bluuebunny/crossref_metadata_2025 huggingface dataset:
Cirrhosis of liver is a risk factor for gallstone disease
Authors: Shirole Nikhil U. , Gupta Sudhir J. , Shah Dharmesh K. , Gaikwad Nitin R. , Sankalecha Tushar H. , Kothari Harit G.
Published: April 2017

Background: Gallstones are common clinical finding in general population. Mean prevalence rate in Indian population is 4-5%. The prevalence of gallstones is found to be high in cirrhotic patients compared to the general population in some western studies. Cause of this increased prevalence however is not known. Aim of the study was to evaluate prevalence of the gall stones in the cirrhotic patients, assess risk factors in cirrhotic patients and clinical presentation.Methods: This is the cross sectional observational study, included cirrhotic patients (compensated or decompensated). Risk factors for gallstone formation (age, gender and diabetes mellitus), characteristics of liver cirrhosis (etiology, Child Turcotte Pugh class, hypersplenism and varices) and clinical presentation were assessed in all cirrhotic patients with gallstones.Results: 336 patients with liver cirrhosis are included in this study; 201 (59.80%) male and 135 (40.2%) female. Mean age of the patients is 44.95±13.1 years. Overall prevalence of gall stones was 12.8% (43/336). Out of 43 patients, 23 (53.5%) are male and 20 (46.5%) are female. As child status progresses from A to B to C, prevalence of gall stone increases, with 60.46% (26/43) of gall stones occurring in the patients with CTP class C. Only 8 (18.6%) patients had gallstone related symptoms while rests were asymptomatic. 5 (11.6%) had concurrent CBD stones. Cholecystectomy was possible in only 2 patients with symptomatic gallstones.Conclusions: The prevalence of gall stones in cirrhotic is higher than general population which increases with the severity of liver cirrhosis. Most cirrhotic patients are asymptomatic for gallstones.
Assessment of trend and etiological factors for cesarean delivery among women residing in Ahmedabad, Gujarat, India
Authors: Govani Kapil J. , Jogia Priyanka D.
Published: April 2017

Background: Cesarean section (CS or C-section) is a surgical intervention and it is the 2nd commonest surgery performed on women in India after tubectomy operation. So, the study was conducted with objectives to assess the socio-demographic profile of recently delivered women and to assess the trend and etiological factors of cesarean delivery among women.Methods: A cross sectional study was conducted among recently delivered women of Ahmedabad city, Gujarat, India during April to September 2015. Pretested performa was used for study after informed consent. Total 200 women were selected for study.Results: Majority (56%) of women were belongs to 25 to 30 year. age group. Few (5%) of women were found illiterate. 31% women were delivered through cesarean section. Majority (63.5%) of women were delivered at Government hospitals. Most common reason (23%) for cesarean delivery was previous history of LSCS. Most preferred (33%) first choice of contraceptive method was barrier method.Conclusions: Commonest reasons for cesarean deliveries were previous history of LSCS, Oligohydramnios and prolonged labor. Most preferred first choice of contraceptive method was barrier method followed by Oral Contraceptive pills.
Candidemia in neonatal intensive care unit: a cause of concern
Authors: Yadav Sarita , Dahiya Shalley , Budhani Diksha
Published: April 2017

Background: Candidemia in neonates is a serious and common cause of late onset sepsis. Candida species are the third most frequent organism isolated in late onset sepsis in very low birth weight (VLBW) infants (i.e., <1,500 g). Methods: This study was performed to evaluate epidemiology, species distribution, antifungal susceptibility and outcome of candida blood stream infections at a tertiary care centre.Results: About 1-2 ml of blood was collected aseptically in suspected cases of septicaemia and inoculated in 20 ml of Brain Heart Infusion(BHI) broth. Candida species isolates were confirmed by germ tube production, chlamydospore formation on corn meal agar(HiMedia), pigmentation on Hichrome Candida differential agar (Himedia), and carbohydrate assimilation tests. Non-albicans candida spp. are of special concern, due to their high virulence and low azole susceptibility characteristics, augmenting the high mortality rates.Conclusions: The emergence on non-albicans Candida merits attention as they display higher degree of resistance to azoles and are associated with higher mortality rates. Additional studies are required to define more accurately the prevalence and sensitivity pattern of Candida spp. which may serve as a template for development of preventive and therapeutic strategies for neonatal candidemia especially at peripheral health centres.
Surgical resection for hepatic space occupying lesions: a histopathological analysis
Authors: M. Vani , Kachappilly Jeena Sam , K. Geetha
Published: April 2017

