bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluating effectiveness of patient counseling, teach back versus standard method
Authors: Mathew Mary R. , Mohan Linu , Paul Mammen , Maideen Mahira , Jose Liya , Ommanakuttan Minnu
Published: December 2017

Background: The aim of the study was to assess memory retention of new prescription education by comparing Teach back method and standard counseling method. And also to evaluate association of age, sex, drug use in past and education in memory retention.Methods: A prospective experimental study was carried out for a period of six months. Eligible subjects visiting pulmonary medicine outpatient department were screened and grouped into standard groups and teach back group. Patients in the standard group are taught eight counseling points about the drugs by one way dialogue method and asked at the end if there are any questions. while patients in the teach back method builds on the standard method by asking three open ended questions to recall what was taught and correcting any misunderstandings by two way dialogue method.Results: The demographic information (age, sex, education, current prescription use) are collected from both groups. The post counseling score is assessed by evaluator using a scoring sheet. Scores were analyzed using Mann Whitney U test Teach back group shows statistically significant (p value = 0.0001) increase in score compared to standard group. The mean value of teach back scoring is 6.28 while that of standard is 4.44.Conclusions: All the demographic parameters (Age, sex, drug use in past three months and education) do not show any significant association with scoring and memory retention (p value >0.05 for chi square test). The group that received teach-back method of counseling showed a significant improvement in patient knowledge and memory retention.
Preclinical hematological profile studies of an ayurvedic medicine Siddha Makardhwaja after chronic administration to male sprague-dawley rats
Authors: Sikder Md. Mamun , Chakraborty Proshanta , Mahbub Md. Ruhul , Zulfiquar Tasniya Nahiyan , Neon Md. Nuruzzaman , Saha Nilay , Chowdhury Imtiaj Hossain , Choudhuri M.S.K.
Published: December 2017

Background: Siddha Makardhwaja (SMD) is a classical Ayurvedic formulation markedly used as a traditional medicine in the rural population for various purposes such as stimulant, tonic, and rejuvenator.Methods: The present study is conducted to evaluate the effect of conventionally prepared SMD on the hematological parameters in experimental animals, for providing scientific data base for its logical use in clinical practice. Acute toxicity tests were conducted to determine the LD50 of the drug. To find out the effect of chronic administration of SMD on hematological parameters it was administered chronically to the male Sprague-Dawley rats at a dose of 40mg/kg for 28 days.Results: In this experiment the TC, DC, various erythrocytic parameters, platelet parameters, ESR were determined. The results of the studies are given below. There is an (13.41%) increase in the number of white blood cell count of the male rat, the increase though not significant yet it was prominent (p=0.257). There is an (15.87%) increase in the absolute count of Neutrophils of the male rat, the increase though not significant yet it was prominent (p=0.371). There is an (12.29%) increase in the absolute count of Lymphocytes of the male rat, the increase though not significant yet it was prominent (p=0.388). There is a statistically significant (p=0.035) increase in the number of platelet count of the male rat (11.13% increase). There is a (2.03%) decrease in the platelet volume distribution width of the male rat, the decrease though not significant yet it was noticeable (p=0.094). There is a statistically insignificant (p=0.619) (10.0%) increase in Erythrocyte sedimentation rate in blood from the male rat.Conclusions: As SMD decreases and increases abnormally on the hematological parameters in body of treated rats, so it should not be administered chronically at a higher dose. Further studies should be done by reducing the administered dose.
Knowledge, attitude, perceptions and assessment of effectiveness of educational intervention on Pharmacovigilance among undergraduate medical students at Gulbarga Institute of Medical Sciences, Kalaburagi, India
Authors: Bagewadi Harish G. , Deodurg Priyadarshini M. , Patil B. V. , Dass Asha P.
Published: December 2017

Background: The Study was designed to assess the awareness of Pharmacovigilance and to evaluate the impact of an educational intervention.Methods: This was a questionnaire-based pre- and post-test educational interventional study. Students were given handouts containing information about pharmacovigilance one month before the educational intervention. A pre-validated 20-point questionnaire on (KAP) Knowledge, attitude, perception about Pharmacovigilance was distributed to second year medical students (n=115). An interactive educational intervention (Power point presentation) was designed. The chi-square test and unpaired paired t-test was used for statistical calculation.Results: The overall response rates were expressed as percentages, Mean±SD. The knowledge, attitude and perceptions of pharmacovigilance when compared before (pre-KAP) and after (post-KAP) the educational intervention, the correct response rates were found to be statistically significant (P<0.001). The feedback from the students was encouraging, handouts before the lecture classes helped them to easily grasp the pharmacovigilance concepts better during lectures.Conclusions: The study concluded that imparting the knowledge about pharmacovigilance and ADR reporting promotes drug safety and rational use of medicines in future.
Effect of agomelatine on psychomotor function tests in healthy human volunteers
Authors: Sirisha G. , P. Shovan
Published: December 2017

