bluuebunny/crossref_metadata_2025 huggingface dataset:
Knowledge, attitude and practices towards pharmacovigilance among health care professionals in a teaching and general hospital of South India
Authors: Ghazala Zainab , Kalshetty Prakash , Vardhamane Shrenik
Published: January 2019

Background: Pharmacovigilance is the science and activities relating to detection, monitoring, assessment, understanding and prevention of adverse effects or any other drug related problem from any pharmaceutical products. The core purpose of pharmacovigilance is to enhance patient care and generate the evidence based information on safety of medicines. The objective of present study was to evaluate the knowledge, attitude and practices of the healthcare professionals about pharmacovigilance and to assess the reasons for underreporting of ADRs.Methods: A cross-sectional study was conducted by administering KAP questionnaire to the healthcare professionals. There were 22 multiple choice questions. Ten related to knowledge, 5 related to attitude, and 6 related to practice. One question was asked to determine the reasons for underreporting of ADRs. The performance in each category was graded as good, average and poor if the number of participants giving correct/positive responses were >70%, 50-69%, <50% respectively. Question no 22 was assessed independently to find out reasons for underreporting of ADRs. Data was compiled and analyzed by descriptive statistics, Chi-square and ANOVA test.Results: The response rate in this study was 62.5%. The study included professors (11%), associate professors (6%), assistant professors (20%), postgraduates (26%) and interns (37%). That there was statistically very highly significant difference of mean score of knowledge, attitude and practice among health care professionals (P<0.001). The performance score with respect to attitude of health care professionals towards pharmacovigilance was good as compared to knowledge which was average followed by practice which showed poor performance (72.5% >51.6% >36.8%) (p <0.001).Conclusions: Awareness campaigns, CMEs, workshops on pharmacovigilance should be conducted regularly such that good knowledge about pharmacovigilance can be imparted which can be moulded into good practice.
Correlation between changes in placental morphological features with abnormal Doppler flow in pregnancy induced hypertension
Authors: Gadhavi Vijay N. , Gadhavi Mansi K. , Pandya Manish
Published: January 2019

Background: Placenta is one of the most challenging organs; it is an instrument of transfer of essential elements, i.e. nutrients and oxygen from mother to fetus and waste product of metabolism in reverse manner.Methods: Cases of PIH between 20-36 weeks of gestation will be studied over a peri-od of 2 years having B.P ≥140/90mm Hg and protienuria ≥1+ in this prospective analytical study having color Doppler scanner with PI, RI of umbilical, uterine artery and middle cerebral artery PI along with placental morphological changes are observed.Results: In present study where, placental weight was <300g also has LBW babies born were higher 51(100%). In placental gross examination 58% infarction, 42% calcification and 48% retroplacental were found. among 58 samples with infarction 76%, 42 placentas had calcification 48% and among 49 samples retroplacental clots 61% were belonged to uterine artery PI >1 group. While 78% placental infarction, 57% calcification and 69% retroplacental clots be-longed to uterine artery RI > 0.6 group. Infarction were 77.50%, calcification were same as infarction 77.50% while retroplacental clots 80% in group having MCA PI <1.3 that were higher than group of cases having MCA PI >1.3.Conclusions: In recent years placenta has drawn attention as valuable indicator for maternal and fetal diseases in preeclampsia. Decreased circulation in placenta reflects on its morphological features and these changes causes alterations in Doppler flow velocities of uterine, umbilical and middle cerebral vessels pregnancy induced hyper-tension.
Prevalence of various dermatoses in pregnancy at a tertiary care centre in Moradabad, Uttar Pradesh, India: an observational study
Authors: Uniyal Shruti , Agarwal Ritika , Nandi Nupur , Jain Pulkit
Published: January 2019

Background: This was a prospective study which was done to observe various skin lesions in pregnancy and to determine the most likely causes and their incidence in antenatal patients, it was noticed that many women in our institute were having pregnancy related cutaneous complaints thus this observational study was carried out so that better preventive measures and treatment options could be provided to these patients.Methods: Study was conducted in out-patient department of Obstetrics and Gynaecology, TMU, Moradabad. All ANC cases between October 2017 to September 2018 having any type of dermatoses were included in the study irrespective of gestational age. 6348 patients appeared in OPD in the given time period out of which 1256 were included. In case of pruritus, liver function tests were done with USG whole abdomen and patients were reviewed by physician if required. Screening with VDRL, HCV, HbSAg and ELISA for HIV was done in all. Results were tabulated and analyzed.Results: 50.8% primi gravidas ,49.2% multi gravidas. age range 18-38 years. 29.3% presented in third trimester ,25.6% presented in second trimester. Physiological changes seen in all cases, 8.68% specific dermatoses of pregnancy. 40.4 % no complaints, 5.65% melasma, 90.8% hyperpigmentation, 94.6% linea nigra. Secondary areola 89.3%,striae 80.3% out of which 38.9%- primi gravidas and 41.40% -multi gravidas. 92.9% no change in hair density. Montgomery’s tubercles 30-50% of cases. spiders nevi 67%. No cases of palmar erythema. Pruritus gravidarum 38.53%. PUPPP 28.4%. Pemphigoid Gestationis 9.17%. Prurigo of pregnancy 18.34%. Pruritic folliculitis 1.8%. Eczema in pregnancy : pre-existing in 3.7% , out of which exacerbation 1, 3 unaffected. 3 chicken pox.1 filariasis.24 herpetic lesions (herpes simplex).1 scleroderma.17.27% pre-existing taenia infection . Scabies 20.46%.11 0.87% dual infection (scabies-taenia).Conclusions: This study highlights high prevalence of community acquired infections in our region like taenia, scabies giving rise to skin lesions in Antenatal women. Moreover, it highlights a probable association between the prevalence of skin lesions with factors like poor personal hygiene, overcrowding, low socioeconomic status, anaemia and poor nutritional status.
Serum anti-Mullerian hormone and homocysteine in premenopausal females with and without cardiovascular disease
Authors: Khan Huma , Gupta Madhur M.
Published: January 2019

