bluuebunny/crossref_metadata_2025 huggingface dataset:
Perspectives and Practical Advice About Writing Your Own Letter of Recommendation
Authors: Currier Thomas Theresa , Romero Andrea Jean , Kuper Mary Frances Miller
Published: February 2020

This article was migrated. The article was marked as recommended. Drafting your own letter of recommendation (LoR) is becoming a more common request across all levels of medicine and academia. This can be a daunting task in an environment where metrics for advancement continually increase and meaningful relationships with mentors, supervisors, and leaders are not promoted or easy to come by. The authors recently held a workshop where the challenges, advantages, and pitfalls of writing you own LoR were discussed. In this Personal View article, we took into consideration audience feedback and provide proactive successful approaches based on experience of writing our own LoRs and writing and reviewing LoRs from the level of undergraduate admission to faculty promotion in academic medicine. We acknowledge the advantages and pitfalls of writing your own LoR and offer practical methods/approaches as tools for success.
The Liquidity Coverage Ratio and Corporate Liquidity Management
Authors: Yankov Vladimir
Published: February 2020

This note examines the changes in the liquidity management at banks and nonbank financial firms in the United States that occurred following the proposal of the liquidity coverage ratio (LCR) requirement in 2010 and its finalization in 2014.
The Increasing Deflationary Influence of Consumer Digital Access Services
Authors: Byrne David M. , Corrado Carol A.
Published: February 2020

Consumer digital access services—internet, mobile phone, cable TV, and streaming—accounted for over 2 percent of U.S. household consumption in 2018. We construct prices for these services using direct measures of volume (data transmitted, talk time, and hours of programming). Our price index fell 12 percent per year from 1988 to 2018 while official prices moved up modestly. Using our digital services index, we estimate total personal consumption expenditure (PCE) prices have risen nearly 1/2 percentage point slower than the official index since 2008. Importantly, the spread between alternative and official PCE price inflation has increased noticeably over time.
Relación entre depresión y calidad de vida en pacientes con enfermedades crónicas de un hospital de nivel I de Lima Este
Authors: Roque Afray Missael Gabriel , Quinteros Zuñiga Damaris Susana
Published: February 2020

El objetivo de la presente investigación es analizar la relación entre depresión y calidad de vida en pacientes con enfermedades crónicas de un hospital de Nivel I de Lima Este. Su diseño es no-experimental, de corte transversal y de tipo correlacional. Para este trabajo se utilizó el Cuestionario de Estado de Salud SF36, que contiene ocho dimensiones, y la Escala de Depresión de Hamilton. La muestra estuvo conformada por 61 pacientes con enfermedades crónicas, de ambos sexos, y con edades entre  20 y 80 años. Los resultados indican una relación inversa altamente significativa entre depresión y las ocho dimensiones de calidad de vida, las cuales comprenden:  función física (rho= -.331; p<0.01), rol físico (rho= -.407; p<0.01), dolor corporal (rho= -.448; p<0.01), salud general (rho= -.467; p<0.01), rol emocional (rho= -.518; p<0.01), función social (rho= -.537; p<0.01), vitalidad (rho= -.637; p<0.01) y  salud mental (rho= -.566; p<0.01). En  consecuencia, se confirma que: a mayor nivel de depresión, menor será la calidad de vida en los pacientes con enfermedades crónicas de un hospital de Nivel 1 de Lima Este.
Conocimientos y actitudes sobre sexualidad en estudiantes del nivel secundario de la Institución Educativa Almirante Miguel Grau- Chaclacayo, Lima 2017
Authors: Marquez Andres Luddy
Published: February 2020

El presente estudio tiene como objetivo determinar la relación entre los conocimientos y actitudes sobre sexualidad en estudiantes de nivel secundario de la I.E Almirante Miguel Grau, Chaclacayo, 2017. Esta investigación es de enfoque cuantitativo, diseño no experimental, de tipo correlacional y de corte transversal. La muestra estuvo conformada por 150 estudiantes, elegidos a partir de muestreo probabilístico. Para la recolección de datos, se emplearon los cuestionarios de “Conocimientos y actitudes sobre sexualidad” elaborados porPareja y Sánchez (2016) en Huancayo (Perú); que a su vez se determinó con un Alfa de Cronbach de 0,779 y 0,881, respectivamente. Los resultados muestran la relación entre los conocimientos y actitudes sobre sexualidad con un p-valor<0,05, a través de la prueba estadística Chi-cuadrado. De igual manera se halló relación entre los conocimientos y las dimensiones “responsabilidad” y “prevención del riesgo sexual” (p-valor=0,0001), “libertad para decidir” (p-valor=0,0003), “autonomía” (p-valor=0,0001), “respeto mutuo” (p -valor=0,0001) y “sexualidad como amor” (p-valor=0,0001). Se concluye que existe relación entre ambas variables.
Electrodynamic Parameters of a Coaxial Cable at Bipolar Pulses Propagation
Authors: Bulbik Yanis I. , Zograf Fedor G.
Published: February 2020

