bluuebunny/crossref_metadata_2025 huggingface dataset:
Antimicrobial stewardship: need of the hour
Authors: Ahmad Razi , Rehman Sana
Published: July 2018

Efforts to tackle the global threat of Antimicrobial Resistance (AMR) have recently taken shape in a number of potentially far-reaching collaborative initiatives. When microbes become resistant to medicines, the options for treating the diseases they cause are reduced. This resistance to antimicrobial medicines is happening in all parts of the world for a broad range of microorganisms with an increasing prevalence that threatens human and animal health. The direct consequences of infection with resistant microorganisms can be severe, including longer illnesses, increased mortality, prolonged hospital stay, loss of protection for patients undergoing operations and other medical procedures, and increased costs. Antimicrobial resistance affects all areas of health, involves many sectors and has an impact on the whole of society. To overcome the threat of antimicrobial resistance, a three-pillar approach has been advocated i.e. Optimize the use of existing antimicrobial agents, prevent the transmission of drug-resistant organisms through infection control and Improve environmental decontamination. Antimicrobial stewardship [AMSP] is one of the key strategies to overcome resistance. It is an inter-professional effort, across the continuum of care, involves timely and optimal selection, dose and duration of an antimicrobial for the best clinical outcome for the treatment or prevention of infection with minimal toxicity to the patient and minimal impact on resistance and other ecological adverse events.
Antioxidant activity and effects of Kenyan Tea (Camellia sinensis) on the liver function and serum biochemistry in male Wistar rats
Authors: Areba Gerald Otwabe , Khalid Rashid , Nderitu Nyaga Samuel , Kevin Thuo Jesee , Okongo Moseti Kelvin , Mbuthia Karori Stephen , Nyamu Wachira Francis , Muchangi Ngure Raphael
Published: July 2018

Background: Tea is a beverage that is most widely consumed worldwide. Studies have shown that oral consumption of tea has health benefits however, there is paucity of data in Kenya detailing the biochemical effects of tea in the liver and elucidation of its mechanism of action.Methods: The polyphenol composition and antioxidant capacity of tea were determined by HPLC and the Folins Ciocalteu spectrophotometric methods. Metal levels were determined using flame Atomic Absorption Spectrometer (AAS). Aqueous black and green tea extracts were administered to the rats at dosages of 400mg/kg b.w.t. The effect of tea on total blood proteins, Albumin, ZHX1, TBARS, AST, ALP and ALT were determined by spectrophotometric methods. The body weight of each rat was also determined at one week interval.Results: Total Polyphenols (TP), Total Catechins (TC) and Antioxidant Activity (AA) between the black and green teas were significantly (P<0.05) different. Green tea had the highest levels of TP (19.70-26.12%), TC (8.51%-17.60%) and AA (86.65%-94.50%). Tea did not have a significant (P>0.05) effect on TP, ALB, ALT, AST, ALP, MDA and ZHX1 in the test animals compared with the controls. This data indicates that green tea is rich in catechins while black tea being rich in Theaflavins (TFs) and Thearubigins (TRs). Both tea products possess essential and non-essential metals well within the maximum permissible concentrations.Conclusions: Findings from this study indicate both green and black tea aqueous extracts have polyphenols and high antioxidant activity. Administration of the aqueous tea extracts have no toxicological effect on the liver.
The prospective, non-interventional, pharmaco-vigilant study of antibiotic treatment of pediatric patients in pediatric intensive care unit and in-patient wards suffering from sepsis in a tertiary care hospital
Authors: Bhattacharyya Subhradipta , Mohanty Manjushree
Published: July 2018