Background: The objective of this study is to assess the association of anti-Mullerian hormone (AMH) and homocysteine (Hcy) levels in premenopausal females with and without cardiovascular disease.Methods: A case control study was conducted in premenopausal, menopausal and normal fertile females (n=30) with and without cardiovascular disease in a tertiary care hospital and research centre in central India. Fasting sample obtained was assessed for AMH and Hcy levels. Results were compared and data was analyzed.Results: The levels of AMH and Hcy were significantly altered in premenopausal and menopausal females as compared to normal fertile females. Moreover, there was a weak correlation when intergroup comparison was made between the parameters in females with and without cardiovascular disease.Conclusions: A prospective study with a larger sample size to assess levels of AMH need to be performed to provide insight in premenopausal females for the early detection cardiovascular disease.
A comparative study of sublingual versus oral misoprostol following oral mifepristone for second trimester termination of pregnancy
Authors: Gupta Ruchi , Banerjee Krishna Priya , Pant Reena
Published: January 2019

Background: The objective of this study is to assess the effectualness and safety of sublingual versus oral misoprostol following oral mifepristone for second trimester termination of pregnancy.Methods: This institution based contingent study was conducted on 220 women requesting for mid-trimester termination of pregnancy between 12-20 weeks with legal indication as per Govt. MTP act. After excluding the women as per exclusion criteria, they were randomly allocated into two groups (Group A Sublingual, Group B Oral), the women received 200 mg oral mifepristone followed by sublingual or oral misoprostol 400µg three hourly for a maximum of 5 doses 48 hours later. The course of misoprostol was reiterated if women failed to abort in 24 hours.Results: The mean induction-abortion interval of Group-A and Group -B was 4.02±1.39 hours and 6.44±1.79 hours respectively. The mean dose of misoprostol in Group–A and Group-B was 680±220.4µg and 1003.6±274.9µg. Hence mean Induction-abortion interval and dose were shortened in  Group-A as compare to Group-B (p <0.05). There was 100% success rate noticed via both routes. Evacuation was done in 4 (3.64%) women in Group-B as compare to only 1 (0.91%) in Group-A . The acceptability was significantly more in Group-B (100%) as compare Group-A (52.73%), probably because of unpleasant taste of sublingual misoprostol. All side effects (Nausea, pain, headache, and diarrhea) were common in both the Groups, only fever was significantly more common in sublingual group as compare to oral group (p<0.05).Conclusions: From present study authors conclude that, sublingual misoprostol when combined with mifepristone is effective for medical abortion in second trimester in terms of effectualness, endurability and success rate than oral route.
Clinical versus ultrasonographic fetal weight estimation and its correlation with actual birth weight
Authors: Ingale Ashwini , Khade Shweta Avinash , Shirodkar Sneha
Published: January 2019

Background: This is a prospective study was conducted at Obstetrics and Gynecology department, tertiary care Hospital, to compare the accuracy of clinical and ultrasonographic estimation of fetal weight at term with actual birth weight.Methods: The present study is a prospective comparative study of fetal weight estimation in Antenatal women with term gestation (37week to 42week of gestation) singleton pregnancy with vertex presentation, who had gestational age confirmed by dates and ultrasound scanning of< 22weeks admitted in tertiary care center from March 2016 to November 2016. Patients with Polyhydramnios, oligohydramnios, Antepartum hemorrhage, Congenital anomalies of fetus, Obese (Body mass index >30 kilogram/meter2) are excluded from the study. Estimation of fetal weight is done by clinical method and ultrasonography. Birth weight after delivery was recorded in grams by electronic weighing machine and tabulated.Results: Clinical as well as ultrasonography estimates observed to be strongly correlate with actual birth weight. Both the methods had more sensitivity in birth weight range 2500-4000gm than <2500g and >4000g. The overall mean absolute percentage error of the clinical method (7.2±7.7) was smaller than that of the sonographic method (16.2±11.1). In low birth-weight (<2,500g) group, mean absolute percentage error was 9.0±11.3 with USG and same with clinical was 11.7±9.0. No statistically significant difference was observed.Conclusions: The present study concludes that clinical estimation of birth-weight is as accurate as routine ultrasonographic estimation.Clinical palpation should be considered as diagnostic tool for FWE and is equally reliable even when done by trained medical person. It is cheap and easy to teach. The need is to practically apply this method in obstetrics and guide the management decisions.
Predictors and symptomatic burden of uterine fibroids among women in South-Eastern India: a cross-sectional survey analysis
Authors: Swain Dharitri , Yadav Chanchal , Kumari Jyoti , Rani Monika , Rongmei Priyanka Daunrai , Khurana Sehaj Kaur
Published: January 2019