All-in-interworking technology, based on IEEE 802.3 standard, was mainly developed for the separable media cabling and data transmission speed increase. Although the high-speed networking is already provided by a fiber optic cable, coaxial guides are in demand for similar applications. Time-domain analysis is undertaken to estimate electrodynamic states of inner and outer guiding conductors at periodic bipolar pulses propagation on a coaxial cable. An electric current density distribution on the cross-section of the inner conductor is obtained from a solution of Maxwell equations under periodic boundary conditions that are prescribed by a product of two functions. The first one is introduced implicitly for a profile of surface current density in the axial direction, while the other determines this profile transient states. As for shielding braid, which is the cable outer conductor, its current density distribution is derived from an analysis of field harmonics that penetrate into conductive subsurface layers under similar boundary conditions. It is also shown that prescribed implicative boundary conditions for both conductors allow to obtain, at least under auxiliary assumption, some completed formulae useful to the estimation of the pulses duration admissible decrease at their transmission on the coaxial cable. The paper contains some comparative and numerical results as well
Reliability Analysis in Planning of Traction Substation Reconstruction Based on Fuzzy Set Theory
Authors: Belov Vladislav G. , Tremyasov Vladimir A.
Published: February 2020

The study proposes a probabilistic method using triangular fuzzy numbers to analyze the reliability of the traction substation. With this approach, the reliability assessment of the traction substation can be performed considering changes in the values of reliability indicators of electrical equipment, determined on the basis of the fuzzy set theory
Városi közösségi kertek Magyarországon
Authors: Bársony Fanni
Published: February 2020

A városi közösségi kertek („community garden”) külföldön több évtizedes múltra tekintenek vissza, Magyarországon néhány éve terjedtek el. A közjavak (commons) és városi közjavak (urban commons) tudományos irodalma a kerteket az önszerveződő és a megosztás gyakorlatait előtérbe helyező közösségeknek egy új, egyre nagyobb társadalomtudományos érdeklődést kiváltó típusába sorolja. Tanulmányomban elsőként áttekintem, hogyan kapcsolódnak a kortárs közjószágkutatások a közjavakkal kapcsolatos hagyományos elméleti keretekhez és a kertek példáján keresztül megpróbálom igazolni a nemzetközi irodalomban tett megállapításokat.  A magyarországi kertekről gyűjtött empirikus tudást a kertekben folytatott terepmunkára és a kertek működtetése kapcsán felmerülő problémákat feltáró csoportos interjúra alapozom. Arra keresem a választ, hogy milyen típusú közjavakként interpretálhatók a városi közösségi kertek, mi jellemzi a közösségeiket az erőforráshoz való viszonyt illetően, pontosan milyen erőforrás áll a közösségi kormányzás fókuszában, és milyen megosztáson alapuló gyakorlatot követnek a kertközösségek. Munkámmal egyik célom betekintést nyújtani a magyarországi kertközösségek működésébe, másik pedig a kertek példáján keresztül reflektálni a városi közjavakról zajló tudományos diskurzusra. A kertek külső, intézményes környezete, valamint a működtetésükkel kapcsolatban felmerülő belső problémák és gyakorlatok jó kiindulópontként szolgálnak a városi közjavakkal kapcsolatos koncepcionális kérdések feltárásához. Terepkutatásom azt igazolja, hogy a városi közjavak esetében nem elég arra koncentrálni, mi a közös erőforrás és mik a hozzáférés feltételei, a közjavakat az őket működtető közösséggel összefüggésben kell vizsgálni, és az erőforrás mibenlétére, a használók és haszonélvezők körére is mint változó kategóriákra érdemes tekinteni. A közjavak nemcsak a jószágok típusaként, hanem társadalmi gyakorlatként is felfoghatók, és a közösségek különbözhetnek abban, mennyire engednek a megosztás gyakorlatainak.
The Bureaucratic Violence of the Health Care System for Pregnant Immigrants on the United States-Mexico Border
Authors: Heckert Carina
Published: February 2020

Using the concept bureaucratic violence, this article explores how health care bureaucracy contributes to harm for pregnant immigrants on the United States-Mexico border. The term bureaucratic violence captures how even when laws and health policies are not targeting a specific group, bureaucracy can do this work instead, causing systematic harm. Prenatal care in the United States captures this dynamic. In many states, prenatal coverage is available for low-income women regardless of immigration status. Yet, the bureaucratic routes for gaining access to coverage create latent forms of exclusion and fear, leading women to delay or not seek prenatal care or to experience anxieties over seeking care. In-depth interviews with pregnant and postnatal immigrant women revealed that threats of changes to bureaucratic procedures via the likely public charge rule was shaping the use of pregnancy-related public benefits. Even when women applied for these programs, they faced bureaucratic barriers and described bureaucratic monitoring as a source of emotional distress. These patterns can have detrimental effects on maternal and infant health outcomes. Bringing attention to bureaucratic violence can emphasize to health practitioners the struggles immigrants face in seeking prenatal care and the need for additional measures to support pregnant immigrants.
Remarks on Essential Maximal Numerical Range of Aluthge Transform
Authors: Cyprian Omukhwaya Sakwa , Chikamai Lucy , Aywa Shem
Published: February 2020

This paper focuses on the properties of the essential maximal numerical range of Aluthgetransform T. For instance, among other results, we show that the essential maximal numerical rangeof Aluthge transform is nonempty and convex. Further, we prove that the essential maximal numericalrange of Aluthge transform e T is contained in the essential maximal numerical range of T. This studyis therefore an extention of the research on Aluthge transform which was begun by Aluthge in hisstudy of p−hyponormal operators.
Doç. Dr. Birol GÜNDÜZ’ün Hayatı ve Bilim Dünyasına Katkıları (1986-2019)
Authors: AKBULUT Sezgin
Published: February 2020