Background: Sepsis with septic shock has remained a dreadful disease inspite of early intervention mostly due to lack of sensitivity to first line antibiotics. This observational study was conducted to evaluate the utilization of antimicrobials and sensitivity-resistance pattern in paediatric patients suffering from sepsis due to various causes.Methods: A prospective, non-interventional, pharmaco-vigilant study. 38 patients suffering from sepsis admitted in paediatric ward and PICU from September 2012 to February 2014 were evaluated. The research protocol was approved by Institutional Ethical Committee, KIMS. Data were collected from case sheets of patients from the ward as well as Medical Record and Data section. Average of Data on a continuous scale was expressed as a mean along with standard deviation, Categorical data was expressed as percentage. Comparative statistical analysis was done by using student's t-test in respect of data measured on a continuous scale. All differences with P value below 0.05 were labelled as statistically significant.Results: Total 38 patients were admitted with provisional diagnosis of sepsis. 52.5% patients were suffering from ≥2 diseases while pneumonia (64%) and meningitis (22%) were observed to cause sepsis. 10(27%) patients presented with septic shock while 39.3% patients having single organ failure and 10.4% patients having multiple organ failure. inj Dopamine (33%) and inj Dobutamine 11% were used and ventilator was used in 1 patient. Most of the patients received multiple antibiotics in I.V. route, 30 (79%) patients received ≥3 antibiotics. Linezolid+ piperacillin+ tazo + aminoglycoside + 4th drug combination was observed to be used in 34% patients while Linezolid+ 3rd gen. cephalosporin+ aminoglycoside+ 4th drug combination was used in 21% patients. Cephalosporin was most frequently withdrawn antibiotic (47 % of use). High resistance was observed for both gram +ve and gram -ve bacteria against cephalosporin.Conclusions: Anti-MRSA agents (Linezolid) and anti-MDR GNB agent (Meropenem) significantly used to control the severe sepsis in conjunction to Piperacilin/ ceftriaxone + amikacin.
Pattern of self-medication amongst housewives vs working women in urban population in Southern Rajasthan
Authors: Atray Meena , Vijay Radhika
Published: July 2018

Background: The use of medications without prior medical consultation regarding indication, dosage, and duration of treatment is referred to as self-medication1. Self-medication has its own benefits regarding reduction in load and cost of medical services. Women are primarily responsible for the health needs of the family and self- medication is frequently practiced by them. Working environment may influence the attitude of women towards safe and rational self-medication. This study focuses on the pattern and attitude of women (housewives/ working) towards self- medication and influence of working atmosphere and exposure of women on self-medication.Methods: 170 women of age group 18-60 years were included in the study and after taking permission from Institutional ethics committee. Data was collected by making the participants fill a semi structured detailed questionnaire under observation of instructor. The data was analysed using Microsoft excel and compared by using Fischer exact test.Results: Most common ailment for which self-medication was practiced was pain. Working women primarily used pharmacist and house wives use old experience and family friends as primary source of information. Working women were more cautious about adverse drug reactions, drug-drug interactions, expiry date of medicine, reading instruction manual, use of counterfeit medicine and referring the experience to their known subjects as compare to housewives.Conclusions: Self-medication was prevalent in both the groups, though working environment has positive influence towards safe, responsible and rational self-medication. There is need for education regrading safe use of medicine and strict rules and regulations for availability of drugs.
Drug utilization study in a neonatal intensive care unit of a government tertiary care hospital in Western Maharashtra
Authors: Kumbhar Arvind V. , Halasawadekar Nimish R. , Ramanand Sunita J. , Ramanand Jaiprakash B. , Patil Praveen T. , Shah Ruchi D. , Salunke Arundhati T.
Published: July 2018

Background: Presently drug utilization studies (DUS) are in an evolving era. Current literature search has shown paucity of epidemiological studies in the field of paediatric pharmacology. Hence the present study was designed to assess the drug utilization pattern in neonatal intensive care unit to improvise the current prescription practices, if required and to determine areas in neonatal pharmacology in need of further research.Methods: A prospective, observational study spanned for a period of one year from January 2015 to December 2015 was conducted at the neonatal intensive care unit (NICU), Government teaching tertiary care hospital, Maharashtra. Data of prescribed drugs was collected. WHO prescribing indicators were used for evaluating DUS. Assessment of exposure rates of different class of drugs in different gestational age groups was done. Data were analysed using descriptive studies.Results: Data of 205 neonates, showed male preponderance (53.17%) over female neonates (46.83%). With regard to the gestational age, 47.31% were term, 52.68% preterm. Average number of drugs per encounter was 6.69. 76.29% drugs were prescribed by generic name and 69.80 % drugs were from IAP list of essential medicines for children. Mean drug use was 6.23±3.34 per patient. Most common class of drug to which neonates were exposed was antibiotics (96.10%) and amikacin topped the list with exposure rate of 91.22%.Conclusions: The present study substantiates the need for implementation of institutional antibiotic policies, awareness regarding IAP list of essential drugs for children, prescription by generic name and rational drug use.
Drug prescribing pattern in surgical wards of a tertiary care hospital in Western part of India
Authors: Patel Khyati M. , Jadav Shilpa D. , Parmar Shailesh P. , Trivedi Hiren
Published: July 2018

