10% of total variance in EPG of buffalo was explained in multiple linear regressions due to environmental variables. This shows that the climate in this region is exclusively conducive for the development and propagation of parasites.
Management of distal femoral diaphyseal fractures with string of pearls locking plate in dogs
Authors: Kumar K. Manoj , Devi Prasad V. , Lakshmi N. Dhana , Raju N.K.B.
Published: January 2018

Distal femoral diaphyseal fractures in six dogs about 10-22 months old with body weight ranging from 12-25 kg were stabilized with String of Pearls (SOP) (Orthomed, UK) locking plates along with standard cortical and cancellous screws following standard AO/ASIF principles. Selection of appropriate size of plate and screws was according to body weight and type of fracture (2.7mm plate for dogs below 12 kg body weight and 3.5 mm plate for dogs above 12 kg body weight) which provided good fracture stability. The outcome of fracture stabilization and healing was evaluated with lameness grading and radiography. Postoperatively, all the animals showed weight bearing with early functional limb usage of grade I lameness and good joint mobility in an average of 7 weeks. Functional outcome was excellent in good in four cases and excellent in two cases. The average overall healing time in all the cases was 7-11 weeks. The fractures showed radiographically excellent postoperative healing of cortical union, absence of fracture lines with limited and also bridging callus. Based on present study, it was concluded that, String of Pearls (SOP) locking plates were good for stabilization of distal femoral diaphyseal fractures for early limb ambulance and healing.