Background: Uterine fibroid is the most common pelvic tumor in women of reproductive age and are asymptomatic in at least 50% of affected women. Various risk factors are associated with development of uterine fibroids during this reproductive age. The present study established various associated risk factors increases the prevalence of uterine fibroid among reproductive age group and clinical symptoms burden of diagnosed case.Methods: A cross sectional study design was used to collect samples for a period of six months in an OPD basis. Purposive sampling technique was used to select the 362 sample of reproductive age group (15-45 years) women in a tertiary care hospital, Southeastern India. Women diagnosed with uterine fibroid by ultrasonography were included as cases. Symptomatic features and associated risk factors of UF were collected through structure interview schedule.Results: Point prevalence of uterine fibroid among women in reproductive age group during the period of six months was 20%. Majority of them were in the age group of 30-39 years. Demographic factor such as overweight and obesity and consume dairy products daily has increased the prevalence of UF, whereas use of oral contraceptive pills and normal BMI had inverse relationship with UF risk. Most of the cases reported of having menstrual disturbances like heavy bleeding, passes blood clots during menstruation, prolonged period, urinary symptoms and pressure symptoms were considered independent predicting factors for the occurrence of uterine fibroid.Conclusions: Uterine fibroid is more prevalent among women of reproductive age causing various bleeding and renal symptoms that can have negative impact on quality of women’s life.
An observational study to compare between conventional condom balloon catheter with CG balloon
Authors: Xess Somila , Baghel Preeti
Published: January 2019

Background: Postpartum haemorrhage (PPH) is a life-threatening complication of delivery. The most common cause of PPH is uterine atony. Intrauterine balloon tamponade has been suggested as an effective, easily administered minimally invasive treatment option to control uterine bleeding while preserving the mother’s ability to bear additional children.Methods: Twenty women with normal vaginal delivery were studied over a period of six months, 10 were inserted conventional balloon tamponade and rest 10 were inserted CG balloon and outcome studied in terms of time to assemble, leakage, expulsion, lumen occlusion, volume of fluid used, time to arrest bleeding, cost, drainage port, inflation deflation interval.Results: Most of the women were para 4 or more, unbooked belonging to age group of 20-30. Mean time to assemble Condom balloon tamponade was 1.8min   and that in CG balloon was 1.2 minute. There was leakage and expulsion in two and lumen occlusion in three in the conventional balloon catheter. In the second group there was  no leakage ,lumen occlusion  or expulsion . There is uterine drainage port present in CG balloon which is characteristic of it which helps in determining the actual blood loss in real time. The inflation deflation interval and mean volume of fluid are almost same in both the groups.Conclusions: Both conventional balloon and CG balloon are effective and lifesaving in low resource setting with few advantages of CG balloon over conventional balloon tamponade.
Comparative clinical study of laparoscopic assisted vaginal hysterectomy and non-descent vaginal hysterectomy
Authors: Shiragur Shobha S. , Rajammal B.
Published: January 2019

Background: Laparoscopic assisted vaginal hysterectomy (LAVH) is increasingly becoming popular. It's really a technique made to replace abdominal hysterectomy. The need of the hour is the minimal invasive surgery, early discharge from the hospital, early resumption of work, avoidance of disfiguring scar on the abdomen and cost-effectiveness of the procedure which are as important as cure of the disease. The objective of this study is to compare the effectiveness and safety of laparoscopic and vaginal hysterectomies for non-descent uteri (NDVH).Methods: The study was undertaken in the department of obstetrics and gynecology, Amrita Institute of Medical Sciences, Kochi for the period of one year. About 50 women in each group undergoing LAVH and NDVH for benign pelvic conditions were studied preoperatively, intra-operatively and post-operatively in detail for indications, operative time, intraoperative blood loss, duration of stay in hospital.Results: The mean operative time in LAVH was 240.6 minutes and in NDVH 168.3 minutes. Minimum duration of stay was in LAVH 3 days and in NDVH 4 days. Mean duration of stay in both groups was 6.4 days. Maximum duration of stay-15 days in both groups.Conclusions: LAVH is a better approach for a larger uterus whereas NDVH is preferable for a small uterus, not only for shorter operative time and minimal wound, but also for much lower costs.
Prospective study of maternal perception of decreased fetal movement in third trimester and evaluation of its correlation with perinatal compromise
Authors: Nandi Nupur , Agarwal Ritika
Published: January 2019

