bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of the endotracheal cuff inflation techniques and its postoperative laryngotracheal morbidity: an observational study
Authors: Mali Ashish , Solanki Jinal Ashok , Deshpande Charulata M.
Published: January 2017

Background: Endotracheal tubes cuffs are used to prevent gas leak and also pulmonary aspiration in mechanically ventilated patients. The commonly employed intubation techniques are the use of inflation to a constant pressure (25 cm H2O), sealing pressure and estimation of the cuff pressure by finger palpation. However, the use of the cuff inflation volumes may cause tracheal morbidity. The aim of the present study was to compare the effective tracheal seal and the incidence of post-intubation airway complications between the three techniques.Methods: 90 patients under N2O free general endotracheal anaesthesia were included in the study. They were randomly allotted into three groups consisting of 30 in each. After induction of anesthesia, endotracheal tubes size 7.0 mm for female and 8.5 mm for male were used. Constant pressure group (n=30), the cuff was inflated to a pressure of 25 cm H2O; sealing group (n=30), the cuff was inflated to prevent air leaks at airway pressure of 20 cm H2O and finger group (n=30), the cuff was inflated using finger estimation. Manometric cuff pressure and volume of air required to inflate the cuff, incidence of sore throat, hoarseness and dysphagia were tested.Results: Significant differences was not observed between the three groups in case of demographic data, ASA grading, endotracheal tube size used, number of attempts to place the endotracheal tubes, duration of intubation between the three groups. On the other hand, the cuff pressure, volume of air to fill the cuff and the incidence of sore throat was significantly higher in the finger group compared to other two groups (p ≤0.05). The incidence of dysphagia and hoarseness was also higher in finger palpitation group but the difference is insignificant.Conclusions: In cases of N2O free anesthesia, sealing cuff pressure is an easy and safe alternative technique compared to other two techniques, regarding effectiveness and low incidence of tracheal morbidities.
Levetiracetam monotherapy effect on serum calcium and serum vitamin D in patient of epilepsy
Authors: Garg Anubha , Dabla Surekha , Nagenhalli Sandeep , Fotedar Sanjay
Published: January 2017

Background: Objective of the study was to determine the Levetiracetam monotherapy effect on serum calcium and serum vitamin D levels in tertiary care hospital in Haryana, India.Methods: A total of 110 patients with epilepsy, were enrolled to the study for one year between April 2013 to August 2014. All male patients aged 15-60 years and premenopausal females with epilepsy were included in the study. The study was a interventional prospective study design. The antiepileptic drug levetiracetam was administered starting from a dose of 20 mg/kg and dose was titrated according to the clinical response. During the follow up period, the subjects were asked about the seizure frequency and other side effects. The patients were be subjected to questionnaires based proforma. Baseline investigations, Hemogram, renal and liver function tests, calcium, phosphate, vitamin D and bone mineral density and T scores were noted. All investigations were repeated after one year of levetiracetam monotherapy.Results: The mean age of onset of seizures in the study group was 23.22±6.62 years. 58% (n=29) were seizure free after 1 year of levetiracetam monotherapy, 28% patients had adequate control and 14% patients had poor control of their seizure episodes. There was an insignificant change in Hemoglobin, total leukocyte count, platelet count, renal parameters and Liver enzymes from baseline over a year of levetiracetam therapy. Serum calcium levels increased insignificantly from baseline levels of 9.68±0.59 mg/dl to 9.72±0.56mg/dl. Vitamin D levels increased from baseline of 39.35±14.91ng/ml to 39.84±14.07 ng/ml. Bone mineral density increased insignificantly from baseline of 0.92±0.13 g/cm2 to 0.93±0.13 g/cm2.Conclusions: Present study has shown an overall beneficial effect on serum calcium, Vitamin D level, bone mineral density and T scores on DEXA scan.
Computed tomographic evaluation of inflammatory sinonasal diseases
Authors: Kandukuri Rashmi , Phatak Suresh
Published: January 2017

Background: Computed Tomography plays a major diagnostic role in patients with inflammatory sinonasal diseases and determines the mode of management by displaying the complex osteomeatal anatomy, determining anatomical variations, extent of disease and characterizing various inflammatory sinonasal diseases. Purpose of the study was to assess the role of CT in evaluation of inflammatory sinonasal diseases by evaluating the sensitivity and specificity of CT in diagnosis of various inflammatory Sinonasal diseases.Methods: In this hospital based prospective study 122 patients with symptomatic inflammatory sinonasal diseases were evaluated by 16 slice MDCT. CT diagnosis is correlated with final diagnosis obtained from findings of nasal endoscopy/Functional Endoscopic Sinus Surgery, histopathological examination and fungal culture. Statistical analysis was done by descriptive and inferential statistics using Test statistics (sensitivity, specificity, PPV, NPV and accuracy) and Z test for single proportions (Z value >1.96 is considered significant). Software used in the analysis was SPSS 17.0 version and graph pad prism 6.0 version and p <0.05 is considered as level of significance.Results: On correlating CT diagnosis with final diagnosis, Chronic Sinusitis had 98.41% sensitivity and 96.61% specificity, fungal sinusitis had 66.67% sensitivity and specificity 99.14%, polyps had sensitivity of 94.59% and specificity of 97.6%, the rest of the inflammatory conditions had sensitivity 93.7 % and 99% specificity. P value in all instances was <0.05, i.e. <0.0001, indicating the significance of the findings.Conclusions: CT is the diagnostic modality of choice in evaluation of various inflammatory pathologies and associated complications thereby planning the further management of the patient.
A hospital based eye health survey to see the pattern of eye diseases in Uttarakhand, India
Authors: Bharadwaj Manu , Singh Lokesh Kumar , Dutt Bhaskar
Published: January 2017