Background: Agomelatine is a melatonergic agonist that acts specifically on MT1/MT2 melatonergic receptors and 5-HT2C antagonism. The present study was taken up to evaluate the effect of Agomelatine 25mg on psychomotor function in healthy human volunteers.Methods: The effect of Agomelatine was studied in 12 healthy volunteers of either gender. The study was a randomised, cross over, placebo controlled study, done after obtaining permission from NIMS Institutional Ethics Committee and informed consent taken from all the subjects, after briefly explaining the study procedure and training them adequately. Psychomotor function was assessed using Choice reaction time (CRT), Critical Flicker fusion test (CFFT), Digit letter substitution test (DLST), Six letter cancellation test (SLCT), Card sorting test (CST) and Visual analog scale (VAS). Psychomotor function tests were performed, 90 minutes after administering Agomelatine 25 mg or placebo. Washout period of seven days was allowed between the cross over. Statistical analysis was done by comparing groups using unpaired t test.Results: There was significant decrease in the mean percentage of time (p<0.01) in CRT in Agomelatine group (20.09±9.47%) when compared to placebo (10.48±3.68%). Improved mean percentage of performance was seen in CFFT with Agomelatine (6.2±2.1%) compared to placebo (9.11±2.99%). No significant difference was noted in the performance of DLST, SLCT and CST. Drug was subjectively rated as sedative on VAS.Conclusions: There is no significant effect of Agomelatine on psychomotor performance. CNS processing of information also improved. Agomelatine can thus be safely administered to depressed patients.
Department of Pharmacology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh, India
Authors: Singh Vijay Kumar , Kushwaha Virendra , Agrawal Pooja , Gupta Ambrish , Kumar Amit , Chaudhari Dhananjay , Kumar Anand , Bindal Mahesh Chandra
Published: December 2017

Background: Lipid profile parameters may be used as biomarker for depression. Sertraline belongs to selective serotonin reuptake inhibitors (SSRIs), the most commonly used group to treat the depression in multidrug resistant tuberculosis patients.Methods: A prospective clinical trial was carried out in department of Psychiatry and department of Tuberculosis and Respiratory disease G.S.V.M. Medical College, Kanpur. Diagnosed MDR TB patients were screened for depression applying Hamilton Depression Rating Scale (HDRS) and these patients were referred to Psychiatrist for diagnosis of depression. Total 25 diagnosed patients of MDR TB with mild to moderate depression were selected. HDRS Score and morning blood sample of 5ml were collected to analyze biomarker for depression before intervention. Same test was repeated in 18 patients who completed the study at day 30 and 120 after administering Sertraline (50mg). Data were compiled and analyzed using SPSS 20.0 and paired t - test.Results: The mean decrease in HDRS score from base line at day 30 and 120 of administering Sertraline were 6.22 (±1.26) and 2.72 (±0.67) which were significant (p˂0.001). The mean increase in serum cholesterol at day 30 was 153.94 (±19.31) and at day 120 was 157.83 (±19.36) which were significant (p˂0.001). Rest of Tg, HDLc, LDLc and VLDL cholesterole levels were not increased significantly.Conclusions: As the depression symptoms improved by sertraline. The biomarkers of depression were also increased (within the normal range) from baseline but significant increase was observed in serum cholesterol only.
Comparative study to evaluate efficacy and safety of azilsartan and telmisartan in patients with grade I-II essential hypertension
Authors: Bhosle Deepak S. , Khan Sameer , Mubeen Mohd Faheem , Quazi Zubair
Published: December 2017

Background: Objectives of the study was to study the effect of Azilsartan 40mg once daily versus Telmisartan 40mg once daily in patients with Grade I-II essential hypertension.Methods: A prospective study was conducted at MGM Medical college and Hospital which included 80 patients in each group with Grade I–II essential hypertension. The sex, age, presenting illness, and family history of the patients were recorded. Investigations such as blood sugar, urine analysis, kidney function test, lipid profile, and ECG were performed before starting the treatment. Any adverse effects during the treatment were noted. Blood pressure was recorded at baseline and during follow-up. One group received Azilsartan 40mg once daily and another group Telmisartan 40mg once daily. Patients were followed-up every week for 5 weeks.Results: Patients receiving Azilsartan 40mg and Telmisartan 40mg showed a significant fall (P <0.05) in systolic (SBP) at the end of fifth week, when compared to baseline and diastolic blood pressure (DBP) significant fall at fourth and fifth week. The difference in fall in SBP and DBP was insignificant between the groups, after first, second and third week (P >0.05). Adverse effects such as Nasopharyngitis, Upper respiratory tract inflammation, Gastroenteritis, headache, dizziness, and fatigue were reported with both drugs.Conclusions: Reduction of blood pressure with Azilsartan and Telmisartan was similar, but fall in blood pressure from baseline was highly significant in both groups.
The health literacy level and eating behaviours of the teachers working at the city center of Eskisehir Turkey
Authors: Atay Emrah , Göktaş Saniye , Öztürk Emiral Gülsüm , Dağtekin Gökçe , Akbulut Zencirci Sevil , Aygar Hatice , Arslantaş Didem , Ünsal Alaettin
Published: December 2017