Background: Intrauterine fetal movements are sign of fetal life and well being. Perception of decreased fetal movements by the expecting mother is a common concern for both the mother and her obstetrician. Inadequate evaluation of reported decreased fetal movements may lead to catastrophic perinatal outcome. These necessitates us to identify the mothers perceiving decreased fetal movements, evaluating them to identify any risk factor, and follow up them to know the correlation with perinatal outcome.Methods: Antenatal mothers with singleton pregnancy at third trimester are recruited from OPD/ Emergency of Obstetrics and Gynaecology departments of Teerthankar Mahaveer Medical College and Research Center, Moradabad, Uttar Pradesh, India. Both case and control group comprise of 80 mothers matched by demographic profile, with perception of decreased fetal movements only in case group. They were evaluated thoroughly to identify risk factor if any and were followed up till delivery to know the perinatal outcome.Results: Majority of women reporting reduced fetal movements were between 20-30 years of age group (73%), Primigravida (80%), 72.5% were at term pregnancy. Common (46%) pattern of decreased movements was both in frequency and as well as intensity. 62% women with decreased fetal movements had anteriorly placed placenta.  In the study group, 48.75% women were identified with risk factor, and association of more than one antenatal risk factor was significantly high (p value 0.0026). LBW was more common (21.25%), many neonates were associated with low Apgar score in the study group.Conclusions: Pregnant mothers reported with decreased fetal movement in third trimester should be evaluated adequately for identification of risk factors, as well as for fetal surveillance. Record of fetal movement for 2 hours while the mother is in rest, Cardiotocography, elaborative USG, BPP should be monitored to have good perinatal outcome by providing timely intervention.
The risk factors and preventive measures for the recurrence of endometrial polyps
Authors: Doobaly Nitisha , Wang Xiuli , Lin Minjuan , Zhu Shu , Wang Xia
Published: January 2019

Endometrial polyps (EPs) are a frequently encountered gynecologic disease with abnormal uterine bleeding and infertility being the two common presenting problems, and hysteroscopic polypectomy is an effective method to remove them. The postoperative polyp recurrence might result in reappearance of abnormal uterine bleeding or infertility, whereas factors influencing the postoperative recurrence potential have limited data. Endometrial polyp recurrence remains a concern with recurrence rates of 2.5% to 43.6%. As such, it is critical to identify the risk factors and the preventive measures for endometrial recurrence, especially in reproductive-age women desiring future conception, to aid in clinical counselling and decision making. The recurrence of EPs is related to estrogen stimulation and endometrial hyperplasia. The progesterone-containing drugs are currently the most commonly used method to prevent the recurrence of EPs. In this article, authors aim to discuss the high-risk factors of EPs recurrence and the preventive measures for EPs recurrence. The preventive measures will focus on the combined oral contraceptives (COCs) and the levonorgestrel-releasing intrauterine system (LNG-IUS).
Relationship between leptin levels and lipid profile in obesity adult in Puskesmas Nanggalo Padang working area
Authors: Diana Bina , Semiarty Rima , Yerizel Eti
Published: January 2019

Background: Obesity is a condition with abnormal or excessive fat accumulation in adipose tissue so that it can interfere with health. Leptin is an adipokine produced by adipose tissue that acts as the main regulator in regulating energy balance and weight. High leptin levels inhibits lipid synthesis, fatty acid synthesis and acetyl CoA carboxylase which contributes to lipid accumulation. Leptin and lipid profiles were found to be elevated in obese subjects. The purpose of this study was to determine differences in leptin levels and lipid profiles between obese and non-obese adults, to know the association between leptin levels and lipid profiles in obese adults in the Nanggalo Padang health center work area.Methods: Comparative cross sectional research design. The research was carried out in the Nanggalo Padang Health Center, Biomedical and Biochemistry Laboratory, Medical Faculty of Andalas University in December 2017 until August 2018. The sample was 22 obese adults and 22 non-obese adults. The sample was taken by consecutive sampling technique. Serum leptin levels was measured using the ELISA method and lipid profile using the CHOD-PAP and GPO-PAP methods. Data analysis using data normality test with Shapiro Wilk, mann whitney T-Test and correlation.Results: There was a significant difference between obesity and non-obesity leptin (p<0.05), there was no significant difference between total cholesterol (p>0.05), triglycerides (p>0.05), LDL (p>0.05), HDL (p>0.05), there is a weak association between leptin levels and lipid profile.Conclusions: There was significant difference in leptin levels between obese adult and non-obese adults, there was no significant difference in lipid profiles between obese adults and non-obese adults, and there was a weak association between leptin levels and lipid profiles in obese adults.
Retracted: Prevalence of refractive errors and corneal topographic changes in unilateral congenital ptosis vs the fellow eye: a clinical study
Authors: Vichare Nitin V.
Published: January 2019

The article titled, "Prevalence of refractive errors and corneal topographic changes in unilateral congenital ptosis vs the fellow eye: a clinical study", published in the International Journal of Research in Medical Sciences, Volume 7, Issue 2, 2019, Pages 442-446, DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20190350 is being retracted due to authorship dispute.
A cross-sectional study on iodine status among pregnant and non-pregnant women of Tripura: a North-Eastern state of India
Authors: Majumder Nilratan , Sutradhar Balaram , Riang Saradindu , Datta Shib Sekhar
Published: January 2019