Background: Hepatic resections are done for both neoplastic and non-neoplastic diseases of liver with malignancies constituting a major share of cases. The objective of this study was to assess the various neoplatic and non-neoplastic lesions in hepatic resection specimens and to categorize the various histopathological types of primary and secondary liver tumors.Methods: The study was conducted in the Department of Pathology, Academy of Medical sciences, Pariyaram. This was a hospital based study which included 79 patients who underwent hepatic resection for space occupying lesions over a period of 5 years from January 2012 to December 2016. IHC was performed in cases with diagnostic dilemma.Results: Of the 79 cases, there were 45 males and 34 females with the age range of 22-85 years. There were 70 neoplastic lesions out of which 11 were benign with 6 cavernous hemangiomas, 3 hepatic adenomas and one each of intraductal papillary neoplasm and mucinous cystic neoplasm. Among the 59 malignant lesions, hepatocellular carcinomas predominated followed by metastatic malignancies and cholangiocarcinomas. Of the metastatic malignancies, adenocarcinoma from gastrointestinal primary was the commonest followed by metastatic gastrointestinal stromal tumor.Conclusions: Liver is a frequent site for many neoplastic and non-neoplastic diseases with malignant neoplasms forming the major bulk. Non-neoplastic lesions like simple liver cysts and focal nodular hyperplasia showed female predominance while benign neoplasms like cavernous hemangioma and hepatic adenomas were seen exclusively in females. Of the malignant liver tumors, hepatocellular carcinoma was the commonest followed by metastatic malignancy, gastrointestinal tract being the commonest source of primary tumor.
Solitary Langerhans cell histiocytosis of liver with sclerosing cholangitis in an adult female
Authors: Kader Nazneen A. , S. Indusarath , Supriya N. K.
Published: April 2017

Liver is affected as a late complication of high risk cases of Langerhans cell histiocytosis. Sclerosing cholangitis is a rare pattern associated with Langerhans cell histiocytosis of liver, which is even rarer in the adult population and has high mortality. The treatment is difficult and may require liver transplantation. We report a unique case of a 40-year-old female who developed sclerosing cholangitis associated with Langerhans cell histiocytosis without any evidence of involvement of other systems. Our patient required only surgery, and had been followed up for two years without recurrence. We could not find any other case of solitary liver involvement of Langerhans cell histiocytosis in literature published so far.
Mediastinal tuberculosis in adult: case report
Authors: Singh Gurminder , Joshi Neeraj , Garg Robin , Garg Sudhanshu
Published: April 2017

Mediastinal lymph node enlargement commonly seen in sarcoidosis, lung cancer, lymphoma and tuberculosis in children’s. Tuberculosis in adult mostly involve parenchyma of lung and very rarely involve mediastinal lymph nodes, here we report a 27-year-old male, non-diabetic, non-hypertensive, non-alcoholic and non-smoker who present with low grade fever and dry cough. Search for the cause of morbidity revealed him to be suffering from mediastinal tuberculosis. He was treated for tuberculosis with ATT.
Middle lobe syndrome- a rare but an important clinical entity
Authors: Dsouza Moses Charles , Shivappagoudar Vikram M. , Spurthi . , Mallela Laviena
Published: April 2017

Middle lobe syndrome refers to a clinical condition that is characterized by recurrent or chronic collapse of the middle lobe of the right lung. Inefficient collateral ventilation, infection and inflammation in the middle lobe or lingula are thought to play a role in the pathogenesis of this condition. MLS can be obstructive or non-obstructive; the management varies according to the aetiology. Patients with proven endobronchial lesions or malignancy are usually offered surgical resection while most patients with non-obstructive aetiology respond to medical treatment consisting of bronchodilators, mucolytics and broad-spectrum antibiotics. We present a case of MLS who was managed conservatively in our ICU but did not respond and required surgical intervention later.
Knowledge and attitude concerning Autism Spectrum Disorder (ASD) among Taif Medical College students Kingdom of Saudi Arabia
Authors: Helmy Farihan Farouk
Published: April 2017

Background: To Assess the knowledge about childhood ASD among second and sixth year medical students in Taif medical college KSA.Methods: The cross-sectional descriptive study was conducted in medical college - Taif City, KSA-from September to December 2016. All students of second and sixth year present at time of data collection were included in our study. Data collection was done by Knowledge About Childhood Autism Among Health Worker questionnaire from second and sixth year medical students. Data was analyzed using SPSS 20.Results: Second year (Group A) out of 163 students who completed the study 88 (54.0%) males, and 75 (46.0%) females, regarding sixth year (Group B) total respondents were 84 students 44 (52.4%) males and 40 (47.6%). The mean score of questionnaire assessing knowledge for group B was (8.99±1.91) which was statistically significant higher than group A (6.44±2.24) p=<0.001*. Also the attitude score for group B (3.92±0.97) was statistically significant higher than group A (3.29±1.33) p=<0.001*. Moreover, there was a significant correlation between total overall knowledge and attitude of our study sample p= <0.001*Conclusions: Medical students curriculum should include information about ASD allowing them better screening, early diagnosis, thus better prognosis.
A study of short term outcome of late preterm babies
Authors: Tamil Selvan , P. Saravanan , S. Nagaraj M. , Tudu Mrigendra Nath
Published: April 2017