Background: The purpose of this study is to determine the level of Health Literacy of teachers who work at the city center of Eskisehir and to evaluate the relation with eating behaviors and some of possible related variables.Methods: This cross-sectional research study was conducted between 1st of March and 28th of April 2017 with the primary, secondary and high school teachers. Study group consists of 825 teachers who agreed to participate to the study. The Questionnaire form includes the socio-demographic variables of teachers, potential factors associated with the health literacy, Turkish Health Literacy Scale 32 (THLS-32) and The Three-Factor Eating Questionnaire.Results: The mean age was 41.91±8.80 years ranging from 22 to 65 years. The median score of the general index of the THLS-32 was found to be as 32.81 and 52.1% of our study population were found to be above the median score. The participants showed a negative correlation between the scores of ‘emotional eating’,‘uncontrolled eating’ scale and THLS-32, positive correlation between ‘cognitive restraint’ eating scale THLS-32.Conclusions: The health literacy level of teachers is important because of effecting both themselves and students. The teachers and the health care providers should collaborate on the topic more and they should be encouraged to participate in health related programmes.
The assessment of the knowledge and awareness about glaucoma in glaucoma patients and general population: a sample from Turkey
Authors: Dağtekin Gökçe , Demirtaş Zeynep , Soysal Aziz , Yildirim Nilgün , M. Önsüz Fatih , Metintaş Selma
Published: December 2017

Background: The study aimed to evaluate the level of knowledge and awareness of glaucoma and their possible determinants in a group of people diagnosed with glaucoma and in a population based group without glaucoma.Methods: The study included people with an age range of 40 to 80years; 410 patients without glaucoma who admitted to primary health care service and 113 patients who admitted to hospitals with diagnosis of glaucoma. In addition to Glaucoma Knowledge Level Questionnaire (GKLQ), participants were asked about their socio-demographic characteristics, level of awareness and resources of the information about glaucoma. Multivariate logistic regression and multiple linear regression analyses were used to assess the variants which have impact on the level of the awareness about glaucoma and to evaluate the factors effective on the score of GKLQ, respectively.Results: The ratio of awareness about glaucoma was found to be 64.1% in people without glaucoma. The knowledge and awareness about glaucoma were found to be higher in glaucoma patients compared to healthy people but not at a desired level. The education level was the only factor effecting both awareness and knowledge about glaucoma.Conclusions: As awareness about glaucoma can lead to early detection, the assessment of the knowledge and awareness about glaucoma is very important in terms of disease prevention. Health education and preventive health care services should be programmed including for both glaucoma patients and healthy people based on the level of their education.
The effect of 0.25% levobupivacaine and 0.25% ropivacaine in fascia iliaca block in elderly patients with fracture femur given before positioning for subarachnoid block
Authors: Gupta Neetu , Jain Pooja , Kapadia M. , Sanwatsarkar Sadhana , Saxena Dipti , Maheshwari Meghna
Published: December 2017

Background: Positioning of elderly patients with fracture femur for subarachnoid block (SAB) is a challenging task, both for the patient and anesthesiologist. Severe pain not only adds to the morbidity but also alters the success rate of SAB as appropriate positioning becomes difficult. Fascia iliaca compartment block (FICB) is a simple, rapid, effective and safe method for achieving excellent pain relief. The purpose of this study is to compare the efficacy of 0 .25% of levobupivacaine and 0.25% ropivacaine in FICB on reducing preoperative and postoperative pain and analgesic consumption in lower limb surgery.Methods: 60 elderly patients of ASA class I-III scheduled for elective fracture femur surgery were enrolled in the study and randomly divided into two groups. Group L received 30ml 0.25% levobupivacaine in FICB while Group R received 0.25% ropivacaine in FICB 15min before SAB. Parameters recorded were blood pressure, heart rate, visual analogous scale (VAS), quality of positioning and time to first rescue analgesia. VAS was noted before and after performing FICB and at the time of positioning for subarachnoid block (SAB).Results: The VAS score at different time interval and time to first rescue analgesia were comparable (P >0.05). Quality of positioning was also similar in both the groups (P >0.05).Conclusions: The study demonstrates that levobupivacaine and ropivacaine produce comparable preoperative and postoperative analgesia when used for FICB.
Distribution of illness of orthopaedic outpatient department in a tertiary care teaching hospital in West Bengal: a cross sectional study
Authors: Kum Ajayar , Dalai Chanchal Kumar , Banerjee Santanu
Published: December 2017

Background: Orthopaedic Outpatient Department (OPD) is an important part of health care system. Patients coming with different illness for treatment. Distribution pattern of illness represents the area from where patients come for treatment.Methods: Cross sectional, Observation Study. The patients who had willingly participated were enrolled on the basis of subject selection criteria. Prescriptions were collected from newly patients attending the Orthopaedics OPD. No follow up visit was done.Results: Male patients attended more than female gender (62% vs 38%). 18-30 years age group attended OPD much than another group (32.5%). Trauma is an important contributing factor (38.5%). History of trauma was seen more in male gender group and among 18-30 years age group. Low back pain is common problem. (29.5%).Conclusions: Low back pain is the common problem among patients attended Orthopaedic OPD. Trauma is an important contributing factor among 18-30 years age group.
Prospective study of skin adnexal tumours for a period of two years in a tertiary care hospital
Authors: Sanapala Sridevi , Suvvari Jagadeeswari , K. Seeram Satish , Kondapalli Mounika , Masa Suresh , Atla Bhagyalakshmi
Published: December 2017