Background: The cause of blindness and low vision differs in different countries and communities. The requirements of eye services also vary according to the need of the native population. Studies showing the pattern of ocular morbidity are needed to build better infrastructure of eye care facilities.Methods: This prospective study was conducted in eye department of Government Doon Medical College, Dehradun, Uttarakhand, India between April 2016 to May 2016.the patients were seen in eye OPD by ophthalmologists. Proper anterior and posterior segment evaluation was done and patients were treated accordingly. Data including the registration number, name of the patient, age, sex and diagnosis were recorded in OPD register and analysed.Results: Total 1259 patients were examined. 605 were male and 654 were female. The mean age of male patients was 43 years and for females was 41.33 years. Refractive error (20.97%) was the commonest ocular morbidity in our study followed by cataract (20.02%), follow ups of cataract surgeries and allergic conjunctivitis. Besides refractive errors total 137 (10.88%) patients were presbyopic.Conclusions: This study shows a slightly exceeding number of female patients, which shows that females are equally aware of their health problems. Refractive errors are the most common cause in present study with cataract being second, may be because of higher mean age of the patients presenting to OPD. In present study allergic conjunctivitis was third commonest cause of ocular morbidity in our district may be due to windy weather. The leading causes of ocular morbidity in our study were refractive errors, cataract, allergic conjunctivitis and, presbyopia. The high prevalence of refractive errors and cataracts shows that hospital still requires an improved infrastructure with spectacle provision to the patients.
A cross sectional study of the knowledge, attitude and practice of asha workers in implementation of Janani Suraksha Yojana in Tadikonda Mandal, Guntur, Andhra Pradesh, India
Authors: Kumar Valiveti Pavan Datta Syam , Vinjam Brahma Naidu , Bandarupalli Tharun , Rachamadugu Nageswara Rao
Published: January 2017

Background: Janani Suraksha Yojana (JSY) was evolved to reduce the maternal and neonatal mortality in India which is being implemented in Andhra Pradesh state also through ASHA workers by promoting 100% institutional deliveries to poor pregnant women. Study was undertaken to evaluate the knowledge, attitude and practices of ASHA workers in delivering the JSY services.Methods: A cross sectional community based observational study conducted in the field practice area i.e. Tadikonada Mandal of Community Medicine Department, Guntur Medical College, Guntur, Andhra Pradesh. Study sample was 50% of Tadikonda Mandal ASHA workers for 3 months (December 2012 to February 2013) with pre designed pilot tested semi structured questionnaire, Microsoft Excel.Results: Study revealed that there was 90 % of institutional deliveries, Infant Mortality Rate (IMR) was reduced to 20 per 1000 live births and Maternal Mortality Rate(MMR) was also reduced to 190 per 1,00,000 live births.Conclusions: Based on the results found in our study we came to a conclusion that in implementing the JSY services the ASHA workers are found as a back bone to reduce the IMR, MMR by promoting institutional deliveries.
Clinicopathological study of carcinoma stomach over a period of 5 years
Authors: Sushma J. , Kartheek B. V. S. , Lakshmi A. Bhagya
Published: January 2017

Background: Gastric cancer represents one of the most frequent neoplasias. Although its incidence decreased over the last few decades in industrialized countries, it still represents nowadays a major cause of death through cancer throughout the world. The purpose of this study was to identify clinicopathological parameters in gastric carcinoma.Methods: A total of 115 gastrectomy specimen received in 5 year period at a tertiary care center was analyzed. The clinical data was recorded. After fixing the specimen in 10% formal saline for 24 hours the gross appearance of the specimen was studied. The gross findings were recorded following Borrmann classification. The tissue blocks were routinely processed and stained with H&E stain. The results were tabulated.Results: The prevalence of gastric carcinoma was 4.46%, with male: female ratio of 3:1 and mean age of 50years.The prevalence of carcinoma stomach was more common in rural areas and poor socio economic status. Sixty percent of patients who consumed mixed diet suffered from carcinoma and 82.8% had history of intake of alcohol. Carcinoma stomach was more common in A blood group. The tumor was more common in pyloric antrum (73.04%). According to Borrmann classification type II tumour was the commonest (66.09%) of the lesions. Commonest histological pattern was adenocarcinoma; intestinal type (86.72%).Conclusions: The prevalence of carcinoma stomach in the present study was 4.46%. High prevalence of gastric carcinoma was seen in patients with history of smoking, intake of alcohol and consumption of mixed diet. Carcinoma stomach was more common in A blood group followed by B blood group. Adenocarcinoma of intestinal type was the commonest.
Morphometric analysis of menisci of adult human knee joint in North Indian population
Authors: Rohila Jyoti , Rathee Suresh Kanta , Dhattarwal Suresh Kumar , Kundu Zile Singh
Published: January 2017