Background: In surgical wards, drugs are required to manage pain, nausea, vomiting, infections, etc. A growing number of pharmaceutical products are available in present era. Irrational prescribing of drugs is prevalent worldwide. Drug utilization study can be used to assess prescribing patterns. Authors undertook this study to determine current practice of prescribing in surgical wards of the hospital.Methods: Authors conducted observational, noninterventional, descriptive study among patients admitted in surgical wards for one year. Authors have analysed collected data of 604 patients using descriptive statistics to determine utilization pattern of drugs and drug use indicators.Results: Appendicitis (14.9%) followed by hernia (10.6%) were leading diseases for admission. Mean duration of stay was 7.44. Average number of drugs in a prescription was 8.94. Antibiotics (32.07 %), analgesics (17.11 %) and antacids (16.09 %) were leading drug groups prescribed. Amikacin (5.81 %) followed by metronidazole (5.30 %) and ciprofloxacin (5.19 %) were commonly prescribed antimicrobial drugs. Tramadol (5.31 %) and pantoprazole (7.17 %) were leading drugs prescribed from analgesics and antacids respectively. All prescriptions had at least one injectable drug. At least one antibiotic was present in 92.05 % prescriptions. Majority of drugs (87.27 %) were prescribed by generic names. Proportion of drugs prescribed from essential medicine list was 84.22 %.Conclusions: Polypharmacy and injectable drug prescribing were common in practice. There is a scope for improving such prescribing practices among practitioners. Use of multiple antibiotics should be avoided whenever possible and usage should be evidence based.
Carbamazepine induced Stevens Johnson Syndrome: a case report from a tertiary care hospital
Authors: Gadhade Jyoti B. , Hiray Rajesh S. , Ghongane Balasaheb B.
Published: July 2018

Stevens Johnson Syndrome is a rare but life-threatening skin disease and Carbamazepine is considered as one of the most common cause. The reported frequency of serious Carbamazepine hypersensitivity reaction is between 1/1000 and 1/10000 new exposures to the drug. Here, we report a case of a 40 year old female patient, who developed multiple ulcerative lesions all over the body three days after starting treatment with Carbamazepine for Trigeminal Neuralgia. (Worldwide Unique Number- 2017-58502 and AMC Report Number- BJGMC-Pune/Nov-2017/BBG-1860) Stevens Johnson Syndrome was diagnosed. Carbamazepine was withdrawn, and the patient was treated with topical and intravenous antibiotics. A biopsy was done which confirmed the diagnosis of Stevens Johnson Syndrome.
Assessment of emotional intelligence in medical university staff in Ardabil: Northwest of Iran
Authors: Abbasi Vahid , Zakeri Anahita , Amani Firouz , Molaei Behnam
Published: July 2018

Background: Emotional intelligence is one of the most important factors for the job and social success of individuals that is necessary for effective performance of all employees working in different governmental and private sectors, medical centers, factories and others. The aim of this study was to investigate the Emotional Intelligence (EI) in Ardabil University staff.Methods: This cross-sectional descriptive study was done on 150 staff employed in Ardabil University of Medical Sciences which selected randomly. Data collected by Goleman EI questionnaire and analysed by statistical descriptive methods in SPSS.19.Results: The mean age of samples was 7.6±40.8 and 56% of samples were male. 93.3% of samples had university degree. The EI of most of employees with 68% were in moderate level.Conclusions: Conducting appropriate and effective training courses on emotional intelligence can be very effective in promoting job success, social success, and better interaction between staff and people.
Study of role of amniotic fluid total protein (AFTP) assessment in the diagnosis of tubercular ascites
Authors: Kalmegh Rohan , Chaudhary Sameer
Published: July 2018