Birol Gündüz'ün ardında kalanlar
Etiological factors and maternal outcome in pregnancies with malpresentation: an observational study
Authors: Shruthi S. , Apollo A. Anisha
Published: February 2020

Background: The most common presentation of the fetus is malpresentation. These include breech, face, brow, shoulder and compound presentations. Malpresentations of fetus complicate labor in about 5% of pregnancies. To find out the incidence of malpresentation, to analyze etiological factors of malpresentation, to evaluate the maternal outcome in cases with a malpresentation.Methods: This prospective observational study was done in, Chengalpattu Government medical college and hospital. Study period from October 2018 to September 2019. Pregnancies with malpresentation presenting to the department of obstetrics and gynecology at CMCH were included in the study.Results: A total of 680 malpresentation were admitted in this period were included in this study. The incidence of malpresentation during the study period was 7.72%. The incidence of the breech was 4.38%, transverse lie 1.11%, face 0.28%, brow 0.05% and compound presentation 0.13%. The common causes were prematurity, multiple gestations, grand multiparty, IUGR, oligohydramnios, anomalies of uterus, polyhydramnios, contracted pelvis, placenta previa, hydrocephalus, prematurity was reported as the commonest cause of breech presentation and multiparty for transverse lie, face and brow presentations. The most common complication was obstructed labor 6.9% followed by post-partum hemorrhage 3.65%. There was no maternal death due to malpresentation during the period of study.Conclusions: Early diagnosis and timely management can prevent the complications of labor associated with a malpresentation. Delivery should be planned at centers which have expertise in conducting vaginal delivery in malpresentation with good intrapartum monitoring and with facilities for cesarean section for the better feto-maternal outcome.
Routine versus selective use of episiotomy in primigravida: a prospective non-randomized case-control study
Authors: Modi Dipti A. , Vaishnav Palak P.
Published: February 2020

Background: Episiotomy is a surgically planned incision on the perineum and the posterior vaginal wall during second stage of labour. It is an inflicted second-degree perineal tear. Objective of this study was to determine the possible benefits and risks of the use of selective episiotomy versus routine episiotomy during delivery in primigravida.Methods: This is a prospective non-randomized case-control study designed to analyze and compare the maternal outcomes following routine versus selective use of episiotomy in primigravida. In control group, 122 patients were recruited and mediolateral episiotomy was given in all patients; while in study group, 61 patients were recruited, in whom episiotomy was given selectively.Results: In study group 61 patients were recruited, out of which episiotomy can be avoided in 23 (37.7%) of cases. There was no 3rd or 4th degree perineal tear found in any group. Perineal pain score on 3rd day postpartum was less in study group, as compared to control group on bed rest, sitting, walking and defecation.Conclusions: Selective use of episiotomy can improve maternal outcome by reducing perineal lacerations and those having intact perineum can have the best outcome when episiotomy is given selectively.
Assessment of knowledge regarding anaemia and its preventive measures among lactating mothers of North Gujarat region, India
Authors: Nimbalkar Pankajkumar B. , Joshi Maulik D. , Thakor Nilesh , Bhatt Avirat A.
Published: February 2020

Background: Anaemia in pregnancy and lactation period has detrimental effects on maternal and child health. Objective of this study was to assess knowledge of lactating mothers regarding anaemia and its preventive measures before and after educational intervention.Methods: The interventional study conducted in purposively selected lactating mothers attending the outpatient department of obstetrics and gynecology. Hospital ethical committee permission was obtained. After taking informed consent 100 lactating mothers were selected by systemic random sampling methods. Knowledge of lactating mothers regarding anaemia and its preventive measures was assessed by pre-designed, pre-tested and semi structured questionnaire. Health education for 30 minutes was given to selected lactating mothers. Knowledge of pregnant women for the same was assessed after health education. Thus, collected data was analyzed using Epi info 7.Results: Awareness among lactating mothers regarding causes, signs and symptoms of anemia and dietary sources of iron was 41%, 26% and 5% respectively which was significantly increased to 73%, 56% and 42% respectively after health education. Awareness among lactating mothers regarding factors which inhibit and increase iron absorption was 31% and 22% respectively which was significantly increased to 80% and 65% respectively after health education. Out of 100 lactating mothers only 24% were aware regarding treatment of anemia.Conclusions: Lack of awareness among lactating mothers regarding anemia and its preventive measure should be addressed by health education during hospital visits.
Role of obstetric colour doppler studies in predicting perinatal outcome in pregnancy induced hypertension
Authors: Mishra Ritu , Misra Aditya P.
Published: February 2020