Background: Of the synovial joints in the body knee joint is the largest. Each meniscus is a piece of fibrocartilage with a thickened outside edge and a thin inner edge so that it is wedge-shaped in cross section. The purpose of the present study was to establish database on standard dimensions in knee menisci of adults of north Indian population.Methods: The sample for this study was collected from April, 2012 to June, 2013. For this study, 200 menisci (100 right and left each) of 50 adult humans were taken for analysis. Measurements were done with the help of non-elastic thread and digital vernier calipers. All dissections were performed in a systematic fashion.Results: The width of the lateral meniscus was significantly different form medial meniscus with lateral and medial menisci widest in middle and posterior third respectively. The middle one third of both lateral and middle menisci was the thickest.Conclusions: It is always good to have a set of anatomical morphometric parameters of the menisci like the width and thickness. The measurements of suitable grafts may provide a more acceptable meniscal replacement in the future.
Effect of warm footbath with vibration on arteriovenous fistula puncture-related pain in hemodialysis patients
Authors: Ali Madadi Zahra Abbas , Azimian Jalil , Falahatpishe Farzaneh , Heidari Mahmoud Alipour
Published: January 2017

Background: Pain and stress of hemodialysis are experienced by more than 50% of patients who are suffering from renal disease; hence decreasing a part of these adverse effects can be effective on individual’s long term coping with hemodialysis. The current study was done to determine the effect of warm footbath with vibration on arteriovenous fistula puncture-related pain in hemodialysis patients.Methods: This clinical trial was conducted on 31 hemodialysis patients in 2014. The patients were selected by simple random sampling method and placed in one group. First, the pain intensity of all patients was measured in the six frequent hemodialysis sessions without any intervention (control method). After two weeks, the intervention of warm footbath with vibration was done on all patients and the pain intensity was measured for six frequent hemodialysis sessions (intervention method). The patients were received 40±2 °C footbath with vibration by foot massage spa machine for ten minutes; then, fistula needles were placed and the pain intensity was assessed by using a numerical rating scale. Data were analyzed by ANOVA and T test.Results: The study group had contained 20 males (64.5%), 11 females (35.5%), with an average age of 44.16±14.85 and a range of 18 to 65 years old, which shows that the pain intensity of the warm footbath with vibration method was lower than the control method (P< 0.05).Conclusions: Warm footbath with vibration can be used as an effective palliative method to reduce pain of hemodialysis patients.
Proteinuria in early detection of human leptospirosis
Authors: K. C. Thresiamma , Biju Asha , Chaurasia Reetika , Sritharan Manjula , Jayaprakash Chithra , Thomas Sunil , C. K. Eapen
Published: January 2017

Background: Leptospirosis is an infectious disease caused by spirochetes bacteria Leptospira spp. and is reported from all over the world. As the clinical signs and symptoms of Leptospirosis often are nonspecific and the disease is early mistaken for other major infectious febrile illness, laboratory test to confirm the clinical diagnosis thus is essential for optimal treatment and patient management.Methods: Serum and urine samples were collected from patients clinically suspected cases of Leptospirosis. Preparations of urine concentrate by precipitation and centrifugation.Results: It was interesting to note that immunoglobulins are present in the urine protein concentrate of patients with Leptospirosis on the day of admission in the hospital, with urine albumin reports either positive or negative. By ELISA test it was noted that antibodies present in urine and serum were of both IgM and IgG class against the Leptospiral antigens from three pathogenic serovars and one non-pathogenicserovars. In the immunospot test which was done and compared with standard ELISA test for serum antibodies using same antigen showed that antibodies present in urine protein concentrate, which was collected on the day of admission when patients come with suspecting symptoms of Leptospirosis.Conclusions: Proteinuria is the most frequent abnormality noted in all patients at some stage of illness. This is the first report on the presence of immunoglobulins in urine samples, which were found to be of IgM and IgG classes. These findings are of significant diagnostic potential as a simple immune-spot test can be done for detecting anti-leptospiral antibodies in urine samples of suspected cases. The present attempt was aimed at developing an immunospot test, a simple and rapid diagnostic test to detect Leptospirosis using urine samples of clinically suspected patients of the infection at the earliest. It was found to be in good correlation with standard ELISA method which is being used to detect serum antibodies in Leptospira infected patients using the same antigen.
A comparative study of morbidity pattern among rural and urban postmenopausal women of Allahabad, Uttar Pradesh, India
Authors: Goyal Ankita , Mishra Neha , Dwivedi Shraddha
Published: January 2017