Background: Skin adnexal tumours are rare tumours with complex histological patterns and variations and difficult to diagnose by histopathology only, so clinical history and presentation is necessary. The objective of the study was to correlate with age, sex, location, type of differentiation of adnexal tumours in our pathology department.Methods: The present study was a prospective study done in the department of pathology in Andhra medical college, King George Hospital, Visakhapatnam. A total of 51 cases were included in this study from January 2015 to December 2016. Specimens were formalin fixed and after adequately processing the sections were stained routinely with hematoxylin and eosin stain and properly evaluated for histopathological examination.Results: Out of these 51 cases, 88.24% (45 cases) were benign, and 11.76% (6 cases) were malignant tumours. Hair follicle differentiation were most common (35.3%) followed by sebaceous gland differentiation (31.37%) and sweat gland differentiation (29.41%).Conclusions: Benign adnexal tumours were most common than malignant tumours. Skin adnexal tumours are clinically often misdiagnosed, so histopathological examination remains gold standard for their correct diagnosis.
Changes in bone marrow in malaria-a prospective study of 47 cases
Authors: Rastogi Nupur , Rehman Neha
Published: December 2017

Background: Bone marrow aspiration done in cases of repeated fever, fever of unknown origin, pancytopenia to detect Malaria parasite in bone marrow.  The study was undertaken to evaluate the role of bone marrow aspiration in establishing the etiology of Plasmodium vivax in cases of pancytopenia or thrombocytopenia in recurrent fever or fever of unknown origin.Methods: Patients of different age groups presenting with recurrent fever or fever of unknown origin with pancytopenia or thrombocytopenia from Jan 2015 to Oct 2017. Out of the 108 bone marrow aspirations abiding the above criteria 47 showed presence of Plasmodium vivax trophozoites in bone marrow.Results: The age of patients varied from 8 months to 65 years. 47 cases showed presence of Plasmodium vivax trophozoites, mainly with hyperplastic marrow showing normoblastic and megaloblastic hyperplasia, presence of hemophagocytosis in 6 cases and also 2 cases showing increase in plasma cells.Conclusions: Bone marrow aspiration studies are of vital importance in diagnosing malarial infection in endemic areas as being one of the cause of pancytopenia or thrombocytopenia.
A study of deaths due to railway fatalities at a tertiary care hospital mortury 2015-16
Authors: Kumar P. Ravi
Published: December 2017

Background: Railway accidents according to the NCRB, 25,006 people died and 3,882 were injured in a total of 28,360 railway accidents across the country in last year. Railway crossing accidents like India has an extensive rail network with high levels of injury and violence.Methods: This study was conducted at Forensic medicine department, PIMS (pondicherry institute of medical sciences). The study group consisted of all the victims reporting to PIMS hospital Mortuary, during the period of study (January 2015-January 2016) were subjected to thorough post mortem examination and the pattern of injuries were noted.Results: A total of 300 postmortems, performed at the mortuary of the Dept. of Forensic Medicine, DMC during the period of January to December 2016, were studied. Of them 164 (54.89%) cases were of accidents, 72 (23.19%) cases were suicide, 54 (17.12%) cases homicide, 8 (2.46%) cases undetermined and 2 (0.80%) cases were of natural deaths. In this study accidental deaths were commonest, seen in (72.12%) cases followed by suicidal (20.63%) and least was homicidal seen in (7.16%) cases.Conclusions: Deaths have occurred in association with railway since the inception of railway in the present study males are commonest victims of railway deaths which concurs with studies conducted by other authors. Helpline numbers should be printed inside the coaches to inform the authorities in case of emergency. Railway should strictly implement the laws of railway acts and the people should be penalized for breaking the rules for the safety of passengers.
Undergraduate nursing students’ attitude towards mental illness: a cross sectional study
Authors: C. Sharma Ravi , D. Sharma Dinesh , Kanwar Neeraj , Kanwar Pankaj , Manta Santosh
Published: December 2017

Background: People suffering from mental illness commonly face stigma, bias, and discrimination by general public. Health care professionals are not immune to social biases and share the public's attitude meted out to people with mental illness. Nursing students are future health manpower. There are only few studies conducted on medical students’ attitude towards people with mental illnesses in India. We have planned this study to examine the undergraduate nursing students’ attitude towards people suffering from mental illnesses.Methods: It was a cross-sectional study. A total of 220 undergraduate nursing students were selected randomly with their consent to complete the Attitude Scale for Mental Illness (ASMI).Results: The nursing students were found to have a significant positive attitude towards mental illness in five of the six attitudes factors: Restrictiveness (8.42), benevolence (28.6) and stigmatization (7.3), separatism (15.6) and stereotype (9.4) However, these students had negative attitude in pessimistic predictions (12.5) domain as they rated this domain slightly on the higher side.Conclusions: Academic education in this field must be conceptualized and planned in order to favor the change of the attitudes that includes greater utilization of those teaching strategies that challenge beliefs and assumptions and promote a commitment to provide holistic care to people with mental illness.
Pattern of histopathological lesions in lung autopsy
Authors: Patel Chandni B. , Patel Komal , Bhagat Vasudha M. , Shah Pinkal
Published: December 2017