Background: Pregnancy induced hypertension (PIH) is associated with adverse perinatal outcome. Multi vessel colour Doppler studies are useful in these cases for timely intervention. The aim of present study was to know the significance of umbilical, middle cerebral and uterine artery Doppler in PIH and to analyse their role in predicting perinatal outcome.Methods: This is a study of 150 pregnant women with pregnancy induced hypertension (PIH). These patients were evaluated with colour Doppler and were followed subsequently for any adverse perinatal outcome.Results: Out of 150 cases 70% of cases were found in 20-30 years age group. 98 cases had abnormal uterine artery Doppler indices accounting for 65.3%, while 52 cases had a normal Doppler index accounting for 34.3%. Out of 150 cases, 94 (64.6%) cases had abnormal middle cerebral artery. In our study 53 cases had abnormal umbilical artery Doppler indices accounting for 35.4%, while 97 cases had a normal Doppler index accounting for 64.6%. Out of 150 cases in our study 27 cases had Reversal of a wave in ductus venosus waveform that is in 18%. In this study total 5 cases (35.7%) of perinatal mortality were seen.Conclusions: The knowledge of various doppler parameters may help to improve pregnancy outcome and identification of PIH at earliest gestation age as compared to other antepartum test modalities.
Pregnancy outcomes in non-gynecological and non-hematological cancers: a retrospective cohort
Authors: Kumari Minakshi , Yenuberi Hilda , Rathore Swati , Abraham Deepak , Titus V. T. K. , Mathews Jiji Elizabeth , Singh Ashish
Published: February 2020

Background: Of all the cancers in women, about 10% manifest in the reproductive age group. These can be broadly classified as gynaecological cancers and non-gynaecological cancers; Among the non-gynaecological cancers besides haematological cancer, breast, thyroid, colon, bone and CNS are seen rarely. Clinical acumen in diagnosis and management of these rare cancers that appear during pregnancy or before pregnancy are difficult due to insufficient guidelines and rarity of the conditions.Methods: A retrospective analysis of rare cancers during a period of 10 years in this hospital was performed. Data concerning the gestational age at delivery, birth weight, mode of delivery and complications and the management of the cancers during the pregnancy were collected.Results: Among the 41 women with these rare non-gynecological, non-hematological cancers, 13 pregnancies were in women with prior history of cancers and 28 pregnancies were with current history of cancer. Majority of these cases with prior history were thyroid cancers who had uneventful pregnancies and delivered normally. Among pregnancies with current history of cancer, breast, CNS, GIT, and head and neck were the cancers with 5-6 cancers in each category. About 50% of these cancers were delivered early between 31-35 weeks to facilitate optimal treatment. Cancers with guarded prognosis diagnosed before 20 weeks had a termination of pregnancy.Conclusions: Cancers during pregnancies are rare and their care must be individualized.
Patient satisfaction and experience with various modes of Xylocaine administration for cervical dilatation and endometrial curettage: a randomized interventional study
Authors: Kanchan Swati , Hebbar Shripad
Published: February 2020

Background: Patient satisfaction after a surgical procedure is an important outcome of hospital care. Many of the gynaecological menstrual problems such as abnormal uterine bleeding, postmenopausal bleeding requires endometrial evaluation which is done traditionally by dilatation and curettage. But this procedure is painful and requires appropriate pain management protocol. The aim is to evaluate the post-operative patient satisfaction following dilatation and curettage procedure.Methods: This study was conducted in a tertiary care hospital belonging to a medical college. A total of 236 patients were recruited for the study who subsequently underwent dilatation and curettage with different mode of Xylocaine anesthesia for pain relief. Of them 16 patients were excluded due to valid reasons and the remaining 220 were interviewed face to face following the procedure. The level of anxiety was assessed using Beck’s Anxiety inventory and also perception of satisfaction was documented along with complication related to the anesthesia.Results: The overall level of satisfaction was higher in the group receiving both paracervical block and intrauterine instillation of lidocaine during the procedure of dilatation and curettage. A further analysis showed that increase in level of satisfaction was due to improvement in pain scores due to combined mode of paracervical and endometrial anesthesia.Conclusions: A multimodal pain management protocol which involves pre-procedural sedation, combined cervical and endometrial anesthesia improves overall outcome with respect to reduction in anxiety scores and postoperative satisfaction levels.
A study comparing non-gestational diabetes mellitus and gestational diabetes mellitus in antenatal patients in a tertiary care center
Authors: Sharma Preeti , Chaudhary Neeta , Singh Suchitra
Published: February 2020

Background: Gestational diabetes mellitus is defined as any glucose intolerance with the onset or first recognition during pregnancy. Objectives of this study were to diagnose cases of GDM by screening with DIPSI criteria at less than 28 weeks. And observation and comparison of maternal and perinatal outcome in women diagnosed of GDM in less than 20 weeks and at 24-28 weeks.Methods: This was the prospective analytical study conducted in the department of obstetrics and gynecology for one year in Muzaffarnagar medical college and Hospital. After history taking, clinical and obstetrics examination 1503 antenatal patients of less than 28 weeks were enrolled underwent screening with DIPSI criteria. Out of which 80 patients with abnormal OGTT of gestational age less than 20 weeks and 69 patients with abnormal OGTT of gestational age 24 -28 weeks.Results: In early diagnosed GDM group alive and healthy babies were slightly lower as compared with late diagnosed GDM group.Conclusions: The diagnosis of GDM gives us an opportunity in identifying individuals who will be benefitted by early therapeutic intervention with diet, exercise, and normalizing the weight to delay or prevent the onset of the disease.
Factors associated with increased blood loss during delivery
Authors: Jain Paridhi , Thakur Nisha , Jain Ashu , Agarwal Sunita , Kamra Sangeeta , Jacob Shyla
Published: February 2020