Background: Late preterm babies born between 34 to <37 weeks of gestation are associated with adverse short term and long term outcomes and an increased burden on health care. Aim was to study the short term outcome of late preterm babies in comparison with term babies and to study the maternal risk factors involved in late preterm.Methods: Prospective and descriptive study was conducted on the late preterm babies born at SIMS & RC over a period of 15 months from October 2015 to December 2016. Cases included were late preterm newborns and control was term newborns.Results: Among late preterm babies, the common maternal risk factors observed was PIH in 35.3% (40/113), antepartum haemorrhage in 20.3% (23/113) and PPROM in 19.4% (22/113) of the cases. Based on gestational age, majority of them were between 35≤36 weeks in 38.9% (44/113). Based on birth weight, most of them were between 1.5-2.5 kg in 85.8% (97/113). Among gender majority of them were males in 56.6% (64/113) of the cases. Late preterm babies had more morbidities and mortality compared to term babies. The common morbidities observed were jaundice in 63.7% (72/113), feed intolerance in 28.3% (32/113), hypoglycemia in 27.4% (31/113) and sepsis in 22.1% (25/113) of the cases when compared to term babies jaundice were noted in 62% (1228/1978), sepsis in 5.7% (113/1978), hypoglycaemia in 3.4% (68/1978), respiratory distress in 3.1% (63/1978) of the cases respectively. The late preterm mortality was 1.7% (2/113) compared term mortality of 0.45% (9/1978). Overall late preterm mortality rate was 0.86% (2/2311) compared to term which was 3.89%(9/2311) of the total live births.Conclusions: This study shows morbidity and mortality was high in late preterm babies compared to term babies with significant maternal risk factors.
A study of the etiology and short term outcome of status epilepticus in children
Authors: Selvan Tamil , V. Nagaraj M. , P. Saravanan , Tudu Mrigender Nath
Published: April 2017

Background: Convulsive status epilepticus is the most common childhood medical neurological emergency, and is associated with significant morbidity and mortality. Most data for this disorder are from mainly adult populations and might not be relevant to childhood. This study was done to obtain a uniquely paediatric perspective. The objective of the study was to the etiology and short term outcome of patients admitted with status epilepticus between the age group 1 month to 12 years at a medical college hospital.Methods: Study design: Prospective descriptive study. Study Place: Department of Paediatrics, SIMS and RC, Bangalore, India. Study population: All children in the age group of 1 month to 12 years admitted with status epilepticus. Sample size:66. Study period: From January 2016 to December 2016.Results: Prevalence of status epilepticus among children admitted in this study was 8.7%. Most common age was found to be 1-3 years (54.5%). Preponderance of male (51.5%) over female (48.5%) was observed. The two most common etiology observed was Atypical febrile seizures (33.3%) and meningitis (22.7%). 57.5% children presented as first episode of seizure and duration of seizure was less than 2 hours in 65.1%.In our study, short term mortality rate was found to be 3% and morbidity was found to be 9% and meningitis was responsible for all the deaths. The mortality and morbidity in the form of neurodeficits were observed between the age group of 1 month to 3 years. Based on the duration of seizure lasting more than 8 hours, two third had mortality and one third had morbidity.Conclusions: Status epilepticus is a severe life threatening emergency with substantial morbidity and mortality. Major causes were due to atypical febrile seizure and meningitis. Patients with younger age, male sex and seizures lasting longer duration had higher mortality and morbidity, predicting the poor outcome.
Study of hepatic dysfunction of dengue fever in children
Authors: Selvan Tamil , P. Saravanan , M.V. Nagaraj , Tudu Mrigender Nath
Published: April 2017

Background: Dengue is a major international health concern that is prevalent in tropical and sub-tropical countries. It is estimated that worldwide nearly 2.5 billion people continue to live at risk of contracting the infection while 50 million cases and 24,000 deaths tend to occur in 100 endemic countries. Hepatic dysfunction is common in dengue fever and the degree of liver dysfunction in children varies from mild injury with to severe injury.Methods: Prospective and descriptive study was conducted on all the laboratory confirmed cases of dengue fever in children admitted at SIMS and RC over a period of 1 year from Dec 2015 to Nov 2016 both clinically and biochemically.Results: This study reveals, the prevalence of hepatic dysfunction in 30.6% (174/568) of the cases. Among the gender and age, majority of the hepatic dysfunction were seen in males 55.7% (97/174) and in the age group of 10-18 years 44.2% (77/174). Based on the severity, majority of hepatic dysfunction was seen in severe dengue cases 59.2% (103/174). Among clinical findings, most common symptom was jaundice 27.5% (48/174) and commonest sign was hepatomegaly 39.6% (69/174). The commonest liver function test altered was AST level in 45.4% (79/174) of the cases. Commonest abdominal USG finding was gall bladder edema in 90.8% (156/174) of the cases. The mortality was nil in this study.Conclusions: This study concludes prevalence of hepatic dysfunction was seen 30.6%, most of them seen in severe dengue 59.2% of the cases suggesting any febrile child with hepatic dysfunction, dengue infection should be suspected.
A clinical study of incidence and etiology of apnea in newborn
Authors: L Rajith M , R. Punyashree
Published: April 2017

Background: Apnea, defined as cessation of breathing resulting in pathological changes in heart rate and oxygen saturation, is a common occurrence especially in preterm neonates, apnea is not a disease and is a symptom of various diseases that affect neonates. Aim was to know the incidence and etiology of apnea in newborn in Indian setup.Methods: All admitted neonates who developed apnea is documented to know the incidence and selected cases were retrospectively studied to know the etiology.Results: Incidence of apnea was 19.92%, hypoxic ischaemic encephalopathy and sepsis 25.67% each were the common etiologies.Conclusions: Occurrence of apnea definitely reflects the mortality rate in newborns. Incidence of apnea in general and apnea in term newborns in particular are significantly more in comparison with western data. The association of HIE and Sepsis, the potentially preventable causes, perpetuates the incidence of term apnea reflecting the bad obstetric care, poor infrastructure, illiteracy, poor health seeking behavior affecting the child health antenataly, nataly and post nataly. Incidence of apnea in premature newborns is almost comparable to western studies. The primary apnea which is the most common cause, is an uncontrollable entity affecting similarly the newborn community of developed and developing world. India’s taboo of having high infant mortality is once again reflected in the study.
Increasing trend in pediatric scrub typhus admissions in a tertiary care hospital, South India: Clinical profile and outcomes of cases over four years, 2011-2014.
Authors: K. Gandhimathi , Thekkur Pruthu , Majella Marie Gilbert , Selvaraj Kalaiselvi , Chinnakali Palanivel , Adhishivam Bethou , Bhat Vishnu B
Published: April 2017