Background: It is not economically feasible to estimate the serum and ascitic albumin level for calculating Serum Ascites Albumin Gradient (SAAG) in every suspected tubercular ascites patient. Ascites fluid total protein (AFTP) seems a cheaper and viable alternative. Authors attempted to compare the efficacy of Amniotic Fluid Total Protein (AFTP) against Serum Ascites Albumin Gradient (SAAG) in the diagnosis of Tubercular Ascites.Methods: Patients who were admitted to Medicine Wards, with the complaints of distension of abdomen, proved by ultrasound to have ascites, were included in the study. Total 102 Patients of ascites were included. The incidence of Tuberculous ascites was observed and special features regarding their clinical presentation, ascitic fluid values and imaging studies were noted.Results: Tubercular ascites was seen in 18 (17.6%) patients out of the 102 subjects studied. In the group of patients having raised ascitic fluid ADA, authors found that the number of patients having raised AFTP (16 cases, 88.88%) was significantly more than the patients having lower SAAG (13 cases, 71.22%) (p=0.007).Conclusions: In the setting where calculating SAAG may prove to be quite expensive, AFTP is a reasonable predictor of Tubercular infection in ascitic fluid.
A study of non-alcoholic fatty liver disease and its relation to type 2 diabetic patients and cardiovascular risk markers
Authors: Sau Manabendra , Chakraborty Subhasish
Published: July 2018

Background: Non-alcoholic fatty liver disease (NAFLD) is a unique entity characterised by fatty changes with lobular hepatitis in absence of a history of alcoholism. Compelling evidence over the past several years has substantiated a significant link between NAFLD and cardiovascular disease ranging from coronary artery disease to subclinical carotid atherosclerosis. Close follow up, treatment of risk factors for NAFLD, and cardiovascular risk stratification are necessary to predict morbidity and mortality in these patients. The objective of this study is to find out hepatic involvement in type 2 diabetic patients and to correlate the associations between non-alcoholic fatty liver disease and different Cardiovascular risk factors.Methods: This prospective and observational study was conducted in a tertiary care Centre, Kolkata, West Bengal and was conducted among 128 patients having patients having been diagnosed as type 2 diabetic and whose liver USG scan showing fatty changes.Results: In the studied 128 cases, 99 patients had fatty liver and 29 cases without fatty liver diagnosed by abdominal ultrasonography. Most of the Diabetic NAFLD cases were detected in their 5th and 6th decade of life with a male preponderance. Ultrasonography remains a reliable non-invasive method for detection. Ischemic changes in ECG were noted in the study population without statistical significance probably due to low sampling.Conclusions: Left ventricular diastolic dysfunction found to be the prime echocardiographic abnormality in type 2 diabetes mellitus patients.
Comparative study of lipid profile between clinical and subclinical hypothyroidism
Authors: A. Tumbanatham , K. Jayasingh , Vijayan Varun Vijayan
Published: July 2018

Background: Subclinical hypothyroidism (SH) is characterized by elevated levels of serum thyroid stimulating hormone in the presence of normal thyroxin levels. Subclinical hypothyroidism is often associated with elevated total cholesterol and other lipid profile parameters. This study was done to evaluate the lipid metabolism in subclinical hypothyroidism.Methods: This case control study was done to compare the lipid profile parameters between subclinical and overt hypothyroidism cases attending the outpatient facility of our tertiary care hospital of our medical college in Puducherry. Newly diagnosed cases of hypothyroidism were selected by convenient sampling. A total of 37 SH cases and 31 overt hypothyroidism cases were included. Blood samples were drawn to measure lipid profile. A 2D echocardiogram was done to evaluate cardiac function. Ultrasonogram was done to evaluate fatty liver.Results: The mean age of the participants in the subclinical hypothyroidism group was 34.2±12.2 years while in the clinical hypothyroidism group was 35.7±9.8 years. About 13.5% of the participants in subclinical hypothyroidism group and 12.9% of the participants in clinical hypothyroidism had fatty liver in ultrasound. A significant difference was observed in the mean values of total cholesterol, triglycerides and LDL levels between clinical and subclinical hypothyroidism.Conclusions: This study highlights the need for screening of subclinical hypothyroidism in order to prevent the incidences of cardiovascular complications and other diseases like metabolic syndrome.
Incidence and clinico-immunological assessment of patients of rheumatoid arthritis in Gorakhpur district, Uttar Pradesh, India
Authors: Vishwakarma Pawan Kumar , Saroj Umesh
Published: July 2018