Background: Menopause is an inevitable reproductive phase during midlife when various physical and mental changes may impair the quality of life of women. Middle-aged women may experience a wide range of physical and psychological symptoms. Decrease in the production of estrogen leads to the premenopausal symptoms of hot flushes, insomnia and mood changes, as well as post-menopausal osteoporosis and vaginal atrophy, leading to decrease in quality of life.Methods: Community based cross-sectional study. Door to door survey was conducted among women who had attained menopause for more than 1 year, in rural and urban area of Allahabad. Multistage random sampling was done. 400 postmenopausal women, 200 each from rural and urban area were selected. A pre-tested structured questionnaire was used for data collection.Results: Majority were in the age group of 50-60 years followed by 60-70 years. Majority of women were having a parity of 3. Vasomotor symptoms were experienced by 34.5% and 39.5% rural and urban women respectively. Out of total post-menopausal women who reported genitourinary complaints, the most commonly reported complaint was stress incontinence i.e. 10.5% and 8.5% respectively in rural and urban communities followed by increased urinary frequency i.e. 9% and 7.5% respectively in rural and urban areas. Vaginal dryness was reported by 2.5% of rural women and 6% of urban women. Vaginal discharge was reported by 7% of rural and 4% of urban women. Uterine Prolapse was reported by 6% of rural women and 3.5% of urban women.Conclusions: The study shows that postmenopausal women in India suffer from various vasomotor, physical as well as psychiatric problems related to menopausal hormonal changes with varied frequencies. There is a need to address their problem and establish health care centers for them. Postmenopausal women should be sensitized for availing the health facilities for their health problems by information education and communication (IEC) and behaviour change communication (BCC). Family support should be ensured by creating awareness in community. Awareness regarding menopause and problems among women related to it need to be improved. Health workers, ASHA, Aanganwadi workers can help women to understand about the menopausal symptoms, if they are given adequate training.
Hepatic artery embolization for treating giant hemangioma of liver: an experience from a tertiary level hospital in India
Authors: Bhuva Dharmik , Agrawal Manish , Rathod Jawahar , Kamble Chandrakant , Biswas Anup
Published: January 2017

Background: Transcatheter hepatic artery embolization (TAE) is a minimally invasive procedure. This study aimed to assess radiological features of giant haemangioma of liver on untrasonography, contrast enhanced tomography, magnetic resonance imaging and digital subtraction angiography, to assess the safety, feasibility and efficacy of transcatheter arterial embolization of hepatic artery in giant liver haemangioma.Methods: This prospective study was conducted in the Interventional Radiology Department, Government Medical College Nagpur from September 2013 till August 2015. Patients were enrolled who were diagnosed with liver hemangioma after obtaining an informed consent. Patients underwent routine investigations and imaging modalities like ultrasonography, contrast enhanced computed tomography. Patients were followed up at 3 months and 9 months.Results: During the study period, 28 patients were enrolled, 9 males, most common age group being 31-50 years. Abdominal discomfort was the most common symptom. Majority of the lesions were hyperechoic and not vascular. On CECT most of the lesions appeared progressive centripetal. On DSA heaptic artery was the most common source of vascular supple. Statistically significant change in size of the lesion was observed on either lobe when imaged via USG or CECT. No long term complications were seen in majority of the patients.Conclusions: This study shows that TAE in Giant Hepatic Haemangiomas is safe, feasible, efficient, and minimally invasive with good patient acceptance, minimal complications and no mortality.
Aberrant origin of left vertebral artery: a rare case
Authors: Kindra Amanjeet S. , Gupta Suneel K.
Published: January 2017

The Vertebral Artery (VA) is classically described as originating as the first branch of the ipsilateral subclavian artery. The VA origin is variable and has been identified at the aortic arch, Common Carotid Artery (CCA), and Internal Carotid Artery. The VA arising from the carotid artery is an extremely uncommon variant. Left VA origin from the left CCA has been reported only thrice. These rare anomalous origins of the VA usually are asymptomatic. We describe symptomatic aberrant origin of left vertebral artery from left common carotid artery, a rare case.
Juvenile polyposis syndrome with extraintestinal anomalies: report of a rare case with review of literature
Authors: Venkatesh Kusuma , Pillarisetty Karishma , B. N. Sreedhara Murthy
Published: January 2017

Juvenile polyposis coli is a rare condition in children with neoplastic potential having an incidence of about 1 in 1,00,000 population. A minority of such patients have extraintestinal abnormalities like cardiac and pulmonary arteriovenous malformations. Juvenile polyposis is a disorder of hamartomatous polyposis syndrome having a malignant potential. The progression of hamartomatous polyp to carcinoma is still elucidated when compared to the understanding of transformation of an adenomatous polyp into a carcinoma via a gatekeeper defect. Here is the report of a rare case of Juvenile polyposis in a 7 year old boy who presented with bleeding per rectum and prolapsed rectum showing multiple polyps. Patient had undergone surgery for closure of ventricular septal defect and pulmonary valvotomy 3 years back. Proctocolectomy was done and the resected colon showed 40 polyps. Histologically polyps contained benign glandular tissue and one of the larger polyps showed low grade epithelial dysplasia. In this case, there was no positive family history and extraintestinal congenital defects are said to be more common in such sporadic cases.
Case series of rare ovarian malignancy: granulosa cell tumor
Authors: Duraisamy Kavitha Yogini , Balasubramaniam Devi , Chinnusamy Palanivelu , Barnwal Rashmi
Published: January 2017

Granulosa cell tumors are rare ovarian sex cord stromal tumors characterized by indolent course and favorable prognosis. The treatment of granulosa cell tumor is individualized based on many factors like age, desire for future fertility and stage of the disease. Here, we report three cases out of which two were acute presentation and one was diagnosed incidentally when she got evaluated for menstrual irregularity. Fertility sparing surgery with proper staging is offered to young patients presenting in early stage. In patients who have completed family, comprehensive surgical staging including hysterectomy with bilateral salpingo oophorectomy is the standard treatment. Lymph node metastasis in granulosa cell tumor is very rare, hence pelvic and para aortic lymphadenectomy can be safely avoided if preoperative findings and frozen section favour granulosa cell tumor.
Multiple carcinoid tumour of duodenum: an uncommon case
Authors: Patil Vivek A. , Mahapatra Bibekananda , Panchal Anuraha , Deolekar Sandesh R. , Patil Soniya A.
Published: January 2017