Background: Due to excess metabolic demand of iodine in pregnancy, pregnant women and lactating mother and their neonates are most vulnerable of iodine deficiency disorder. Urinary iodine excretion is a good marker of recent dietary iodine intake. Thus, present study was conducted to assess the iodine status and median urinary iodine excretion (UIE μg/lit) among pregnant and non-pregnant women of Tripura.Methods: Tribal and Bengali pregnant and non-pregnant women from Bokafa and Jolaibari Block of South Tripura district were included in the study. Urinary iodine excretion was done using simple micro plate method. Salt iodine was estimated using iodometric titration. All the tests were performed at CNRT Lab, ICMR, India.Results: Total number of subjects included in this study was 1071. Total number of urine samples collected from pregnant and non-pregnant women was 538 and 533 respectively. Median value of UIE in pregnant and non-pregnant women of Tripura was 155.0µg/L and 130.0µg/L. In pregnant women percentage prevalence of severe (<20µg/L), moderate (20-49µg/L) and mild iodine deficiency (50-149µg/L) was found in 4.1%, 15.1% and 29.6% subjects. In case of non-pregnant women severe (<20µg/L), moderate (20-49µg/L) and mild iodine deficiency (50-99µg/L) was found in 0.6%, 9.6%, 27.8% subjects respectively. The overall prevalence of iodine deficiency was found in 48.8% pregnant women, compared to 38.0% non-pregnant subjects.Conclusions: Efforts towards universal salt iodization need to be stepped-up in Sub-Himalayan region (NE part of India) and pregnant and lactating mothers may be targeted with alternate iodine supplements (Colloidal Iodine).
Effect of thyroid dysfunction on disease activity of patients with rheumatoid arthritis
Authors: Waseem Mir , Shah Tabinda , Nadeem Mir , Singh Jaspreet , Maqbool Saba , Dahiya Chhaya
Published: January 2019

Background: Rheumatoid arthritis (RA) is a chronic autoimmune systemic inflammatory multisystem disease of unknown cause that may affect many tissues and organs, but principally attacks synovial joints, primarily affecting the peripheral joints in a symmetrical pattern. The pathology of the disease process often leads to destruction of articular cartilage. It is the commonest inflammatory arthropathy worldwide with a gender predilection towards women. Prevalence of RA in the adult general population is approximately 1%. An association between RA and thyroid dysfunction with or without autoimmune origin has been reported in 6% to 34% of patients with RA. On the contrary, when presence of thyroid antibodies is considered, despite normal thyroid function, the prevalence can rise up to about 38%. These rates are significantly greater when compared with the general population.Methods: RA patients who were diagnosed according to the new 2010 EULAR/ACR criteria and thyroid function tests were done and patients with thyroid dysfunction were identified and then patients were divided into two groups based on presence of thyroid dysfunction with rheumatoid arthritis and disease activity was illustrated in both groups based on different scales.Results: In all, 250 patients 215 (86.8%) were females and 33 (13.2%) were males. ESR was elevated in 85 (34%) patients while as it was normal in 165(66%) patients. CRP was positive in 127 (52.7%) negative in 123 (47.3%) patients. Although subclinical hypothyroidism was the most frequent abnormality observed in 38.3% patients, only 30% had concomitant anti-TPO raised and 71.4% patients of overt hypothyroidism had raised anti-TPO antibody. Disease activity parameters were significantly higher in patients of RA with hypothyroidism as compared to other group. Although most of parameters of disease activity showed a higher frequency in the group having patients with thyroid disorder but the swollen joint count was comparable in both the groups and was not statistically significant.Conclusions: Presence of thyroid disorders in RA patients is suggestive of a more aggressive disease. To diagnose concurrent thyroid disorders at an earlier stage, routine measurement of serum thyroid- stimulating hormone is recommended in all RA patients at the time of diagnosis and with yearly interval thereafter.
Study on association of serum lipoprotein(a) with coronary artery disease
Authors: Mohanraj P. , Sandhya S.
Published: January 2019

Background: Most studies of lipid-lowering therapy for the prevention of coronary heart disease (CAD), focused on lowering low density lipoprotein cholesterol and non-HDL cholesterol. Other dyslipidemias, such as an elevated level of lipoprotein(a), also may promote atherosclerosis, establishment of relationship between lipoprotein(a) excess and risk for CAD, interventions directed toward altering these have only infrequently been evaluated in clinical trials. Objectives was to study the association of raised serum lipoprotein(a) in coronary heart disease.Methods: This study was conducted in 50 patients of CAD and 50 people as control group. All patients underwent a standard clinical examination and a blood draw for a lipid profile and lipoprotein(a) assay. Pearson chi-square test was used to assess the statistical significance.Results: Lipoprotein(a) value of more than 30 mg/dl is considered as elevated. In case group 19 patients (38%) were showed elevated lipoprotein(a) and in control group these were 9 patients (18%). p value is 0.026. It shows elevated lipoprotein(a) is statistically significant with the relative risk of 2.79.Conclusions: The association of elevated lipoprotein(a) with CAD was statistically significant. Higher lipoprotein(a) levels were observed in patient with family history of premature CAD.
Awareness and attitude of Saudi cancer patients toward participation in clinical research
Authors: Sheblaq Nagham , ElBagoury Marwan , Elagouz Ahmed M. , Kotb Maryam
Published: January 2019

Background: Public awareness about the importance of clinical research (CR) is crucial for patient’s participation in clinical trials. Their enrollment may be impacted by their levels of awareness and attitudes toward participation. Our study aimed to assess the Saudi cancer patient’s knowledge and perception about CR, and determine the influencing factors and barriers affecting participation.

Methods: A cross-sectional study was conducted in 300 cancer patients attending the Oncology Department at King AbdulAziz Medical City (KAMC) Riyadh between February 2011 and February 2012 using a survey covering the demographic data, knowledge of clinical research, and attitude toward participation; followed by statistical analysis.