Background: Rheumatoid arthritis (RA) is a chronic inflammatory disease manifesting itself in various extra-articular signs and progressive articular damage. The present study was designed to find out the incidence and clinico-immunological characteristics of patients with RA.Methods: This one-year observational study involved 150 adult patients attending orthopaedics department at Nehru Hospital, B.R.D. Medical College, 2010.  Each patient was subjected to clinical, functional, radiological and laboratorial examination after taking informed consent. SPSS software was used for data analysis.Results: Nearly 36% patients had some radiological changes in the form of surrounding osteopenia articular erosion, joint space narrowing and degenerative changes. All NSAIDs when used alone showed poor fall in values of acute phase reactant i.e. ESR and CRP. Maximum fall in acute phase reactant was obtained by treatment with combination therapy of NSAID + hydroxychloroquine + methotrexate + sulfasalazine. NSAIDs did not prevent radiological progression of disease and in more than 50% radiological progression continued however when NSAIDs used with any DMARDs show radiological regression. Maximum radiological regression was caused by combination therapy of NSAID + hydroxychloroquine + sulfasalazine + methotrexate.Conclusions: All NSAIDs produced poor fall in values of acute phase reactants and radiological progression continued in majority of patients, when a DMARD or combination of DMARDs were used with NSAIDs response was much better and relief was obtained earlier, and remission was sustained for longer duration.
Cardiac involvement in adult patients with febrile thrombocytopenia diagnosed by bedside 2-D echocardiography
Authors: Gnanamuthu Selvarani , . Balasubramanian , S. R. Veeramani , S. Naina Mohammed , S. Sivakumar G. , S. Sathish Kumar , R. Ramesh , . Hemanath , G. Nagasundar , M. Saravanan
Published: July 2018

Background: Febrile thrombocytopenia due to various etiologies is very common in India. Its clinical manifestations range from asymptomatic infections to severe disease. Cardiac involvement in such systemic illness should be evaluated. Aim of present study is to evaluate cardiac involvement in patients with Febrile thrombocytopenia with platelets count less than 50,000/µL with the help of handheld echocardiography.Methods: Two hundred patients who had fever with thrombocytopenia were enrolled in the study. ECG and echocardiogram were done to all the patients. One-way ANOVA, Chi square test and correlation coefficient from Pearson correlation and P value of < 0.05 was taken as significant.Results: Out of 200 patients there were 146 males and 56 females. The mean age was 24.12yrs in males 28.32yrs in females .Rhythm abnormalities were present in 60 patients and the most common abnormality was sinus tachycardia; 17 patients had ascites and right pleural effusion; 24 patients presented with pericardial effusion and incidental diagnosis of CHD, RHD, and CAD were made; two patients had myocarditis as evidenced by global hypokinesia of left ventricle. All of those cardiac manifestations were common in Dengue Shock Syndrome.Conclusions: Cardiovascular manifestation in Febrile thrombocytopenia is relatively common ranging from pericarditis to myocarditis. Clinician should routinely screen patients with pyrexia with thrombocytopenia for cardiac manifestations. Early diagnosis at bed side may improve the outcome. Management of patients with pre-existing cardiac diseases should be individualized.
Comparative study of CA-125 and 2D echo for detection of right ventricular failure in COPD patients
Authors: Harshvardhan Leeneshwar , Chand Tara , Mehta Sudhir , Singh Amandeep , Maheshwari Deepak
Published: July 2018

Background: COPD is characterized by persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response in the airways and the lung to noxious particles or gases. It leads to cor pulmonale causing right ventricular failure. Present study compares the serum level of CA-125 and 2 D Echo for detection of right ventricular failure in COPD patients.Methods: In this study 178 patients suffering from COPD has been taken after following inclusion and exclusion criteria and informed consent. Serum CA 125 levels are evaluated in all patients and compared with the right ventricular functions.Results: The mean CA125 was higher in subjects with RV failure (96.32) as compared to those subjects with RV normal (37.17). The result was statistically significant. (p<0.001). The mean duration of illness was higher in subjects with raised CA125 (8.71 years) as compared to those with normal CA 125 (6.67 years) and the difference was also statistically significant (P<0.001).Conclusions: CA-125 levels have a good sensitivity and specificity for predicting right ventricular failure in COPD patients. Diagnostic accuracy, high positive and negative predictive value makes CA-125 a good predictor of right ventricular failure in COPD patients.
Human brucellosis in a non-susceptible host: a case report
Authors: Chidambaram Yoganathan , Alagesan Murali , Dhas Clement Jenil
Published: July 2018