Background: A large number of pathologic conditions involve the lung parenchyma like inflammatory, neoplastic and others. The lungs are also involved in almost all terminal events of cardiovascular disease. Autopsy is an important and most useful way to find out the condition of internal organs and to evaluate any localized lesions or systemic disease and hence determine cause of death. Aims and objectives of study are to identify the histopathological spectrum of lung disease. To find out frequency of various lung pathologies in respect to age and sex.Methods: This study was retrospective and done on 649 cases of medico legal autopsies. The tissue specimens were fixed and processed. Routine paraffin sectioning was done followed by Hematoxylene and eosin (H and E) staining. Special stains were done whenever required. Relevant clinical and postmortem findings, gross and microscopic examination findings were recorded.Results: After thorough histopathological examinations, of total 649 cases, various pulmonary lesions were identified in 348(53.6%) cases while in 301(46.4%) cases no significant pathology was seen. Most commonly affected age group was 30-49 years 43.1% followed by age group of >60years 17.8%. Majority of diseased were male 285 (81.9%). Most common lung pathology found was Edema and congestion in 93 cases (26.72%), chronic venous congestion in 92 cases (26.44%) pneumonia in 65 cases (18.68%) followed by Tuberculosis/Tuberculous pneumonia in 29 cases (8.3%).Conclusions: In our population, the present study reveals that infectious disease are still the most common cause of mortality, despite recent advances in diagnostic technology, the autopsy has remained an important complementary tool for identifying and understanding pathology of disease.
Anatomical and congenital variations of human dry sternum bone: its embryogenesis and clinical implications
Authors: Chakravarthi Kosuri Kalyan , S. Siddaraju K. , Venumadhav Nelluri , Bali Sangeeta Atamaram
Published: December 2017

Background: The sternum is one of the skeleton parts with frequently detected variation in cross-sectional images or autopsy series. The anatomical or congenital variations of the sternum in the anterior chest wall may involve malignancies, injuries or severe traumas. The aim of the study was undertaken to evaluate the incidence of anatomical and congenital variations of human dry sternum bones.Methods: This study was carried out on 120 dry human sternum bones irrespective of age and sex at Varun Arjun medical college- Banthra, UP, KMCT Medical College, Manassery-Calicut and Melaka Manipal Medical College-Manipal. All the sternum bones were macroscopically inspected for the anatomical and congenital variations of human dry sternum bones. Photographs of the anatomical and congenital variations were taken for proper documentation.Results: Complete sternal foramina in the body of the sternum were noted in 9 bones (7.5%), with an average vertical diameter of 17mm and transverse diameter of 16mm (The highest vertical diameter of 19mm and transverse diameter of 17mm was noted); Incomplete sternal foramina in the body of the sternum were noted in 4 bones (3.3%);Complete sternal foramina in the xiphoid process of the sternum were noted in 7 bones (5.8%) with an average vertical diameter of 6mm and transverse diameter of 8mm; Unusual complete sternal foramina in the body and incomplete sternal foramina in the xiphoid process of the sternum were noted in 8 bones (6.6%); Very rare longer xiphoid process (7.3 cm) with complete sternal foramina was noted in 7 bone (5.8%); Unusual Longer xiphoid process with an average length of 6.7cm with sharp bifid ends was noted in 8 bones (6.6%).Conclusions: The knowledge of existence of anatomical variants and congenital foramina of sternum and xiphoid process found in our study is essential, especially for bone marrow sampling, radiology (X - ray, CT, MRI, and USG) reporting, pathology autopsy and forensic medicine post-mortem reporting and patoacupuncture practice to avoid complications during various surgical procedures.
Comparative study of harmonic scalpel haemorrhoidectomy versus conventional (milligan and morgan) haemorrhoidectomy
Authors: Mala Tariq Ahmed , Malla Shahid Amin , Shah Ajaz Ahmad , Kapoor Maria , Gupta Ved Bushan
Published: December 2017

Background: Haemorrhoids are dilated veins occurring in relation to the anus. There are various treatment modalities for haemorrhoids and among them surgical treatment is considered to be most effective one. Harmonic scalpel hemorrhoidectomy was compared with conventional in terms of symptomatic relief and complications.Methods: The aim of our study was to compare harmonic scalpel haemorrhoidectomy with conventional in terms of various intraoperative and postoperative factors for the treatment of grade III and IV haemorrhoids.Results: In our case study of 25 patients average time taken was 17.68 ± 2.84 minutes, while it was 28.44 ±3.69 minutes in control group. The mean blood loss was 8.96 ± 2.15 ml, 31.72 ± 3.28 ml in the case and control group respectively. Postoperative pain with VAS in case group on the first postoperative day was 5.92 ± 0.72, while it was 8.52 ± 0 in the control group. The dose of analgesia was less in case group. The postoperative wound site soakage was less in case study, early ambulation and return to normal work was faster in case study group.Conclusions: Harmonic scalpel haemorrhoidectomy is a simple, bloodless, safe and effective procedure in terms of blood loss, postoperative pain early return to routine work because of less lateral thermal injury.
Deep venous thrombosis in a patient with therapeutic INR for PS deficiency
Authors: Vamegh Motahareh , Hallak Ahmad , Abousherif Wael
Published: December 2017