Background: The present study was done to assess the blood loss during delivery even after active management of third stage of labor with oxytocin and the maternal outcomes of PPH.Methods: We studied 100 pregnant women were either in spontaneous labor or admitted for induction of labor, underwent vaginal delivery or caesarean section in our institute. Active management of third stage of labor in all 100 cases included 10 IU intramuscular oxytocin or 10 to 20 IU intravenous in 500 ml of Ringer’s Lactate. Blood loss in all cases was noted.Results: Of the included cases, 27 had to be given extra-uterotonics for atonic uterus, of which 12 parturient still had PPH. Atonic uterus was the cause of PPH in 11 of the 12 cases, while one case was of atonic uterus plus trauma. Half of all PPH cases responded to medical management alone, five cases had to undergo tamponade/stepwise devascularization and one case had to undergo obstetric hysterectomy. Blood loss was significantly higher in women aged more than 35 years, primigravida, not in labor, oligohydramnios or post-datism, elective LSCS, scarred uterus in and had more than 1 high risk factor. Among various high-risk conditions, significantly higher blood loss was observed in patients with chronic hypertension, gestational hypertension, pre-gestational diabetes mellitus, multipara with prior PPH, placenta previa, preeclampsia and sickle cell trait.Conclusions: Fifteen women avoided PPH by using a reliable method of blood loss measurement and initiating interventions early. Organized PPH management protocol morbidity and mortality of the mother and neonate can be prevented.
Twin-Twin transfusion syndrome: a case report
Authors: Bansal Romi , Kaur Jasleen , . Priyanka
Published: February 2020

Twin to twin transfusion syndrome is a rare but serious complication of monochorionic twin pregnancy. It is characterized by the development of abnormal placental vascular communication from one foetus (donor) to the other foetus (recipient). If left untreated it led to high rates of perinatal morbidity and mortality due to its poorly understood etiology and difficulty in diagnosing and treatment. Authors report a case of twin to twin transfusion syndrome in 24 years old primigravida with gestational age of 18 weeks 5 days diagnosed on ultrasound.
Dilemma in diagnosing ovarian ectopic pregnancy
Authors: Rajpal Harsha , Kaur Harvinder , Miglani Urvashi
Published: February 2020

To study different presentation of ovarian ectopic pregnancy and its management. All the 4 patients of ovarian ectopic pregnancy presented in our hospital in the month of April 2019 were analysed. We reported 4 cases with a pre-operative provisional diagnosis of ruptured ectopic pregnancy and intra-operative diagnosis of? ovarian ectopic pregnancy, however histopathological examination confirmed the diagnosis of ovarian ectopic pregnancy in only 2 of the cases while the other 2 were ruptured corpus luteal cyst. Wedge resection was performed in all 4 patients. Ovarian ectopic pregnancy is rare and can be missed radiologically and intra-operatively. Establishing early diagnosis is a challenge to the clinician, it commonly mimics tubal ectopic or ruptured corpus luteal cyst. Provisional diagnosis can be made intra-operatively when a hemorrhage mass is seen near the ovary with a normal fallopian tube but can be confirmed by histopathological examination. The chief goal of the treatment remains life-saving intervention by early diagnosis to reduce maternal mortality and morbidity.
Speciation of Enterococcus species: better way to deal with clinical infections at resource limited settings
Authors: Patel Kinjal P. , Mulla Summaiya
Published: February 2020

Background: Enterococcus species are well known for its intrinsic resistance pattern to several antibiotics. Hence, appropriate management and prevention is essential in any healthcare facility. Present study was conducted to establish an accessible biochemical tests to differentiate Enterococcus species at resource limited settings.Methods: Enterococci isolated from various clinical specimens were speciated using an array of biochemical reactions and antimicrobial susceptibility testing was performed by Kirby-Bauer disc diffusion method. Results were interpreted as per Clinical and Laboratory Standards Institute (CLSI) guidelines.Results: Out of 107 enterococcal isolates, 63(59%) were E. faecium, 40(37%) were E. fecalis, 2(2%) were E. hirae, 1(0.9%) was E. raffinosus and 1(0.9%) was E. gallinarum. E. faecium and E. fecalis showed 23% and 7% vancomycin resistance respectively, while E. gallinarum showed low level vancomycin resistance.Conclusions: Enterococcus speciation can be done using simple biochemical reactions and its susceptibility pattern enables to distinguish Van phenotypes too. Hence, it is helpful for management of infections in resource limited settings to a greater extent.
Estradiol and lipid levels in men with acute myocardial infarction
Authors: Aparna R. R. , Rajeswari D. Raja , Ramalingam K. , Krishna T. Sharmila , Kumar R. Viswa
Published: February 2020

Background: The incidence of myocardial infarction (MI) is more common in men when compared with women and women after menopause are at high risk of MI. This gender difference in CVD risk might be because of the difference in the circulating estrogen levels in men and women. Dyslipidemia is also one of the major causes of MI. The present study was aimed to estimate the levels of serum estradiol and serum lipids in newly diagnosed male MI cases and to find out any correlation between these two.Methods: The study was conducted on 50 newly diagnosed MI admitted in Cardiology department Narayana general hospital and Medical College, Nellore. Only males were included in the study. Fifty age and sex-matched healthy individuals were selected as controls. Lipid levels are estimated by endpoint colorimetric assay (HUMANSTAR kit) and estradiol was estimated by Chemiluminance immune assay (CLIA).Results: Significantly raised levels of estradiol (p-value <0.0001) and low HDL cholesterol (p-value =0.0085) levels were noticed among the cases compared to controls. No significant correlation was observed between estradiol and lipoproteins (HDL and LDL).Conclusions: The results of the present study in acute MI compared to controls show hyper estrogenemia in Male MI cases, which may be the underlying cause for thrombosis in acute MI. Decreased levels of HDL cholesterol are observed in the MI cases which are known to increase the risk of Atherosclerosis. No significant correlation were noticed between Estradiol and HDL cholesterol in men with acute MI.
A comparative study on concurrent chemoradiation using cisplatin versus carboplatin in the management of locoregionally advanced non-small cell lung cancer
Authors: Raj Nithin D. , Yumkhaibam Sobita D. , Mohanty Srigopal , Chongthu James L. , Laishram Jaichand S.
Published: February 2020