Clinical human brucellosis is quite rare in India, that too in an non susceptible host. This report describes a case of clinical human brucellosis in India. This case involved a 36 years old male, a professor in an Engineering college. He presented with complaints of fever for 4 months with myalgia, generalized tiredness, loss of weight and loss of appetite. On evaluation, total counts and ESR was elevated and all other investigations were normal. Based on history, common causes like occult tuberculosis or autoimmune diseases were considered. But, blood cultures grew Brucella melitensis in all 2 samples and a diagnosis of brucellosis was made. He was treated with Rifampicin and Doxycycline. Suspicion of brucellosis in this patient is low because the patient has no history of contact with animals, consumption of unpasteurized milk or occupational exposure. So, the health care practitioners should be aware of this possibility of this zoonotic infection as a differential diagnosis in patients with nonspecific symptoms and unexplained prolonged fever.
Comparison of one versus two sputum specimens in the diagnosis of pulmonary tuberculosis
Authors: Barnes Carrie E. , Balaji Ramraj , John K. R. , Logaraj Muthunarayanan
Published: July 2018

Background: In 2007, the number of sputum smears required for diagnosis of pulmonary tuberculosis was reduced from three to two. In high burden settings such as India, this practice continues to be the referenced standard whilst using smear microscopy. The objective of the study was to assess the plausibility of relying on one sputum smear rather than two serial sputum smears for tuberculosis diagnosis while also examining inter-specimen grading discrepancies.Methods: A retrospective review of tuberculosis specimen registers (2012–2016) to compare sputum positivity and grading for incremental yield. Inter-specimen grading proportions were compared using McNemar’s test.Results: Incremental yield of the second specimen was 9.9% [95% CI 7.3%, 12.6%]. Differences in inter-specimen grading were not significant: nil (p=0.08), scanty (p=0.75), 1+ (p=0.66), 2+ (p=0.39), 3+ (p=0.15). Less than 25% of specimens showed a change in inter-specimen grading when classified as negative, low-grade, or high-grade results.Conclusions: Two serial sputum specimens for the diagnosis of pulmonary tuberculosis remains a valid practice while continuing to rely on conventional smear microscopy. Inter-specimen grading congruencies support further exploration into same-day two-specimen collections to expedite diagnosis.
Knowledge, attitudes and practices of primary schools learners on sanitation and hygiene practices
Authors: Shilunga Anna P. K. , Amukugo Hans J. , Mitonga Kabwebwe H.
Published: July 2018

Background: Water, sanitation and hygiene played a significant role in schools by reducing water and sanitation related diseases; subsequently improving the health and learning performance of school-aged children. However, ppeople’s knowledge and attitudes on sanitation and hygiene determine the actual practice towards it. This study aimed at assessing and describing the knowledge, attitudes and practices of primary school learners towards sanitation and hygiene.Methods: A quantitative, descriptive design was used. A questionnaire was used to collect data among 450 learners in 10 selected primary schools in Ohangwena region. The study population was grade five, six and seven primary school learners. A three staged probability sampling method was employed. Statistical analysis was done using the Statistical Package for Social Sciences version 23.Results: The result indicated that younger learners in lower school grades, has poorer knowledge, attitudes and practices towards hygiene and sanitation than older learners irrespective of their gender, school circuits or location. This is a logical conclusion because, as learners become older, they become more aware and take precautions about hygiene and sanitation issues.Conclusions: Younger learners in lower school grades, has poorer knowledge, attitudes and practices towards hygiene and sanitation irrespective of their gender, school circuits or location. The older learners become more aware, and cautious about hygiene and sanitation issues comparing to younger learners. The practice and knowledge of sanitation and hygiene are implicated by the reality of the conditions of the sanitation facilities available to them.
Work environment of automated and non-automated rice mills in Amapara district, Sri Lanka
Authors: Chandrathilaka K. R. M. , De Alwis Seneviratne S. R. , Lankatilake K. N. , Samaranayake D. B. D. L. , Karunarathna A. K.
Published: July 2018