Results: A total of 300 patients were enrolled in the study with a median age of 53.6 (42.2-64.01); 62.67% of which were females. The majority of patients (97.31%) were not aware of Institutional Review Board (IRB). However, (75.33%) showed interest in CR participation, if offered. The advanced disease (86.67%), and the lack of other treatment options (85.33%) were the top two encouraging factors, while fear of adverse side effects (58.33%), and the unknown efficacy of treatment (58.32%) were the top two barriers against participation. Respondents younger than 45 years, and educated ones were significantly more interested in participation in CR with P values P=0.0136 and P=0.0239 respectively.

Conclusions: There is an apparent gap in cancer patient’s awareness about CR. However, there is an obvious interest in participation in CR especially in younger and educated patients. Enhancing public awareness is crucial to improve participation in CR.
Assessment of the utility of Yale observation scale as a predictor of bacteremia in children aged 3 months to 36 months
Authors: Sudhakar P. , Ajitha P.
Published: January 2019

Background: The Yale observation scale (YOS) is an illness severity helps to diagnose bacteremia based on simple noninvasive clinical signs and symptoms. The aim of the present study was to assess the utility of YOS as a predictor of bacterial infection in febrile children aged 3 to 36 months.Methods: This prospective observational study was conducted on 200 children aged 3 to 36 months presenting with fever, at the Institute of Child Health and Hospital for Children during the period from April 2016 to September 2016. Rectal temperature was taken for all children. Clinical examination was done as required based on the YOS and scores were given accordingly at the time of initial presentation of the child before invasive investigations. All the observation was assessed statistically and receiver operating characteristics (ROC) curve was performed to analyze the sensitivity of the YOS.Results: Highly significant correlation (p=0.0001) was found to exist between the age of the child, duration of the fever, higher body temperature >104, WBC count, ANC and improved condition of patient with higher YOS. ROC curves showed that the sensitivity and specificity of YOS at the best cut off value of 14.5 was found to be 97% and 79.6% respectively.Conclusions: YOS is very good tool for predicting bacteremia in young febrile children based on simple non-invasive clinical signs and symptoms. The findings ruled out by YOS aids in the immediate and early management of bacterial infections before the arrival of the results of the biochemical diagnostic tests.
Nutritional status assessment by anthropometry in children with chronic liver disease aged 6 months to 12 years
Authors: Sudhakar P. , Dhaarani Giri P. V.
Published: January 2019

Background: In spite of distinctive improvements in nutritional therapy, malnutrition and growth retardation remained as challenging significances of chronic liver disease (CLD) in children. The present study was done to evaluate the severity and frequency of malnutrition using anthropometry in CLD children.Methods: The study included 50 children with CLD attending the OPD of Institute of Child Health and Hospital for Children, Egmore, Chennai during the period from April 2016 to September 2016. Physical growth and nutritional status in the patients were evaluated using anthropometric parameters and Z-scores.Results: The incidence of malnutrition in the children using height for age was found to be 90%, weight for age- 84%, BMI for age- 40%, MAC for age- 88%, TST for age- 88%. SGA showed 96% malnutrition. Weight for age and body mass index were influenced by this fluid retention (P=0.002 and P=0.007 respectively). Whereas height for age, MAC and TST were not influenced by fluid retention (P=0.321, P=0.371 and P=0.031 respectively).Conclusions: Assessment of nutritional status in CLD children can be easily diagnosed by anthropometric measurements. Early diagnosis of malnutrition will decrease the related morbidity and mortality in children.
Cerebral venous sinus thrombosis a study to assess clinical profile among female patients in a tertiary care hospital
Authors: Gujjar Amruth , Babu Sudindra , E. Kalinga B.
Published: January 2019

Background: The Incidence of Cerebral Venous Thrombosis (CVT) is around 3-4 cases among one million population affecting children and young adults. In India the puerperal CVT is 10-12 times more common than western countries. Even though there is apparent “rarity” of the condition but advances in knowledge and available investigation in terms of imaging (CT scan/MRI) diagnosis can be done early for appropriate treatment and decreasing the morbidity and mortality.Methods: A prospective study was conducted at Karnataka Institute of Medical Sciences, Hubli, Karnataka from December 2014 to November 2015. A total of 36 patients were included in the study.Results: Mean age of females in the study was 27.06±9.033years.  75% had seizures, 47.2% had headache, 19.4% had focal neurological deficit, 13.9% had altered sensorium, 8.3% had cranial nerve deficits 5.6% had speech deficits.  72.22% of patients   and were in peripartum period and 27.8% were non-pregnant. 72.2% had superior sagittal sinus involvement, 47.2% had transverse sinus, 47.2% had sigmoid sinus, and 13.9% had internal jugular vein and 5.6% straight sinus. 47.2% had single sinus involvement, and 52.8% had multiple sinus involvement. 94.4% patients were managed conservatively and 5.6% were managed by neurosurgical intervention.  94.4% patients survived and 5.6% had mortality.Conclusions: Cerebral venous sinus thrombosis is most common in young females during peripartum period. Early diagnosis, treatment and if necessary neurosurgical intervention has good outcome.
Carotid and femoral intima-media thickness in adults with sickle cell disease
Authors: Kadam Nakul B. , Bansal Nikhil O. , Acharya Sourya P. , Shukla Samarth A.
Published: January 2019