Background: Concurrent chemoradiation is considered the standard care for locoregionally advanced non-small cell lung cancer. This study aimed to compare the treatment response, progression free survival and treatment toxicities between cisplatin and carboplatin based concurrent chemoradiation.Methods: Between October 2015 and September 2017, 60 eligible patients were enrolled and divided into two arms of 30 patients each. Arm A received EBRT to chest (60Gy/30 fractions) with concurrent weekly Injection Cisplatin 35mg/m2. Arm B received EBRT to chest (60Gy/30 fractions) with concurrent weekly Injection Carboplatin at a dose of AUC-2. Early treatment response was assessed at 1 month and late treatment response at 6 months after completion of radiation using RECIST criteria. Treatment toxicities was assessed using RTOG toxicity criteria. All statistical analysis was carried out using SPSS version 21.Results: Most patients were in the age range of 61-70 years. Mean age of presentation was 67.53±11.038 years in Arm A and 66.03±12.794 years in Arm B. Median follow up was 16 months for both arms. Response rate of was slightly better in Arm A (73.3% versus 60%). 1 year PFS rate was 53.33% in Arm A and 36.67% in Arm B. Median time to progression was better in Arm A (11 months vs 10 months). Toxicities were almost comparable in both the arms.Conclusions: Use of carboplatin in combination with radiation therapy is comparable to cisplatin in terms of treatment outcomes with better compliance and lower toxicity.
Effectiveness of light emitting diode versus conventional phototherapy in neonatal hyperbilirubinemia: a hospital based observational study
Authors: Purkait Radheshyam , Mondal Manik
Published: February 2020

Background: The most commonly used light sources in the conventional phototherapy units are compact fluorescent lamp (CFL), halogen spotlights and fiberoptic blankets. Recently light emitting diodes (LED) has emerged as better light source for phototherapy and almost replacing all the available conventional light sources. Comparative studies on the efficacy of LED versus conventional phototherapy are limited from India. That is why; this study was undertaken.Methods: 48 neonates of ≥35 weeks gestational age with hyperbilirubinemia were participated in this study. Among them, 24 neonates received conventional phototherapy and rest of them received LED phototherapy. The rate of fall of bilirubin levels at 6 hours and at completion along with total duration of phototherapy in both groups was measured. Results analysed by standard statistical methods.Results: LED phototherapy units showed higher rate of fall in bilirubin at six hrs (LED group: 0.38±0.05 mg/dl/hr versus conventional group: 0.30±0.04 mg/dl/hr, p<0.05) and after completion of therapy (LED group:                      0.32±0.03 mg/dl/hr versus conventional group: 0.26±0.03 mg/dl/hr, p<0.05) compared to conventional group. Significant difference was documented in total duration of phototherapy in LED group (30.8±1.8 hours) when compared to conventional group (34.6±0.7 hours). None of the neonate showed phototherapy failure. Side effects were minimal and comparable in both the groups.Conclusions: The LED phototherapy units are more efficacious in terms of higher rate of fall of bilirubin levels and lesser duration of phototherapy compared to conventional phototherapy units.
Histopathological spectrum of gall bladder lesions
Authors: Kulkarni Aparna M. , Jadhav Esha Devendra , Ramteke Ravindra V.
Published: February 2020

Background: Gall bladder diseases are a very common health problem that affects millions of people throughout the world. Cholelithiasis is commonly associated with carcinoma gallbladder. Cholecystectomy is the most commonly performed surgical procedure done for gall bladder disease.Methods: A total of 161 cases of gall bladder lesions were evaluated from January 2017 to December 2018 which were sent to department of pathology. Specimens were fixed in 10% formalin. Appropriate areas were selected from the specimen and grossed, processed, sectioned, stained using haematoxylin and eosin and were observed under microscope.Results: Out of 161 cases, 105 were female (65.22%) and 56 cases were male (34.78%).Histopathologically, the most common diagnosis was Chronic calculus cholecystitis (57.76%) followed by chronic acalculus cholecystitis (22.36%). Remaining cases were of Acute on chronic cholecystitis (6.21%), Acute on chronic cholecystitis with cholelithiasis (4.96%), Acute on chronic cholecystitis with perforation peritonitis (1.24%), Acute suppurative cholecystitis with perforation peritonitis (0.62%), Biliary Atresia (1.24%), Chronic cholecystitis with choledochal cyst (1.24%), Follicular cholecystitis (1.24%), Adenocarcinoma (0.62%), Adenosquamous carcinoma (0.62%) and one case was inconclusive (0.62%).Conclusions: The incidence of chronic calculus cholecystitis was found to be 57.76% with female preponderance and mostly in third decade. Malignancy of gall bladder is a rare condition. Routine histopathological examination of all cholecystectomy specimens is strongly recommended for the detection of various variants of chronic cholecystitis and also of incidental carcinoma of gall bladder which helps in their treatment and prognosis.
Corneal ulcer: an epidemiological, microbiological and clinical study of cases attending Assam medical college and hospital, Dibrugarh, India
Authors: Baruah Mamoni , Das Rajiv Kumar , Agarwalla Vijaya , Basyach Pranami
Published: February 2020