A 45 years old female patient with complaints of pain in epigastric region since 1 year not responding to proton pump inhibitors underwent oesophagogastroduodenoscopy which showed two duodenal masses. On further investigations diagnosis was duodenal carcinoid tumour. Patient underwent Pylorus Preserving Whipples surgery.
Baseline physical fitness as a determinant of resting neuro-psychological profile in students undergoing stressful professional course
Authors: Vinod Ashwin P. , Sinha Meenakshi , Ghate Jayshri , Sinha Ramanjan
Published: January 2017

Background: Several reports indicate that exercise has a positive impact on mental health. However, studies on whether altered physiological status in high fit individuals is reflected in their baseline neuro-psychological profile remains to be ascertained. The aim was to compare the EEG profile and their ability to handle stress in young adult students of high physical fitness with those of low physical fitness.Methods: To achieve this objective, healthy adult male students (18-22 years age) undergoing stressful professional course were grouped into High fitness group (GI: PFI>80) and Low fitness group (GII:PFI<50) as per their Physical Fitness Index (PFI) scores in Harvard Step Test. Thereafter, their state and trait anxiety scores (STAI) were obtained and resting EEG were recorded for ten minutes.Results: No significant difference in the STAI scores between these groups (State: 34.8±4.26 vs 37.57±7.89; Trait: 39.1±6.21 vs 40.29±8.77 in GI vs GII) were observed, supported by absence of significant cerebral lateralization in anterior alpha power band in either group (Right vs Left Frontal GI: 5.56±2.10 vs 6.55±2.12 uV2; GII: 5.03±1.14 vs 4.51±1.83 uV2) in addition to lack of right anterior dominance, thereby nullifying the cerebral lateralisation hypothesis as an indicator of anxiety level. However, there was a generalized predominance of alpha power in the anterior (GI vs GII: 6.05±1.82 vs 4.77±1.28 uV2), temporal (GI vs GII: 23.89±11.87 vs 19.10±12.41 uV2) and posterior (GI vs GII: 25.00±2.18 vs 18.37±0.72 uV2) regions in GI mainly in the right hemisphere.Conclusions: Thus anxiety alone may not be a determinant of mental health in the high fit subjects who may have other dominant characteristics as envisaged by alpha predominance in their EEG profile.
Association of comorbidities in atrial fibrillation in acute myocardial infarction
Authors: Ahamed H.B. Irfan , Abdullah Bilal Bin , Ismail Mohammed , Jagirdar Syed Aman
Published: January 2017

Background: Atrial fibrillation is a most common arrhythmia in patients with and without structural heart disease with an increasing incidence mainly due to the aging population. As the population ages, one can expect that AF will remain a frequent and troublesome complication of AMI with comorbidities. Therefore, the present study was undertaken to investigate the association of co-morbidities in atrial fibrillation in acute myocardial infarction.Methods: The study was performed after the institutional ethical clearance and consent from all the patients. Heart rate, atrial fibrillation, blood pressure, ventricular fibrillation and stroke after acute myocardial infarction were recorded. The blood sugar and serum lipid levels were also measured using commercially available kit as per the manufacturer’s guidelines. The data was analyzed for statistical significance using univariate analysis and comparison was performed by Fisher Exact test and by using SPSS Version 20.Results: In our study, all the patients who developed AF after AMI were more than 60 years of age. Higher heart rate was more than or equal to 100 in 62.5% of the patients. 25% of patients had diabetes mellitus 75% of 8 patients had atrial fibrillation after acute myocardial infarction, 77% of patients without atrial fibrillation were known hypertensive’s. Out of the patients who had atrial fibrillation, 50% had hyperlipidemia and developed ventricular fibrillation.Conclusions: Higher heart rate (>100 bpm) at time of presentation is a risk factor for AF following to AMI. Patients with new onset AF after AMI had more complication during hospital stay.
A study to evaluate different conditions leading to diagnosis of T2DM in a tertiary care hospital in Eastern India
Authors: Roy Nirmalya , Bhattacharjee Kingshuk , Gupta Esha
Published: January 2017