Background: In developing countries, clinical profile based empirical treatment is practiced for treating pediatric scrub typhus cases. Knowledge on pattern of symptoms and signs will help in early initiation of specific treatment. This study was aimed to describe clinical profile and trends in admissions of pediatric scrub typhus cases in a tertiary teaching hospital.Methods: A record based cross sectional descriptive study was conducted among all clinically diagnosed scrub typhus pediatric (<13 years of age) cases admitted between 1st January 2011 and 31st December 2014 in a tertiary teaching hospital, South India. Data on symptoms, signs, laboratory findings, treatment and outcome were extracted from clinical case records. Data were entered and analyzed using Epi Data software.Results: Of the total 228 cases, 124 (54.4%) were males, 131 (57.4%) were less than five years of age and 88% were from rural areas. Fever (100%), vomiting (61.2%) and cough (54.8%) were the most common symptoms. Hepatomegaly (88.6%), splenomegaly (64.5%), lymphadenopathy (48.7%), edema (43.4%) and eschar (38.6%) were the common signs observed. Anemia was present in 122 (59.8%) and thrombocytopenia in 75 (33.3%) children.  Only one child (0.4%) died.  There was an increasing trend in proportion of scrub typhus cases to overall admissions from 1% to 2.2% over four-year period (2011-2014). More cases were admitted between the months of September and January.  Conclusions:Scrub typhus contributed to significant pediatric admissions in the tertiary care centre with an increase in cases over years. Treatment with doxycycline or azithromycin showed good response and mortality was very low
Factors influencing primary immunisation in and around Davangere District: hospital based study
Authors: D. V. Veeresh Babu , S. Latha G. , P. Mallikarjuna G.
Published: April 2017

Background: Infectious diseases are major cause of mortality and morbidity in children. Immunisation is one of the cost effective and easy method of child survival. Universal immunisation of children against a common vaccine preventable diseases have been a goal of universal immunisation programme, but it remains to be done currently. Success of immunisation programme depends on understanding of the reasons for not immunizing a child, so present study was undertaken. The objective of present study was to find out the immunisation status and various reasons for partial or non-immunisation of child to assess the factors associated with immunisation.Methods: The present study was undertaken in the pediatric OPD of medical college hospital among children(n=194) in the age group of 12 to 60 months. Parents of 194 children were interviewed using preformed study proforma. Children were labelled as completely immunised, partially immunised, or non-immunised according to working definition. Various socioeconomic, demographic, cultural and behavioural factors found to influence immunisation status were outlined. Statistical analysis was done by using chi-square test, p value observed, <0.05 is considered significant.Results: There were 147 children’s (75.8%) who were completely immunised and 41 (21.1 %) partially immunised and 6 (3.1%) were non immunised. Immunisation status was significantly influenced by education of parents, type of family, socio economic status, place of delivery, distance of vaccination centre and locality. Sex of child and birth order has no impact. Most common reasons for partial immunisation (n=41) were education of parents (17%), rural children (23%), socioeconomic status (14%), place of delivery (28.8%), not advised by health worker (29%). Reasons for non-immunisation were (n=6) place of delivery (home=19%), non-availability of immunisation card (10%).Conclusions: The various factors found to influence the immunisation status of children need to address in order to achieve millennium development goal of reducing under five child mortality.
Gamut of congenital heart diseases in a tertiary center in South India: an ode to echocardiography
Authors: K Doddabasava , Philip Prijo , B Sumanth Shetty , Jacob Chinthu Sara , K Subramanyam
Published: April 2017

Background: Echocardiography has supplanted clinical acumen in diagnosis of congenital heart diseases (CHDs). Prevalence rates of CHDs across various regions of the world are subject to change over the course of time, with increasing use of this diagnostic modality. Objective: To assess the prevalence and types of CHDs.Methods: The study was conducted at a tertiary care center in South Karnataka, India. Transthoracic echocardiographic records of all patients suspected to have congenital heart disease, over a period of 60 months were analyzed. Categorization of data into acyanotic and cyanotic congenital heart disease, and further, into different types was done after an exhaustive search. Specific variables such as age, frequency and gender distribution of all kinds of CHDs were computed.Results: Of a total 112,372 pediatric patients who attended our center, 1451 reports of subjects suspected to have CHDs were analyzed. The prevalence was found to be 6.22 per 1000 subjects. Of the 700 subjects (48.24%) with CHD, 664 (94.85%) were diagnosed to have Acyanotic Congenital Heart Disease and 36 (5.14%) were diagnosed to have Cyanotic Congenital Heart Disease. Among the Acyanotic CHD, Atrial Septal Defect (ASD) was found to be the most common (40.21%) seconded by Ventricular Septal Defect (VSD) (21.53%). Among the 36 subjects diagnosed to have Cyanotic CHD, it was found that Tetralogy of Fallot (TOF) was the most commonest lesion (61.11%).Conclusions: Increased utilization of Echocardiography as a diagnostic modality significantly helps to better appreciate ever varying prevalence rates and types of CHDs in different parts of India. Frequent longitudinal studies in this regard help in enhanced allocation of available resources and updating of available databases.
Relationship of Transcutaneous Billirubin with Serum Billirubin in Neonates with Jaundice
Authors: Arora Vivek , Singla Sanjay , Sharma Poornima , Ninama Rameshwar , Koli Harimohan
Published: April 2017