We have reported a rare case of DVT in a 25-year-old patient with a known case of Protein S deficiency with INR within therapeutic index. He was seen in the ED and transferred to the Medical ward after diagnosis in the ED using doppler US. The patient was successfully treated with heparin and warfarin with a higher than usual optimal INR. This case adds to the growing evidence that PS deficiency is one of the rare causes of DVT, and also raises awareness that thrombosis can still occur in the current optimal INR for such patients. This case report necessitates the revision of what should be the optimal INR for patients with Protein S deficiency who develop thrombosis in the current optimal INR.
Gingival hyperplasia: anaesthetic implications
Authors: Chahar Shikha , Saxena Anupriya
Published: December 2017

Gingival hyperplasia can be divided in four sub categories: Inflammatory, hereditary, drug induced and associated with systemic causes. It can be localized or generalized. Gingival hyperplasia can cause difficulty in swallowing, speech and mastication, delayed dentition and poor aesthetics. Maintenance of oral hygiene plays a major role in all varieties of gum hyperplasia especially in inflammatory types, which poses a great challenge to anaesthesiologists as the gums are friable, tender and prone to bleed. We report successful management of a child posted for gingivectomy under general anaesthesia.
An anomalous engenderment of a common scenario: upper gastrointestinal bleeding
Authors: Vasa Tirth Nayan , Prabhu Mukhayprana , K. V. Rajagopal , Sahu Devavrata , Bhatia Harnish
Published: December 2017

Upper gastrointestinal bleeding (UGIB) includes hemorrhage originating from the esophagus to the ligament of Treitz. It is a gastrointestinal emergency that can result in significant morbidity, mortality, along with laborious utilization of health-care resources. With the advent of definite management protocols, the recent trends have revealed that patients rarely die from exsanguination, with decompensation of the underlying disorders, rather, proving to be causative of the same. Rapid assessment, resuscitation, and early endoscopic investigation serve as the foundation of early management. Common sinister underlying aetiology include Oesophageal Varices, Peptic Ulcer Disease, NSAID Induced Acute Gastritis or Malignancy. Arising from a conglomeration of aetiologies, an infrequent one, is a silently sinister pseudoaneurym rupturing into the stomach, stemming from a visceral artery. Since the first description by Beaussier in 1770, the condition has been detected with increasing frequency, primarily as a consequence of the increasing use of accurate imaging methods. Coeliac artery aneurysms (CAAs) occur in approximately 0.2% of the overall population and constitute approximately 4% of all visceral artery aneurysms (VAAs). Their risk of rupture is estimated at 10% to 15% and is associated with high mortality. Associated risk factors include atherosclerosis, hypertension, systemic inflammation, trauma, collagen vascular disease, infection, fibromuscular dysplasia, and cirrhosis
Extranodal (cutaneous) Rosai Dorfman: a rare presentation
Authors: Khadatkar Ashwini , Ghodake Nishant
Published: December 2017

Rosai Dorfman disease is a rare histiocytic disorder of unknown etiology commonly involving the cervical lymph nodes first described in 1969, Extranodal involvement is very rare. Clinical course is variable.
Burden of diabetes and hypertension among people attending health camps in an urban area of Kancheepuram district
Authors: Hariharan S. , Umadevi R. , Stephen T. , Pradeep S.
Published: December 2017

Background: Diabetes and hypertension are among the most common non-communicable diseases affecting our population. They are the important risk factors for cardiovascular morbidity and mortality. The aims and objectives of the study were to determine the burden of diabetes and hypertension among people attending health camps in an urban area of Kancheepuram district. Formulation of suitable preventive measures based on the inferences from the study.Methods: A cross- sectional record based study was done on 825 people attending medical camps conducted by Sree Balaji Medical College & Hospital, in Anakaputhur area of Kancheepuram district. The data regarding Random Blood Sugar (RBS) level, blood pressure level, age, and gender were collected from the camp register (January and February, 2017). A random blood sugar (RBS) value of >200 mg/dl in a patient with classic symptoms of hyperglycaemia or hyperglycaemic crisis was defined as having diabetes. Blood pressure level equal to or greater than 140/90mm Hg was defined as having hypertension. Descriptive analysis and Chi square test was done to see the statistical association between various parameters. Results: Of the total study population of 825 people, 215 were males and 610 were females. The overall burden of diabetes and hypertension among the study population was 10.7% and 6.4% respectively. Co-existence of both diabetes and hypertension was seen in 5.7% of people. Conclusions: To reduce the disease burden due to diabetes and hypertension, primary prevention measures such as health education regarding adoption of healthy lifestyle should be instituted. Interventions such as screening and early initiation of treatment should also be made for controlling the diseases and preventing its complications.
Study of uropathogenic Escherichia coli with special reference to its virulence factors
Authors: Kaira Sanjay Singh , Pai Chitra
Published: December 2017