Background: Diabetes is one of the most important public health problems. There is paucity of Indian data as to which conditions leads to diagnosis of T2DM. The present study endeavors to throw some light on the problem.Methods: A cross-sectional and retrospective study including 321 subjects, performed at a tertiary care hospital in eastern India. Descriptive statistical analysis has been carried out in the present study. Results on continuous measurements are presented on Mean±SD (min-max) and results on categorical measurements are presented in number (%). Significance is assessed at 5 % level of significance pooled chi-square/Fischer’s exact test used to explore association between study variables.Results: A total of 321 patients (male: female - 2.61: 1) diagnosed with diabetes over a period of 24 months were included. Mean age at diagnosis being 45.54±10.8 years respectively. Out of these, only 23.05 % presented with osmotic and other symptoms (foot ulcer, weight loss etc.) suggestive of diabetes. A substantial 43.52% of total patients were diagnosed during general healthcare check-up (35.2% in OPD and 8.32% during perioperative evaluation). Remaining patients diagnosed with diabetes included 8.28% patients admitted with acute coronary syndrome, 13.4% with infections of different types and 11.75% with other non-related diseases. Among diagnosed diabetics, 50.47% had HTN and 41.12% had IHD. Diabetic Males have higher prevalence of IHD (48.28%) than females (22.47%), p <0.001. Prevalence of HTN is higher among diabetic females (48.28%) than males (22.47%),         p <0.046. The prevalence of HTN and IHD steadily increased with the increasing age group, p<0.001.   Conclusions: The results of this study suggest that a very low percentage of the patients present with symptoms suggestive of diabetes. Hence, it is prudent to evaluate adult patients coming in contact with healthcare system for diabetes by simple inexpensive test.
Risk factors of pthalmia neonatorum in newborns at Ardabil city
Authors: Ojaghi Habib , Masoumi Rahim , Valizadeh Zoleikha
Published: January 2017

Background: The term ophthalmia neonatorum (ON) connotes infection of the ocular surface within the first month of life which have many risk factors. The severity of this infection varies from mild to server and even corne al perforation, panophthalmitis and blindness. The objective of this study was to determine the risk factors of ON in newborns at Ardabil city.Methods: This study is a descriptive cross - sectional study that was done on 40 newborns with ON at Ardabil hospitals. Data collected by visit of newborns and completed cheklists then by statistical methods in SPSS.19.Results: The mean age in infant was 9±8.1 day and the mean age of mothers was 26.4±5.1; and the mean birth weight was 2597±658.6. 27 (67.5%) of infants were male and others were female. 23 (57.5%) of infant mothers had vaginal delivery and 8(20%) of infants have Prom. 24 (60%) of infants were in the first parite. Cojuctivitis was involved in 15 (37.5%) in right side, 5 (12.5%) in left side and 20 (20%) were bilateral. 25 (62.5%) of infants were term and 15 (37.5%) were preterm. 21(52.5%) of infants had history of UTI and genital infection in their mothers.Conclusions: This study showed that ophthalmia neonatoroum is a multifactorial and multilevel problem and many factors have main role in this problem and doing future studies to recognize these risk factors is necessary.
Lipid profile: a conduit in the progression from psoriasis to cardiovascular disease
Authors: Sahu Samir , Devi Ellora , Poddar Anirban , Ray Subhashree
Published: January 2017

Background: Psoriasis although a disease of the skin has been reported to be associated with metabolic syndrome. Metabolic syndrome in turn is associated with dyslipidemia which is a independent risk factor for cardiovascular diseases. Our study therefore aims to assess lipid profile in patients with psoriasis with an objective to observe and report any significant deviations in the same as compared to healthy controls.Methods: 25 patients with psoriasis and 25 age, sex matched healthy controls were recruited in this study and lipid profile was estimated using commercially available reagent kit which employs the CHOD-PAP method.Results: Significant elevation in levels of total cholesterol, triglycerides, VLDL and cholesterol/HDL ratio was observed. Elevated although was observed in case of LDL and HDL levels, but it was statistically insignificant.Conclusions: Dyslipidemia was found to be prevalent in psoriasis patients. Dyslipidemia is an independent risk factor for development of cardiovascular disease. Dyslipidemia in psoriasis therefore clearly suggests an inherent predisposition of psoriasis patients to suffer from cardiovascular diseases. A lipid profile estimation in these patients therefore might serve as an important tool for   risk assessment for cardiovascular disease, thereby aiding a timely intervention.
Effect of 5-fluorouracil on sinoatrial node and conduction system of heart
Authors: Hafeez Imran , Lone Ajaz , Beig Jahangir Rashid , Alai Mohd. Sultan , Dar Iqbal , Tramboo Nisar
Published: January 2017

Background: 5-FU a cytostatic agent is used to treat various malignancies. Cardiotoxicity is infrequent complication of 5-FU. Previously we had observed ECG changes in our patients on 5-FU viz sinus bradycardia, atrial fibrillation. We also found that 5-FU bradycardia might be a hypervagotonia as vagolytics abolished it. This study was undertaken to assess the impact of this commonly used chemotherapeutic agent on basic physiologic parameters of impulse initiation and conduction in human heart. The aim was to study effect of 5-FU on electrophysiological properties of SA node and conduction system of heart.Methods: Pre -5 FU state patients were subjected to electrophysiological study and following parameters were checked viz heart rate, CSNRT. SACT, AH and HV intervals and wenckebach point. Post 5- FU state these parameters were again checked. Response to Atropine was seen in patients who developed sinus bradycardia.Results: Sinus bradycardia was seen in 8% (n=2) of patients in post 5FUstate Their electrophysiological parameters SNRT, CSNRT, SACT, AH were mildly prolonged (above the normal) in post 5FU state. Post atropine there was increase in heart rate and the deranged electrophysiological parameters came back to normal. Atrial fibrillation was seen in two patients while performing sinus nodal functions in post 5FU state.Conclusions: Sinus bradycardia is a rare cardiotoxic side effect of 5FU, is a result of an autonomic imbalance viz hypervagotonia which is abolished by atropine and more common in infusuion form than bolus. Infra-his conduction is not altererd and threshold for inducing atrial arrhythmias is decreased in post 5-FU state.
A comparison of ultrasound versus paresthesia technique for supraclavicular brachial plexus block
Authors: Borah Bidyut , Engineer Smita R. , Patel Kiran B.
Published: January 2017