Background: Neonatal hyperbilirubinemia is a common problem in neonates with an incidence of about 60% in term babies and 80% in preterm babies. It is the commonest cause of admission to the hospitals in the newborn period. Studies comparing the correlation between total serum bilirubin (SBR) and transcutaneous bilirubin (TcB) have yielded different results. So, we planned this study to find out relationship between TcB and SBR values.Methods: A hospital based prospective study was done during March 2016 to September 2016, in which a total of 120 newborns including term and preterm who were admitted with neonatal jaundice in NICU, Maharana Bhupal Hospital, Udaipur, Rajasthan were assessed in terms of age, sex and weight and investigated for both TcB and SBR. The sample size was calculated at a confidence interval of 90% and allowable error of 15%.Results: Out of total 120 study subjects, 59 (49%) were males and 61 (51%) were females, out of which 53 (44%) were preterm and 67 (56%) were term neonates. Mean TcB and SBR values at the time of admission has a mean difference of 2.52 mg/dl with a p-value <0.001 (significant) on the other hand TcB and SBR at 24 hr of admission has a mean difference of 1.57 with a p-value >0.001, which is non-significant. TcB and SBR at 48 and 72 hr of admission also has a mean difference which is also non- significant (p >0.001).Conclusions: From present study, we conclude that there is no significant difference between TcB and SBR values at 24, 48 and 72 hrs after starting phototherapy. The values of TcB are equally reliable as SBR values.
Meningitis in late onset sepsis
Authors: Arora Vivek , Sharma Lalit Mohan , Jangid Dinesh , Choudhary Vijay , Bairwa Ram Prakash , Singla Sanjay
Published: April 2017

Background: Neonatal sepsis contributes substantially to neonatal morbidity and mortality and is an ongoing major global public health challenge. In developed countries, this incidence of neonatal meningitis is 0.3 per 1000 live births. In developing countries, the reported incidence of neonatal meningitis is much higher at 0.8-6.1 per 1000 live births, with a mortality of 40-58%. So, this study was undertaken to estimate the incidence of meningitis in late onset sepsis.Methods: This study was conducted in out born NICU of R.N.T. Medical College, Udaipur (Raj.) from November 2016 to February 2017. All neonates between age 7 days to 28 days of life were included in the study. A sepsis screening and blood culture were sent for all neonates. All positive sepsis screen patients were taken for Lumber Puncture. CSF was examined with positive sepsis screen and high clinical suspicion of meningitis. CSF culture was sent for every patient. CT scan was done in patient with proven bacterial meningitis.Results: A total of 90 patients with suspected late onset sepsis were admitted. Most of the neonates were admitted with complain of temperature instability and poor feeding. Meningitis was observed in 55 out of 90 cases (61.11%). Out of 55 patients CSF culture was found positive in 70% cases. Most common organisms were E. coli in 50% cases, Klebsiella in 15% and Enterobactor in 10%. Mortality was around 45.5% (n=25).Conclusions: Neonatal meningitis is a major disease that results in death and significant mortality and morbidity in neonates.
Prevalence of impaired glucose tolerance test and diabetes in overweight, obese and apparently healthy school going adolescents
Authors: Choudhary Kirti , Mathur Priyanshu , Garg Manisha , Gupta P. P.
Published: April 2017

Background: Adolescence is a period of transition from childhood to adulthood. It occupies a crucial position in the life of human beings characterized by an exceptionally rapid rate of growth in physical, mental, sexual, and psychological behavior etc. The present study was planned to study the prevalence of impaired glucose tolerance amongst overweight, obese and apparently healthy school going adolescents in the city of Jaipur, Rajasthan.Methods: The study has been conducted in the Department of Pediatrics of Mahatma Gandhi Medical College of Mahatma Gandhi University of Medical Sciences and Technology, Jaipur. The study was a cross sectional analytical study conducted in schools of Jaipur. This study was done from August 2011 to November 2011 and 180 patients of aged between 10 to 18 years of age were enrolled.Results: In this study, it was found that the prevalence of overweight to be 32.65 percent in males and 34.15 percent in females. It was seen that 33.67 percent males and 32.93 percent females belonged to the obese category. Out of 180 adolescents, 25 (13.89 percent) were found to have IGT and only 1 was found to have type 2 diabetes (0.5 percent). Out of 25 students with IGT, 15 were boys and 10 were girls. Among these 25 students with IGT, 9 were overweight and 16 were obese. 15 percent of overweight student and approximately 26 percent of obese students had IGT. The association of IGT and increased BMI was found to be highly significant.Conclusions: The present study highlights the fact that type 2 diabetes in children occurs in developing counties and there is an increase need to look for type 2 diabetes in overweight and obese children and adolescents in India. Therefore, it is recommended that all obese and overweight adolescents should be screened at least yearly for type 2 diabetes mellitus using OGTT so that timely intervention can be done.
Patterns of child and adolescent psychiatric disorders and associated factors in outpatients attending child psychiatry clinic: a hospital based study
Authors: Landge Anisha P. , Kaur Darpan , Ghildiyal Rakesh P.
Published: April 2017