Background: This study was conducted to evaluate Carotid Intima Media Thickness (CIMT) and Femoral Intima Media Thickness (FIMT) in adults with SCD.Methods: The present prospective cross-sectional study with control group was carried out in Department of Medicine at Acharya Vinoba Bhave rural hospital over a period of 6months from January to June 2018. A total of 100 (50 cases of SCD, 50 normal subjects) were studied. In the SCD group, 35 cases were patients regular follow up cases and 15 patients were in sickle cell crisis. CIMT of both left and right carotids were taken and the mean of the two values were recorded. The IMT was also measured in the right common femoral artery (RCFA) and left common femoral artery.Results: SCD patients in steady state had significantly decreased Hb%, increased WBC counts and platelet counts as compared to healthy controls. The mean right FIMT, left FIMT, right CIMT and left CIMT the patients with SCD with crisis were significantly higher than that of the patients without SCD (P<0.001). One way showed that there were significant differences in duration of disease in mean level of Hb%, WBC count, platelet count of the patients in the three groups (p<0.01).Conclusions: CIMT and FIMT can pick up the macrovascular involvement early and can be utilized as screening tools to predict vascular injury so that at risk individuals would be subjected to proper treatment protocols, especially hydroxyurea therapy early on.
Prevalence and purposes of gadget use among medical students
Authors: Lunge Vasant Ramraoji , Kokiwar P. R.
Published: January 2019

Background: The prevalence of gadgets is increasing among the medical students and this is the matter to worry as they use it for other purposes than the science. Data need to focus on how many proportion of medical students use the gadgets and for what they use it. The objective was to study the prevalence and purposes of gadget use among medical students.Methods: An institution based cross-sectional study was carried out in among 306 medical students. This study was based on self-administered questionnaires. The whole batch of students was contacted on a particular day for data collection. Study questionnaires were distributed to them. In between, the doubts regarding any questions were clarified. The questionnaires were taken back after a half hour. An attempt was made to see that all the questions were completely responded to. The data was analyzed using proportions and mean values. Statistical tests like Chi-Square test, and Student’s T-test was used.Results: Majority of people using gadgets were female (71%). More than half of users were in the age group of 21-23 years. Smartphone was the most commonly used gadget. About 2/5th of the students used gadgets for about 1-3 hours. More than half of the students used gadgets in the sitting position. The vast majority of students used gadgets at chest level.Conclusions: The findings of this study indicate that use of gadgets takes a prevalent part in the daily lives of medical students.
Ultrasonographic and fine needle aspiration cytology correlation of thyroid gland lesions: a study of 100 cases
Authors: Patel Nehal R. , Patel Alpesh V. , Patel Vaibhav V. , Vadher Payal R. , Kakadia Manali B.
Published: January 2019

Background: Thyroid gland is unique among endocrine organs as it is the largest endocrine gland in the body and the first to develop in the fetal life. There is approximately 4-5% incidence of clinically apparent thyroid lesions in general population. The goal of USG and FNAC diagnosis work up now is to select those patients for surgery who have a high likelihood of harboring malignancy in the nodule. Ultrasonography is the single most valuable imaging modality in the evaluation of the thyroid gland. Indications for thyroid USG include evaluation for palpable thyroid lesion or suspected thyroid enlargement and workup of thyroid lesions discovered incidentally.The present study is undertaken to evaluate the utility of FNAC in preoperative diagnosis of various thyroid lesions and to evaluate the efficacy of in USG and FNAC differentiating between benign and malignant lesions.

Methods: A retrospective clinical study, 100patients, in the age group of equal to or above 18 years, with thyroid swellings, referred to the department of ENT, sent for USG and FNAC at radiology and pathology department during the period from July 2014 to July 2016.  

Results: Out of 100 cases, 6% were malignant, 94% were benign on grey scale ultrasound. Out of 6 malignant cases 2 cases were confirmed malignant by FNAC.

Conclusions: High resolution grey scale ultrasound has emerged as initial imaging modality of choice for the evaluation of patients with thyroid enlargement. Ultrasound can detect solitary nodule, multiple nodules and diffuse thyroid enlargement. It can also differentiate solid and cystic lesions.
Diabetes mellitus and hepatitis c in generalised lichen planus: a case control study
Authors: Parimalam K. , Sowmiya R. , Mithra S.
Published: January 2019

Background: Prevalence of lichen planus (LP) and generalised lichen planus (GLP) is about 2.6% and 1% respectively. Various studies have shown higher prevalence of Diabetes Mellitus (DM) and stronger association between Hepatitis-C virus (HCV) and LP. The main objective of this study was to predict the prevalence of DM and HCV in patients with GLP before starting steroids.

Methods: A case-control study was conducted with 33 patients in each group for one year period. Case group included patients with GLP excluding oral LP and drug induced lichenoid dermatitis. Control group included patients with other skin conditions and not on steroids. Preliminary details and history of DM and HCV were collected. Random blood sugar and Anti-HCV were done.

Results: The proportion of patients with GLP was higher in women compared to men (63.6% vs. 36.3%). Highest prevalence was observed in the age group 35-45 years for both genders. On stratification by sex, odds of having GLP in women are 0.76 times lower among diabetics compared to non-diabetics whereas no association in males. There was no association between GLP and HCV in both sexes.