Background: Corneal ulcer is one of the important ophthalmic conditions causing significant morbidity especially in the developing countries. This study was carried out to evaluate the common etiological agents, predisposing factors, age, gender and occupational distribution and to study the clinical features and management of all corneal ulcers.Methods: A total of 50 cases of corneal ulcers who attended the Ophthalmology outpatient department (OPD) of Assam medical college and hospital, Assam, India, over a 6 months period were included in the study. A detailed history was taken and examination done as per the proforma. Microscopy and culture were performed on all corneal specimens obtained.Results: Corneal ulcers were common in 3rd to 5th decades of life with Male to Female ratio of 1.3:1. Majority of patients were farmers or hired agricultural workers. Ocular trauma was the major predisposing factor in majority of cases (32%). Out of 50 cases, 31 (62%) were culture positive. 19 were bacterial isolates and 12 were fungal isolates. All patients were treated according to standard treatment protocol and majority (95.5%) patients responded well to treatment.Conclusions: This study has revealed that suppurative corneal ulcers are caused by both bacterial and fungal agents with bacterial preponderance in this geographical area. Early and accurate diagnosis and intensive treatment is the need of hour for saving the eye and preventing the catastrophe of lifelong blindness.
Laboratory and clinical profile of dengue: a study from coaching city, Kota, India
Authors: Jain Pankaj , Meena Om Prakash , Jelia Shivcharan
Published: February 2020

Background: Dengue, an endemic disease in most subtropical and tropical regions of the world and it causes severe epidemics in India. Dengue is one of the most common acute viral illness associated with considerable morbidity and mortality. The objective of this study was to study laboratory findings and clinical profile of patients with dengue fever at a tertiary care hospital of coaching city Kota.Methods: This study was cross sectional study. The patients were examined at one point of time and later they were never followed which is similar to the cross-sectional study design. A total of 100 patients of dengue fever who were NS1 Antigen or IgM dengue positive, admitted to department of medicine of government medical college, Kota included in the study. Through clinical examination and relevant laboratory investigations performed in all patients.Results: In the present study, there were 74 males and 26 females. The sex ratio was 2.8:1. Maximum number of males (50%) was in the age group of 15-25 Years. Among females the maximum (42.3%) were in the age group of 15-25 years. The most common presenting symptom was fever in all cases followed by headache in 96%. Among bleeding manifestation, Epistaxis, gum bleeding and melena (24%) were the common symptom. 47% patients showed hepatomegaly and 38% showed splenomegaly. 12% patients were anemic and 51% showed leucopenia while 93% showed thrombocytopenia.Conclusions: Males were commonly affected. Young age group of 15-25 was more commonly affected. Fever and headache were the most common presenting symptom. As dengue causes increased morbidity and mortality and requires prompt diagnosis and treatment for the proper management of these cases, this study helps physicians in early diagnosis of dengue by suspecting the features as of dengue and can prevent morbidity and mortality associated with dengue.
A randomized controlled study of intravenous esmolol to attenuate the cardiovascular responses to laryngoscopy and endotracheal intubation
Authors: Chodankar Ninad Deepak , Shivde Bhagyashree
Published: February 2020

Background: Objective is to compare the efficacy of intravenous Esmolol to attenuate the cardiovascular responses to laryngoscopy and endotracheal intubation with control group.Methods: Study was done on 60 adults, ASA grade I or II normotensive patients, undergoing elective surgery under general anaesthesia and willing to participate. These patients where be randomly allocated in to either group C (Control) or E (Esmolol). Group ‘C’ Control group. Group ‘E’, patients were given intravenous Esmolol 1.5 mg/kg 2 minutes before start of laryngoscopy. All patients were premedicated, induced and intubated using Thiopentone and Succinyl Choline as per the protocol. Heart Rate (HR), SBP, DBP and MAP were recorded at baseline (taken half an hour prior to anaesthesia), Before sedation, After induction but before intubation, Immediately after endotracheal intubation and Thereafter at 1, 2, 3, 4, 5 and 10 minutes.Results: Heart rate was lower in Group E as compared to Group C, and there was statistically significant difference immediately after intubation till 4 minutes after intubation. While Blood pressure was lower in Group E as compared to Group C, and there was statistically significant difference only immediately after intubation.Conclusions: In Normotensive patients requiring general anaesthesia with laryngoscopy and intubation, authors conclude that intravenous Esmolol 1.5 mg/kg attenuated Heart rate response but fails to satisfactorily prevent rise in blood pressure.
Amputation demographic assessment at Saiful Anwar hospital: 5 years of study
Authors: Persada Isma Satria Pandu , Irsan Istan Irmansyah , Purantoro Fiski , Putera Marvin Anthony
Published: February 2020