Background: Childhood mental disorders are common and yet only a minority of children with mental health problems receive appropriate child mental health consultation. There is scarcity of literature on patterns of child and adolescent psychiatric disorders from developing countries like India. Methods: It was a cross sectional survey on outpatients attending the Child and Adolescent psychiatry clinic, Department of Psychiatry, MGM Medical College, Navi Mumbai. Study sample consisted of all new child & adolescent cases attending the clinic and willing to give consent. Data was analysed for sex, residence, informant, socio-economic status, birth history, family history, medical co-morbidity, reason and source of referral, presence of stressors, psychiatric diagnosis etc using SPSS 20. Institutional Ethics clearance was obtained. Results: Data analysis of n= 150 patients revealed mean age of 9.53 with SD of 3.84. Majority of the patients belonged to school going age group (59.3%), male sex (54.7%), living in urban areas (68.7%), belonging to middle class (56%) and accompanied by mother (54%). 28% had significant birth history while 18.7% had family history of psychiatric illness. 28.7% had co-morbid medical illness. The most common reason for referral was academic problems (24%) from the department of paediatrics (34%). The majority of the cases were diagnosed with ADHD (26%), mental retardation (13.3%), Learning disability (10.7%) followed by Autism (8.0%) & Depression (6.7%). Conclusions:We conclude that there are distinct patterns of child and adolescent psychiatric disorders in our study. Further collaborative research in the arena of child and adolescent mental health is recommended.
A variant of Goldenhar syndrome
Authors: Jaiswal Akanksha , Annamalai Thumjaa , M Nirupama , M Shafath Ahmed , V Ramya
Published: April 2017

We report a case of 10 months old child with a variant of Goldenhar syndrome in the form of microtia of right ear, microsomia of the right-side face, right facial nerve palsy with cardiac anomaly, renal anomaly and sensorineural hearing loss on the right side which were rare associations prompted to report this case.
A case of Ritscher-Schinzel syndrome or 3C syndrome
Authors: Deepika G. , Raghoji Chaitali R , Ashwini R. C. , Guruprasad G.
Published: April 2017

Ritscher Schinzel syndrome or cranio-cerebello-cardiac syndrome is characterized by cardiac defects, cerebellar hypoplasia and cranial defects. It is usually inherited as autosomal recessive pattern involving chromosome 8q24. the overall prognosis vary widely and it correlates with the cardiac disease present.
HIV/AIDS amongst street children in Cameroon: their relative knowledge, attitudes and sexual experience
Authors: Cumber Samuel Nambile , Tsoka-Gwegweni Joyce Mahlako , Jackson Jr Ndenkeh N. , Kanjo-Cumber Rosaline Yumumkah
Published: April 2017

Background: Street children are victims of society and are up to 10 - 25 times more vulnerable and affected by HIV/AIDS than their counterparts who live with their families. Objective of study: To examine the HIV/AIDS-related knowledge, attitudes and sexual experience amongst street children in Cameroon.Methods: This study was an analytical cross-sectional survey conducted during the year 2015 through the administration of questionnaires to 399 street children that had been homeless for at least a month.Results: Out of the 399 participants interviewed, more than 90% of them reported to have heard about HIV/AIDS. Though only 14% of the participants knew about the importance of HIV screening, an even smaller proportion of about 6.02% of them reported having been HIV screened before. Most of them stated that HIV could be transmitted through kissing, mosquito bites, eating utensils and through a hand-shake as well as believed that screening and use of Voluntary Confidentiality Counseling and Testing (VCCT) could help prevent its transmission. Many of them also thought of HIV/AIDS as a punishment from God for sins or as witchcraft; and that the disease could be cured through believing in God or even by a traditional practitioner.Conclusions: The level of HIV/AIDS knowledge among street children in the study setting is sub-optimal. Their negative attitudes and incorrect beliefs about the disease could make them even more vulnerable to HIV infection. The use of peer educators would be an effective strategy to implement among this hard to reach population
Hand washing among health workers in tertiary health facilities in Bayelsa State, Nigeria
Authors: McFubara Kalada Godson , Ogbe Deborah K. , Mbooh Romeo T. , Nwizia Baribefii P. , Nasamu Ughiemosomhi P. , Ogori Demedongan S.
Published: April 2017

Background: Hand washing is a cheap and effective method of preventing nosocomial infections by health workers, but it has not been given strong policy support for resource allocation. Objectives: To describe knowledge, attitude and practice of handwashing among health care workers and to identify the factors affecting the practice in tertiary health care facilities in Bayelsa State. Methods: Four groups of health workers who work directly with patients at the Niger Delta University Teaching Hospital and Federal Medical Centre, both in Yenagoa Local Government Area of Bayelsa state, were studied. A multi-stage sampling was conducted to select 224 respondents. Self-administered and interviewer-administered questionnaires were used to collect data which were then analysed on the Microsoft Excel programme.Response rate of 91.50% (205 respondents) was achieved. Krejcie and Morgan’s sample size formula was used at 95% confidence level. Results: 140 (68.30%) of all respondents had good knowledge of hand washing and about half have excellent hand washing practice. But only 44 (21.5%) had very good knowledge of nosocomial infections. The lack of materials such as soap, water and towels are limiting good hand washing practice. Conclusions: Although there is good knowledge of hand washing and of nosocomial infections as well as good attitude towards hand washing, they have no positive correlation with practice. Inadequate resources may be worsening nosocomial infections. Improved health policy for more health manpower and accessible resources for more regular hand washing are recommended.
Socio-economic and behavioural risk factors of visceral leishmaniasis in the East Champaran district of Bihar
Authors: Kumar Navin , Singh T. B. , Meena L. P.
Published: April 2017