Conclusions: There is no significant association between Diabetes mellitus and Hepatitis-C infection with GLP. Future study is planned with larger sample size for a definite conclusion.
Case report of middle aged male patient with extra digital glomus tumor visiting dermatology clinic of King Abdul-Aziz Medical City, National Guard Health Affairs, Jeddah, Saudi Arabia, 2018
Authors: Alamri Awadh , Alahmadi Marwan , Satti Mohamed B. , Alruwaili Amaal F. , Alotaibi Homaid , Al-Mugti Hani Saad
Published: January 2019

Glomus tumors are rare, benign and vascular neoplasm of the glomus body, account for less than 2% of all soft tissue tumors. The most common site is the subungual region of the fingers and toes. Extra digital sites including the forearm are uncommon and usually misdiagnosed as other conditions. Usually the glomus tumors present with the classical triad of severe pain, pinpoint tenderness and clod hypersensitivity. This is a case report study design with detailed history, examination of 54-years-old male patient with a painful nodular lesion in the left forearm, which is misdiagnosed as foreign body granuloma. Elliptical excision relieved the symptoms and histopathologic examination confirmed the diagnosis of glomus tumor.
AN INFORMATION SECURITY RISK ASSESSMENT MODEL BASED ON BAYESIAN NETWORK AND FUZZY INFERENCE SYSTEM
Authors: BEKEN Sevilay , EMİNAĞAOĞLU Mete
Published: January 2019

This study proposes a novel
information security risk assessment approach based on Bayesian network and
Fuzzy Inference System in order to evaluate and calculate both qualitative and /
or quantitative risks. The proposed model is developed to analyse test
processes for a software services company in order to evaluate the information
security risks. Threats, vulnerabilities, risks, and their relations are
constructed with a Bayesian network and marginal probabilities are calculated
for each risk factor. Several fuzzy membership functions and fuzzy decision
rules are designed and constructed for assets’ values, risks’ probabilities,
and relative risk values. Finally, the impacts of risk values are calculated
after the aggregation and defuzzification process. It is shown that this new model
enables the business decision makers and managers to obtain more objective,
reliable, and flexible information security risk assessment results.
Neurotrofiny: ewolucja podejść do eksperymentalnej naprawy ośrodkowego układu nerwowego
Authors: Skup Małgorzata
Published: January 2019

Neurotrophins (NT) were âbrought to life” by Rita Levi-Montalcini and Stanley Cohen, thanks to their discovery of the nerve growth factor (NGF) isolated from the malignant tumor. A hint got from the cancer studies on the presence of NTs and other molecules like metalloproteases, which control neuronal remodeling and extracellular matrix in tumors, was the stimulus to investigate the role of these molecules in physiology and post-lesion plasticity of the nervous system. NTs have long been identified as drivers of neurogenesis during development and regeneration of the nervous system. Thousands of investigations spanned from early sixties till now provided strong evidence that this small family of molecules is indispensable for central and peripheral nervous system maintenance throughout the whole life of different animal species. In mammals NTs regulate sensation, movement, behavior, and cognition. A problem, which accompanies the majority of experimental therapies  using NTs following injury of the nervous system, stems from unspecific and uncontrolled stimulation of the whole circuitry of preserved neurons. Among the already identified causes of clinical trial failure with the use of NT therapy in the treatment of neurodegenerative diseases are: (1) disregarding neuronal preferences to selected NTs; (2) poor knowledge on NT pharmacokinetics (3) uncontrolled spread of NTs when administered systemically, which could have unpredictable effects on other than intended neuronal populations (4) limitations of tissue penetration of some NTs (5) disturbances of the balance between signal transmission through their Trk and LNGTR receptors. I present our contribution to the field and efforts to control spatially and temporally postinjury NT signaling.
Terapia genowa hemofilii – czy wkrótce będzie możliwe wyleczenie?
Authors: Kaczmarek Radosław
Published: January 2019

Hemofilia to osoczowa skaza krwotoczna, której przyczyną jest niedobór czynnika krzepnięcia krwi VIII (hemofilia typu A) lub rzadziej IX (hemofilia typu B). Geny kodująceczynniki krzepnięcia VIII i IX znajdują na chromosomie X, dlatego wrodzona hemofilia A i B dziedziczone są w sposób sprzężony z płcią. Głównym objawem choroby są częste samoistne krwawienia do stawów, które powodują artropatię hemofilową. Hemofilię leczono początkowo za pomocą przetaczania pełnej krwi. Później do leczenia wprowadzono preparaty osocza. Dużym przełomem w leczeniu było zastosowanie krioprecypitatu a następnie liofilizowanych koncentratów czynników krzepnięcia wytwarzanych z osocza, co pozwoliło na domowe leczenie i profilaktykę krwawień. Zmiany te znacznie zwiększyły skuteczność leczenia i jakość życia pacjentów. Od początku lat 1990 stosuje się koncentraty rekombinowanych czynników krzepnięcia otrzymywanych w liniach komórkowych. Dziś główne wyzwania w leczeniu hemofilii to konieczność częstych dożylnych wkłuć w celu zapobiegania krwawieniom i pojawianie się u części chorych neutralizujących przeciwciał rozpoznających czynniki krzepnięcia. W ostatnich latach zatwierdzono kilka rekombinowanych czynników krzepnięcia o wydłużonym okresie półtrwania. Trwają też zaawansowane próby kliniczne leków niezawierających czynników krzepnięcia (np. emicizumab: dwuswoiste przeciwciało naśladujące funkcje czynnika VIII; fitusiran, czyli siRNA hamujący s