Background: Loss of limbs occurs due to different causes and has increased in many countries. This has large economic, physical and social impacts. This study investigates the demographics of patients undergoing amputation at Saiful Anwar Hospital Malang.Methods: This retrospective study was done from January 2014 to December 2018. The patient demographics included age, sex, organ amputation, etiology and amputation level. A total of 479 patients were studied in the study.Results: The average amputation value was 95.8 per year and varied from 72 to 134. The average age of the subjects was 44 years. Of all patients, 311 were male (64.93) and 168 women (35.07), 236 of amputations (49.27%) were major and 243 (50.73%) were minor.Conclusions: The main cause of amputation is trauma and most often is the amputation of the lower extremity. In trauma patients, the average age is 29 years. This result shows the same characteristic in the cause of amputation as in many other developing countries based on some studies. Trauma is the most common cause of amputation in Malang.
Functional outcome after total hip replacement following 30 years neglected posterior hip dislocation: a rare case report
Authors: Purvance Ivander , Dusak Wayan Suryanto , Putra Stanu Gusti Ngurah , Dewi Astawa Ni Made Puspa
Published: February 2020

Neglected traumatic dislocations of the hip is one of disabling condition in lower extremity which are seldom found in adults. However, in developing countries, neglected-unreduced traumatic dislocations are not uncommon. Total hip replacement (THR) still remains a recommendation for the treatment of neglected hip dislocation which occurs more than 3 months. A 45- years-old female came to the outpatient clinic complaining pain on her right hip with history of trauma 30 years before, but instead of seeking medical treatment, she went to bonesetter instead. On physical examination, there is 5 cm leg length discrepancy, and the patient walked with limping gait. Conventional x-ray confirmed persistent dislocation of the right hip. A soft tissue release procedure and femoral neck osteotomy with skeletal traction was done before, followed by delayed THR two months after. The patient’s functional status was improved, and the HHS score increased from 48 to 87. The patient had no pain or significant complaints, except for a finding of mild residual Trendelenburg gait.
Atypical pneumonia in an immunocompromised host
Authors: Shaylika Chauhan , Jawad Noor
Published: February 2020

Pneumonia is a common complication of patient with lung cancer. Various Pathogens have been reported to cause pneumonia in such patients, commonly involved organisms include bacteria (e.g. S. pneumoniae, Klebsiella spp., P. aeruginosa, S. aureus), virus (e.g. CMV, varicella zoster virus, respiratory syncytial virus, parainfluenza and influenza viruses), fungi (e.g.  histoplasmosis, cryptococcosis, pneumocystosis, Aspergillosis), opportunistic infections (e.g.  Aspergillus, Pneumocystis jiroveci) and this list is progressively growing. Here authors are going to discuss a rare case of 61-year-old male patient of lung cancer suffering from pneumonia caused by Chryseobacterium gleum, Stenotrophomonas maltophilia and Actinomyces naeslundii and its management. Since these organisms are rarely known to cause pneumonia, so whenever we encounter such patients while authors consider common pathogens, authors should also keep in mind rare organisms especially when the pt fail to respond standard treatment.
Borderline ovarian tumour of mixed seromucinous histology and bilateral presentation: a case report and review of literature
Authors: Anant Monika , Samanta Sutapan , Sinha Ruchi
Published: February 2020

This article reports the case of a 40 year old woman who presented to the gynaecologic outpatient clinic with pain lower abdomen and an abdominopelvic lump. Clinical assessment, biochemical and radiological investigations revealed bilateral complex ovarian masses. Surgical exploration and histology of ovarian masses confirmed a rare bilateral borderline seromucinous cystadenoma. The purpose of this paper is to highlight the importance of thorough examination of women with symptoms of ovarian tumour which can be vague and to emphasize the necessity of a good collaboration between various medical specialties (primary physician/gynaecologist, oncosurgeon, radiologist and histopathologist) for correct diagnosis, optimum care and best outcome. This article also provides overview of the pathology and biology of borderline ovarian tumours, diagnosis, principles of surgical management and to appreciate the value of follow up.
Pharmacological effects of Sesbania sesban: a systematic review
Authors: Walekhwa Michael Nyongesa , Ogeto Teresa Kerubo , Murithi Mary Kanyiri , Malago Zablon Lister
Published: February 2020

The cost, side effects and imitation associated with conventional drugs have driven a substantial number of global citizens to resort to complementary medicine. Although largely informal and unregulated, the practice of herbal medicine is more engrained in low and middle income than in industrialized countries. Sesbania sesban, a plant which grows generously across most parts of the world, has been a major target by most traditional health practitioners. The effects so far reported include antimicrobial, anti-fertility, anti-diabetic, anti-inflammatory among others. No study has reviewed the scholarly works published and jointly reported results. Authros systematically reviewed papers available in different databases to give a hybrid report on the pharmacological effects of Sesbania sesban. A total of three data bases were searched using key terms like: Sesbania sesban, ethno-botany, phytochemical analysis, pharmacological effects etc. A total of 860 papers were initially recovered and further subjected to abstract and title examination which filtered them down to 40 papers. The 40 papers were assessed more against a set of criteria like: in-vivo and in-vitro studies biased to pharmacological effects of the plant, studies that were less than 15 years old and studies that used experimental design. This further scrutiny reduced the number of papers to 25. Most studies reported Sesbania sesban as having great anti-microbial, anti-fungal, anti-inflammatory and anti-diabetic qualities. No study reported any adverse effect of the plant. Authors recommend a dose-effect assessment and mechanism of action of the plant extracts especially with regard to the antimicrobial, anti-inflammatory and anti-fertility qualities.