Background: Visceral leishmaniasis is a chronic and potentially fatal parasitic disease of the viscera which affect the organs due to infection by Leishmania donovani. Visceral Leismaniasis, also known as Kala-Azar (KA) in the Indian subcontinent. The worldwide incidence is estimated to be between 146,700 and 282,800 cases per year. In India, it is endemic in the states Bihar and it contains more than 90 % of the cases of VL.In this region, Leishmania donovani is the only species causing VL. Objective: To find out the socio-economic and behavioural risk factors of VL in East Champaran district of Bihar. Methods: A case-control study was conducted to understand the socio-economic and behavioural risk factors associated with VL in areas of East Champaran district of Bihar, India. A total of 100 VL cases and 100 healthy controls selected randomly from the neighbourhoods of cases were included in the study. Results: The risk factors identified were showed that presence of a granary inside houses (P=0.000), sunlight inside the living room (P=0.000), banana trees near the houses (P=0.003), presence of domestic animal in the house (P=0.044), people sleep near the animal (P=0.000) and drainage system (P=0.000) were risk factors of VL.Conclusions: These results will be useful for further improvement in the VL control programs for intervention strategies in respect of separate granary house other than the living house, presence of sunlight inside the living rooms, banana trees far from the houses, separate domestic shelter for reducing transmission and incidence of this disease.
A study on epidemiological determinants and reproductive health practices among female commercial sex workers of Dharwad district
Authors: Bathija Geeta V. , Gajula Madhavi
Published: April 2017

Background: Prostitution is linked with many socio-demographic disadvantages like minority status, low income and education level, frequent harassment by family and police and social stigma.Methods: It’s a cross-sectional study, done among female commercial sex workers. A sample of 100 women was chosen conveniently, for a study period of 2 months i.e. May and June 2015. The women were one-one interviewed in depth by a semi-structured questionnaire, finalized after Pilot testing. The data was entered into MS Excel, analysed using SPSS v 20.0 and data was presented as means and percentages.Results: 48% of the study sample belonged to the age group of 30-39. 50% of the study samples were involved in home based sex trade, 6% in brothel and 8% in public streets. All of them reported some sort of STI symptom, 39% reported burning micturition, itching and genital sores and 28% reported excessive white discharge. Regarding violence and harassment, 65% faced domestic violence at home, 37% experienced sexual violence like beatings, burning of private parts and forcible sex without payment. 31% had experienced harassment by unnatural sex.Conclusions: Poverty was cited as the most common reason for getting into this trade with half of their families being unaware of it and for a very meagre pay. Removal of social stigma can help in rehabilitating these women back into the society.
Study of snake bite cases admitted in tertiary care hospital in Nagpur
Authors: Bhelkar Sandeep M. , Chilkar Sanjay D. , Morey Suresh M.
Published: April 2017

Background: In developing countries major portion of individuals bitten by snakes first consult traditional practitioners before visiting a medical centre and resulting delay in transportation leads to mortality. Present study planned to study clinical features and epidemiological factors in snake bite cases.Methods: Hospital based cross sectional study was planned including all snake bite cases admitted during study period. Epi Info 7 used for analysis.Results: Out of 156 snake bite patients, 66.04% subjects were from month of July to September (mean age 37.78 years). About 30.77% of study subjects sought traditional healer for medical care, which was found to be significant when compared with not seeking treatment (Chi square =4.74, df =1, P =0.029). Maximum study subject i.e. 52 (33.33%) received ASV within 1 hour. Only 85 (54.49%) subjects reached the tertiary care hospital within 1- 6 hours following the bite. Mortality was higher in urban area as compared to rural area (P =0.104). Death was higher who had bites on upper limb (11.67%) as compared to bite on lowers limb (2.08%) (P =0.012). Proportion death was higher among those who did not received first Aid measures or took herbal medicine (P =0.022). Mortality was significantly higher in study subjects with complications such as cellulitis and DIC (P =0.006).Conclusions: Mortality among those who received first aid before coming to the hospital was lower (5.56%). Mortality was higher (6.25%) in cases where time interval between bite and initiation of treatment was more than 6 hours.
A cross sectional study on the precocious puberty among girls in the age group of 11-15 years, in two schools in Kollam
Authors: Binu Jeffy , Thomas Sonia Raichel
Published: April 2017