Background: Urinary tract infection (UTI) is one of the most common nosocomial infections, caused by Escherichia coli. UPEC differ from non-pathogenic E. coli by the production of specific virulence factors which enable the bacteria to adhere to uroepithelial cells and to establish UTI. The aim of this study is to check the virulence factors of uropathogenic E. coli.Methods: A prospective study conducted in the Department of Microbiology of a tertiary level hospital in Mumbai over a period of one year (February 2011 to February 2012). A total of 123 Urine samples received in the laboratory were processed as per standard microbiological procedures to look for virulence factors like hemolysin, hemagglutination, cell surface hydrophobicity and gelatinase production. Results: Out of 123 patients 69 (56.09%) cases were from females and 54 (43.90%) were males. Thus female: male ratio was 1:3. Hemolysin production was seen in 27.64%, hemagglutination in 53%, cell surface hydrophobicity in 27.64%. Conclusions: UTI is more common in middle aged females and in community set-up. The knowledge of virulence factors of E. coli will help in better understanding of the organism pathogenicity and guided empirical therapy can result in better treatment outcome.
A community based study of breast feeding and weaning practices among mothers in urban field practice area of SRTR, GMC, Ambajogai
Authors: Shaikh Mohammed Rehan , Nagaonkar A. S.
Published: December 2017

Background: Mother’s milk is the best gift nature has provided. Practicing exclusive breastfeeding for 6 months is the simplest, healthiest and least expensive feeding method that fulfills the infant’s needs for nutrition and growth. Breast feeding is a common practice in India but factors influences breast feeding practice such as gender inequity, lack of knowledge, social pressure, pre-lacteal feed, illness among the lactating mother etc. Study of socio demographic factors and pattern of breast feeding and weaning practices in urban field practice area.Methods: A cross-section study was conduct in Urban Health Center of Govt. medical college and hospital of Ambajogai, Maharashtra. Mothers who are having a child between 0-24 months of age of both sexes were included in this study and interviewed.Results: Out of 193 women’s, most of the mothers were aged less than 25 years (78.04%) and were Hindus (73.9%). Most were illiterate (68.30) and belonged to the class V (97.5%), majority were housewives (99.1%) and multiparous (68.2%). Most had initiated breastfeeding (78.8%) within 24 hours of delivery. About 15.4% of the infants did not receive colostrums and 22.8% of the infants were not exclusively breastfed. Ghutti (water mixed with honey and herbs), boiled water, tea, and animal milk were commonly used pre-lacteal feeds.Conclusions: Despite higher rates of early initiation of breastfeeding and exclusive breastfeeding, awareness of the benefits of exclusive breastfeeding was low. Indicates need to promote awareness of the correct method of infant feeding and care of the newborn.
Prevalence and outcome of anaemia among pregnant women attending tertiary care hospital in Visakhapatnam
Authors: Paladugu Radha Kumari , Pentakota Srinivas Jagath , N. Sushma
Published: December 2017

Background: Anaemia in pregnancy is now considered as a major public health problem, caused by iron deficiency. WHO has estimated that prevalence of anaemia in developed and developing countries in pregnant women is 14% in developed countries and 51 percent in developing countries and 65-75% in India. Various programmes regarding anaemia prophylaxis and maternal health have been implemented but still the prevalence of anaemia related complications among pregnant women continues to be high. Hence the present study was conducted to study the prevalence and pregnancy outcome as a result of anaemia in a tertiary care center in Visakhapatnam. Methods: A cross sectional descriptive study was carried out from June 2016 to August 2016 in the Department of Obstetrics and Gynecology among postnatal women in King George hospital, Visakhapatnam. A semi-structured questionnaire was prepared and information regarding age, socioeconomic status, parity, gestational age interval between pregnancies and outcome and complication of pregnancy were collected. Results: Mean age of study population is 22.4 years. Out of 100 women involved in the study 65 are from urban areas 29 from rural areas and 6 from tribal areas. Majority of the study population 66% were having HB% between 8-11% i.e. mild anaemia. When Outcome of pregnancy was seen in relation to anaemia majority of the women had live births (90%) followed by 7% IUDs and 2% still births. Conclusions: Majority of the women are in the age group of 20-24 years. Socioeconomic status is directly related to anaemic status of the women. Majority of the women had complication of puerperal sepsis.
Nutritional status of the geriatric population in the field practice area of a medical college in Rajasthan
Authors: J. Gandhi Shreyashkumar , Choudary Mahesh Kumar , Kumar Rupesh , Bhatnagar Dinesh
Published: December 2017

Background: Ageing is a physiological process that starts from birth, continues throughout life, and ends with death. Poor nutrition is not a natural concomitant of ageing; older adults are at risk for malnutrition due to physiological, psychological, social, dietary, and environmental risk factors. The objectives of the study were to assess the nutritional status of elderly living in rural India and to study the factors related to nutritional status.Methods: Community-based cross-sectional study was undertaken in the field practice area of Pacific Medical College and Hospital, Udaipur, Rajasthan. Predesigned and pretested questionnaire and nutritional status were assessed using mini nutritional assessment scale for elderly people. Results: Out of the total 152 participants, 2 (1.3%) were having BMI less than 19, 11 (7.2%) were having BMI 19 to less than 21 and 43 (28.3%) were having BMI 21 to less than 23. Out of 152 participants, 30 (41.1%) males and 43 (54.4%) females were at risk of malnutrition. Six (8.2%) males and 5 (6.4%) females were suffering from malnutrition. However, the association of gender and nutritional status of elderly was not found to be statistically significant (p=0.258). Conclusions: Due to the high prevalence of elderly who were malnourished or at risk of malnutrition, a more detailed evaluation, regular follow up & dietary intervention to reverse the situation is required.
Our voice on gender discrimination: adolescent girls
Authors: Malenahalli Chandrashekarappa Smitha , Kadiyala Prathyusha , . Nagendra , M. R. Narayana Murthy
Published: December 2017