Background: Ultrasonography is a newer tool for identification of nerves in the practice of regional anaesthesia. Visualization of target structures and spread of drugs under direct vision and thus avoiding complications like pneumothorax, accidental intravascular injections are potential benefit of ultrasonography technique. Aim of the study was to examine the usefulness of ultrasound guided brachial plexus block and compare it with paresthesia technique with the believe that ultrasound guidance can shorten the onset as well as increase the duration of blockade..Methods: Eighty patients of either sex, 18-60 years, posted for upper limb surgery were divided into 2 groups according to the technique used to give block, group US (ultrasound technique) and group PA (paresthesia technique).  Both the groups received 0.5 % bupivacaine 20 ml with 8 mg of dexamethasone.Results: There was notable difference between the patient groups with regard to initiation of motor blockade (10 min group US vs 11.1 min group PA, p <0.0156) and sensory blockade (5.16 min group US vs 6.96 min group PA, p <0.0001) also duration of motor blockade (1272.88 min in group US vs 899.25 min in group PA, p <0.0001) and sensory blockade (1343.88 min in group US vs 996.75 min in group PA, p<0.0001).Conclusions: Ultrasound guided supraclavicular brachial plexus blocks result in a higher success rate with respect to onset and duration of blockade with less incidence of complications compared to paresthesia technique.
Efficacy of various antihypertensive drugs in the treatment of hypertension in the patients of end-stage renal disease leading to hemodialysis: a retrospective study
Authors: Ahmad Razi , Habib Anwar , Rehman Sana
Published: January 2017

Background: Cardiovascular complications are the leading cause of morbidity and mortality in the patients of end-stage renal disease leading to hemodialysis. Majority of these patients suffers from hypertension and adequate control of blood pressure is a challenge in these patients because of multifactorial etiology and complicated pharmacokinetic changes in these patients. The present study aims is to find out the best possible drug or combination of drugs that can provide better control of blood pressure and improve the quality of life of these patients.Methods: A retrospective study was carried out on the patients who attended the hemodialysis unit of Hakeem Abdul Hamid Centenary hospital from July 2015 to June 2016 (one year), data on antihypertensive drugs and blood pressure control (pre-dialysis and post-dialysis) were recorded and analyzed.Results: 68.75% patients on hemodialysis were suffering from hypertension and were on antihypertensive medication. A combination of Amlodipine and clonidine were the most frequently prescribed antihypertensive agents. Muscle cramps an acute rise in blood pressure and hypotension were the most frequently encountered intradialytic complications in these patients.Conclusions: Although a combination of amlodipine and clonidine was most frequently prescribed antihypertensive medication in these patients these drugs were associated with intradialytic complications like muscle cramps and hypotension. Amlodipine with beta-adrenoceptor blocker (metoprolol or bisoprolol) provided best control of blood pressure in these patients with least intradialytic complications.
A study of extra-pulmonary tuberculosis and its outcome
Authors: P. Ravikumar , G. Priyadarshini Bai
Published: January 2017

Background: Pulmonary tuberculosis being the predominant manifestation of the disease extra-pulmonary sites can also involve as a result of dissemination from a chief focus. Extra- pulmonary tuberculosis is more common in HIV cases. The present study aims to determine the presentation and outcome of patients with extra-pulmonary tuberculosis treated with DOTS and to assess any difference in outcome of treatment in HIV positive extra-pulmonary tuberculosis.Methods: Data was collected from cases of tuberculosis patients diagnosed and treated under DOTS at Sri Siddhartha Medical College for the period of one year (during 2015). We evaluated extra-pulmonary cases and recorded sites of involvement in order of frequency. We also studied treatment outcome by recording as per definitions given by the WHO and also evaluated any difference in outcome of extra-pulmonary tuberculosis disease with HIV co-infection.Results: Extra-pulmonary cases accounted for 30.5% of total TB cases. Among 224 cases of extra-pulmonary TB studied, 136 (60.7%) were males and 88 (39.3%) were females. Most common site of extra-pulmonary tuberculosis was pleura (29.9%) followed by meninges (22.5%), abdomen (19.6%) and lymph node (10.7%) tuberculosis. Among these patients 82.2% completed treatment, 7.5% were defaulted, 9.9% died and 0.4% treatment failure. The most common reason for default was irregular treatment (29.5%) followed by alcohol abuse (23.5%). Among 8 HIV reactive patients, 5 patients completed treatment and the remaining 3 patients died during the course of treatment.Conclusions: Extra-pulmonary Tuberculosis accounts for 30.5% of the total cases studied. Pleura is most common site of extra-pulmonary TB in our study. Treatment irregularities and alcohol abuse are the two most common reasons for default.   Co-infection with HIV seems to have a poor outcome on patients with extra-pulmonary TB and needs to be studied in large number of samples.
Psoriasis and neurodermatitis: comparing psychopathology, quality of life and coping mechanisms
Authors: Nagarale Vivekkumar Ashok , Jaiswal Suyog Vijay , Prabhu Archana , Sinha Deoraj , Nayak Chitra S.
Published: January 2017