Background: Puberty is the period during which human development progresses, from the first pubertal sign to full sexual maturation. Precocious puberty is a common problem affecting up to 29 per 100 000 girls per year. The objective of this study is to find out the prevalence of precocious puberty among school going girls and to find out relation with various risk factors.Methods: A cross sectional study was conducted by enrolling 250 school going girls by selecting one school each from urban and rural setup. Prevalence of precocious puberty was expressed in percentage and Chi square test was applied to check association. P value for statistical significance was fixed at P<0.05.Results: The prevalence of precocious puberty was found to be 10.4%. In urban it was found to be 12.35% and in rural it was 8.43%. Girls whose fathers have primary education are risky to have precocious puberty (P<0.049). Those students who take fish occasionally, that is once or thrice in a week were more prone to have precocious puberty (P<0.000). Prevalence of Precocious puberty is more in rural area when compared to urban area. Parents, especially fathers who were less educated should take of care of their daughter’s health by not giving them dried and junk foods. It is better to take fish daily, rather than once or thrice in a week, occasional consumption of fish is found to be a reason for precocious puberty.Conclusions: Prevalence of Precocious puberty was 10.4%. Fathers of the girls, who are not well educated and occasional fish consumption of girls was found to be the significant reason for Precocious puberty.
Study of tobacco use and related factors among adolescent students of secondary school in south-eastern region of Rajasthan, India
Authors: Meena Rahul , Meena Shivraj , Mittal Deepika , Meena Neelam
Published: April 2017

Background: this study aims to estimate the level of tobacco use among school-going adolescents and also identify the factors that influence youth to use tobacco. Identification of the factors responsible for initiating tobacco use among adolescents will be useful for identifying the most effective interventions to prevent youths from taking up the tobacco habit.Methods: This was a cross-sectional study which was conducted in adolescent students of grade 8, 9 and 10 from secondary schools within Kota city of Rajasthan. 2032 questionnaires (1228 from government schools and 804 from non-government schools) were included in the analysis. Results: About seven in ten (71.0%) adolescent students were living in the family where at least one member uses tobacco. Nearly one-third (31.0%) of the adolescent students were having good knowledge and less than half (42.7%) were having some knowledge about the hazards of tobacco use. About one third (32.3%) of adolescent students were exposed to pro-tobacco advertisements.Conclusions: Immediate action to reduce adolescents' exposure to environmental tobacco smoke is necessary. Prohibiting tobacco use at school and monitoring the high-risk behaviors of adolescents in school is necessary. Strictly Announcing schools and other public places as “tobacco-free places” will help to minimize the exposure to tobacco smoke. It also helps to change social norms and ultimately to minimize the use of tobacco.
Prevalence of type 2 diabetes mellitus among non teaching staff of a medical college in North Karnataka: a cross sectional study
Authors: Yadav Birendra Babu , S. Shivaswamy M. , Mallapur M. D.
Published: April 2017

Background: Diabetes threatens to assume pandemic level by 2030 and there is no available statistics of type2 diabetes mellitus on non-teaching staff. The risk factors like bad habits, family history, waist hip ratio (≥ 0.9 in males and ≥0.85 in females), BMI (≥28) and IDRS (>60) all attributed to the high prevalence of pre-diabetic as well as diabetes. Aims: To know the prevalence of Type 2 Diabetes Mellitus among non-teaching staff and to determine the risk factors associated with it.Methods: A facility based cross – sectional study was conducted among all the non-teaching staff of Jawaharlal Nehru Medical College, Belagavi from February to October 2014.A total 500 (394 males and 106 female) participants between age group 20-59 years were selected for the study. After taking written informed consent, information regarding socioeconomic and risk factors were collected though pre – tested questionnaire. Physical examination were done to calculate BMI, Waist –Hip ratio and IDRS (Indian diabetes risk score). The random blood sugar was estimated to identify the diabetes and pre-diabetics. Results: The overall prevalence of diabetics and pre- diabetics was 5 per cent and 17 per cent respectively. The prevalence of diabetes was highest in age group 50-59 years. The risk factor like bad habit, waist hip ratio (≥0.9 in males and ≥0.85 in females), BMI (≥28) and IDRS (>60) attributed to high prevalence of pre diabetics and diabetics. Conclusions: The prevalence of diabetes was more among non-teaching staff so; both preventive and curative services should be provided to them.
Adherence to weekly iron and folic acid supplementation among the school students of Thrissur corporation – a cross sectional study
Authors: V. Sajna M. , Jacob Shefaly Ann
Published: April 2017

Background: Anemia is one of the major problems among adolescents in India. As daily and once weekly supplementation of iron and folic acid show same effects in terms of growth rate, it has been decided that weekly supply is an effective method to tackle anaemia. The adherence to these tablets is an important factor to monitor the programme. Methods: A cross sectional study was conducted among the school students of 6-10th classes in Thrissur corporation area for a period of 6 months regarding the adherence to weekly iron and folic acid tablets. Sample size was calculated based on a pilot study and for a cluster sampling technology. After getting consent, data were collected, coded and analysed using SPSS17. Results: 380 students participated in the study. Mean age of the population was 13.01+ 1.3 years (with a range of 10 – 16 years). Only 139 (36.6%) students took tablets initially for a period of 1-2 months. Among the total girls, 124 (34.6%) took tablets initially. Of the students who took initially, 57 were continuing intake of iron tablets. The adherence to weekly iron and folic acid tablets for at in this study was 15% (n=57). Among the students who initially consumed tablets 36.6% reported stomach ache. Nausea (13.6%), vomiting (10.7%), black stool (9.3%), diarrhoea (5%) were other reported side effects of the drugs. Conclusions: The adherence to weekly iron and folic to this study was less. This can be effectively improved with continued health education sessions using different methods including the parents.