Background: Gender equality has been one of the goals (Goal 3: promote gender equality and empower women) in Millennium Development Goals (MDGs) as well as Sustainable Development Goals (SDGs) (goal 5: gender equality) which emphasise that gender discrimination remains a major barrier to human development. As gender socialization begins early in India, it is necessary that awareness must start in childhood and adolescent age on gender equity. This study aimed to assess gender discrimination experienced by the adolescent girls at home and surroundings which help to understand the persistence of gender discrimination and to access association of socio-demographic and family characteristics with gender discrimination.Methods: It is a cross-sectional study. Data was collected using a pre-structure pre-tested questionnaire. Information on socio-demographic profile was also collected. Purposive sampling was used and a total of 236 late adolescent girls (16-19 years) were included in the study, from PU and Degree colleges of Mysuru District, each from Urban, Rural and Tribal areas. Data collected was analysed using SPSS V.22. Descriptive statistics like mean, Standard deviation, proportions were used and inferential statistics like Chi-square analysis was used to know the association of socio-demographic variables with Gender discrimination.Results: Among the study participants 47% of adolescents experienced a moderate level of gender discrimination (score >29), 1% experienced severe gender discrimination (score >34). Age, residence, subject that they pursue and education of father were found be significantly associated with gender discrimination.Conclusions: A total of 48% late adolescents experienced either a moderate or severe gender discrimination.
An evaluation: IYCF practices in rural area of Bareilly district, Uttar Pradesh
Authors: Agarwal Medhavi , Joshi H. S. , Tanwar Ruchi , Singh Arun , Katyal Rashmi , Upadhyay Deepak
Published: December 2017

Background: In recent Annual Health Survey conducted in India from 2010 to 2013 covering all the 284 districts (as per 2011 census) of 8 Empowered Action Group (EAG) States (Bihar, Uttar Pradesh, Uttarakhand, Jharkhand, Madhya Pradesh, Chhattisgarh, Odisha and Rajasthan) and Assam, only 21% of breastfeeding and non-breastfeeding children are fed in accordance with the infant and young child feeding (IYCF) recommendations thus this study was taken up to evaluate the infant and young child feeding (IYCF) recommendations practices in Bareilly district of U.P. Objective is to evaluate the infant and young child feeding (IYCF) practices in rural area of Bareilly district, U.P.Methods: Community based Cross sectional study was conducted using 30 by 7 cluster sampling technique in rural area of Bareilly district, Uttar Pradesh from August 2017 to September 2017 in all children of age 1 year residing in the study area. Sample size was 210.The results were compiled and analyzed in Epi info-7.2.Results: In this study­ 69.5% children were put to breast feeding with in 1 hour of birth. Prelacteal feed was given to 20.5% of studied population.Conclusions: There have been considered developments in the status of IYCF practices in Bareilly as compared to National Family Health Survey-3 at national level yet the scope for further progress is substantial.
A study on maternal and perinatal risk factors of cerebral palsy among children attending a cerebral palsy clinic in Visakhapatnam
Authors: Soumya V. , Madhavi K. V. Phani , Madhavi B. Devi
Published: December 2017

Background: Cerebral palsy (CP) is a disorder of movement and posture, defined as an “umbrella term covering a group of non-progressive, but often changing, motor impairment syndromes secondary to lesions or anomalies of the brain arising in the early stages of its development”. Risk factors for CP include maternal infection, placental insufficiency, gestational diabetes, pregnancy induced hypertension, instrumental delivery, low birth weight, hypoxic ischemic injury, hyperbilirubinemia, metabolic abnormalities (hypoglycemia). The families are affected psychologically, financially and socially. It also imposes burden on national health system. The objective of the study was to study the distribution of maternal and perinatal risk factors of cerebral palsy among children attending a cerebral palsy clinic in Visakhapatnam.Methods: A retrospective cohort study was conducted by eliciting history from the mothers of 90 cerebral palsy children who were treated in cerebral palsy clinic, Visakhapatnam, Andhra Pradesh, India for a period of 6 months in 2016. After taking consent, data was collected using a pretested questionnaire. Detailed history was taken from the mothers of 90 cerebral palsy children regarding the period of gestation at which the child was born (preterm or full term), any previous history of pre-term delivery or abortions and neonatal complications was obtained from the care givers. Data was entered into MS-excel sheet and analysed by using SPSS Trial Version 20.Results: Total numbers of study subjects were 90, out of which 58 were boys and 32 were girls. Around 38% of study subjects were born out of consanguineous marriage. As per the records available, only 7% of mothers had gestational diabetes. It was found that 13% study subjects were preterm, 22% had low birth weight, 24% had perinatal hypoglycaemia, 33% had neonatal jaundice and 33% had birth asphyxia.Conclusions: Consanguinity, birth asphyxia, neonatal jaundice are found to be the important risk factors for Cerebral Palsy in our study which can be avoided by improving maternal and paediatric health services.