Background: Both psoriasis and neurodermatitis patients report psychological distress and impaired quality of life, but how they cope with it is area of interest. The objective of this study was to study and compare psychopathology, quality of life and coping mechanism in psoriasis and neurodermatitis patients.Methods: 30 cases each of psoriasis and neurodermatitis were assessed at dermatology out-patient department of a tertiary care hospital by using Symptom check list -90-Revised (SCL-90-R), dermatological life quality index (DLQI) and Brief cope scale (BCS).Results: All Patients with neurodermatitis perceived it as a problem and in psoriasis it was 90%.The quality of life (QOL) was affected in both more in neurodermatitis as compared with psoriasis. Neurodermatitis showed significant psychopathology on SCL-90-Rin parameters of interpersonal sensitivity and Psychoticism. Depression, Anxiety, Somatisation, Obsessive-compulsiveness were seen in both groups. Self-blame, religion, positive-reframing were used commonly as coping mechanisms in neurodermatitis while in psoriasis there was acceptance, active coping, planning, and self-distraction, use of emotional and instrumental support, positive-reframing.Conclusions: Quality of life is significantly lower in neurodermatitis. Psychopathologies were significantly high in neurodermatitis. Maladaptive coping styles were used in both groups.
Sensitivity and specificity of cardiac troponin-T in diagnosis of acute myocardial infarction
Authors: Sharma Dharmveer , Gupta Poonam , Srivastava Sagar , Jain Harshit
Published: January 2017

Background: Myocardial Infarction is the irreversible necrosis of the heart muscle secondary to prolong lack of oxygen supply. Troponin T is a structurally bound protein found in striated muscle cells. They have rapidly attained central role in diagnosis, prognostication and planning of therapeutic strategies in MI patients. The objective of this study was to evaluate the status of Troponin T in MI patients and its role in diagnosis compare to normal subjects.Methods: The study was conducted at M. L .N. Medical College, Allahabad, Uttar Pradesh India. A total of 136 cases were included in our study. Out of these, 86 were patients of AMI and 50 were healthy controls. They were evaluated by measurement of various parameters including enzymatic markers such as CPK-MB, SGOT, LDH1, and LDH2 and non-enzymatic markers such as troponin-T and myoglobin. Apart from these, LDL, VLDL and HDL levels were also kept under evaluation.Results: Troponin-T test was better than CPK-MB or SGOT in diagnosing myocardial infarction. In our study, sensitivity (67.3%) and specificity (73.8%) of troponin-T test was higher than CPK-MB (56.2% and 45.7%) and SGOT (34.2% and 58.3%) respectively. Troponin-T test was better than CPK-MB or SGOT after 2 hours of onset of myocardial infarction. Troponin- T and I: both kind of evaluations are available and are well evaluated. However troponin T estimation is more standardized and thus more popular. The positivity of troponin-T test also varied with area of infarct.Conclusions: High LDL and VLDL were seen while at the same time HDL level was lowered. An Increase in the level of myoglobin (non-specific marker), Cardiac troponin I and T and among the enzymatic markers elevated levels of CPK-MB, LDH and SGOT were observed in patients of MI against the normal subjects. In case of LDH both LDH 1 and LDH 2 were observed and a flipped pattern was noted. Bedside troponin-T test is highly sensitive and specific in the diagnosis of acute myocardial infarction and can be used in emergency and ambulatory settings. Qualitative troponin-T test is reliable above serum level of ≥ 0.10 ng/ml.
Delayed neurological manifestation in viper bite despite anti-snake venom therapy
Authors: Manappallil Robin George
Published: January 2017

Envenomation due to snake bite is an acute life threatening medical emergency. Among the different families of snakes, viper bites are known to cause local manifestations like cellulitis, blebs, compartment syndrome; as well as systemic manifestations which include neurological, hematological and renal failure. This is a case of a middle aged man who presented with viper bite. He was given anti-snake venom (ASV) and became asymptomatic. After about 72 hours of ASV therapy, he started developing generalised paralysis. He was given another course of ASV, following which he recovered completely. To the best of knowledge, this form of delayed neurological manifestations following viper bite, despite receiving ASV has not been reported yet.
A rare case of herpes zoster maxillaris with cranial polyneuropathy
Authors: Patro Shubhransu , Sahoo Debananda , Dash Anil Kumar , Mishra Biswamohan
Published: January 2017

Varicella zoster virus has a high affinity for the ganglion and causes various neuropathies. About 12% of all peripheral facial nerve palsies are caused by varicella zoster virus, a rare complication due to reactivation of the herpes zoster virus in the geniculate ganglion of facial nerve. The occurrence rate of associated cranial polyneuropathy has been reported to be 1.8-3.2% and cranial nerves VII, VIII, IX and X are the ones most commonly affected. Here, we present a case of Herpes zoster maxillaris with cranial polyneuropathy who was improved with oral anti-viral drugs and steroid. Multiple cranial nerve palsies are being observed frequently in patients who were referred with a preliminary diagnosis of facial palsy. These patients are required to be examined in detail for involvement of other cranial nerves. Early diagnosis and treatment is required for reversing the functions of cranial nerves and decreasing the chance of developing other complications.