Background: Paddy cultivation is a major occupation in informal sector in Sri Lanka. In 2014, contribution of the agricultural activities to the country’s annual GDP was 9.9% of which, contribution by paddy was 11.3%. The objective of the current study was to describe the work environment in rice mills with respect to dust, humidity and thermal condition, ventilation and illumination.Methods: A cross sectional study in 107 randomly selected rice mills was carried out in Ampara district in Sri Lanka. Standardized measurements were carried out to assess internal work environment of the mills.Results: Milling activities showed a seasonal variation. The majority of the mills (95.3%) manufactured raw rice only. Other than the basic characteristics, both automated (AMs) and non-automated mills (NAMs) showed common features. All rice mills exceeded the threshold limit values for total (520.04 mg/m3, SD=191.86 mg/m3) and respirable dust (48.14 mg/m3, SD=9.4 mg/m3). Mean daytime indoor relative humidity in the majority of the mills (n=102, 95.3%) was within the accepted upper limit. In most of the mills, ventilation (n=84, 78.5%) and illumination in polishing/packing area (n=60, 56.1%) was satisfactory while in dehusking/paddy inlet area (n=96, 89.7%), illumination was below the limits.Conclusions: Work environment in both the AMs and NAMs in Ampara district presented with poor work standards compared to the required guidelines.
Unsafe sexual behavior of currently married men having sex with men in Thane, Maharashtra: a challenge for ensuring ZERO HIV transmission
Authors: Sakthivel Saravanamurthy P. , Yadav Awdesh , Tayyaba Shaeik , Khambampatti Rambabu , Mandal Siddhartha , Agarwal Ashok
Published: July 2018

Background: Men having sex with men (MSM) in India due to social taboo and pressure, get married to women, and there is limited evidence on HIV-associated risk behaviors among MSM currently married (CM) to a female partner. The aims of the study was to analyse and understand HIV associated risk behaviors among MSM currently married to a female partner in Thane, Maharashtra.Methods: MSM accessing HIV prevention interventions through Targeted Interventions (TIs) in Thane, was approached through a cross-sectional study design. 67 CM-MSM and 57 never married (NM) MSM compared to understand the HIV associated risk behaviors. Engagement in vaginal intercourse, presently living with regular female partner and current marital status used as the screening variables. Statistical analysis used as descriptive, bi-variate and multi-variate analysis performed.Results: Mean age of the CM and NM-MSM together (N=124) is 30 years, with 31% as panthi self-identity, 28% double-decker and 18% bisexual. Unsafe anal sex with paid male/hijra, regular non-paying male and occasional non-paying male/hijra is significantly high among CM-MSM than NM-MSM.Conclusions: Targeted interventions (TIs) in Thane should ensure safe sex practices across all types of partners, especially among MSM married to women, and facilitating a conducive environment for MSM to decide their marital life.
Acute respiratory infections among under five children in a rural area of Kancheepuram district, Tamil Nadu, India: a cross-sectional study
Authors: A. K. Savitha , S. Gopalakrishnan , R. Umadevi
Published: July 2018

Background: Acute respiratory infection (ARI) is an infection of the respiratory tract that may interfere with normal breathing. ARI is one of the leading causes of illness and death among children worldwide. The aim of the study was to estimate the prevalence of ARI among under 5 children in the rural field practice area of a medical college in Kancheepuram district of Tamil Nadu.Methods: This study is a community based cross–sectional study. The study population was children below five years of age and informant was the mother of the child. The sample size is 380 and simple random sampling method was used. Data was analyzed using the SPSS software, version 16, and presented as descriptive statistics.Results: The prevalence of ARI among children was 41.6%. Regarding the symptoms of ARI, 36.6% of them had either cold or runny nose, 27.9% had cough, 23.4% had stridor, 20.8% had reduced intake of food, 2.6% had either ear pain or discharge, 2.6% had rapid breathing.1.3% had wheeze, 0.8% were tired/drowsy, 0.5% had throat pain, 0.5% had convulsions and 17.1% of them had symptoms with fever.Conclusions: This study shows the prevalence of ARI among children below 5 years of age is 41.6% which is relatively high. The symptoms of ARI reflect the non severe form of pneumonia. More hospital based studies should be done in order to know the burden of severe form of pneumonia which contributes to the morbidity and mortality of children below five years of age.
An epidemiological study on ocular morbidities among school students in an urban area of South 24 Parganas, West Bengal
Authors: Mohanta Munu , Dasgupta Aparajita , Pan Tania , Paul Bobby , Bandyopadhyay Lina , Mandal Shamita
Published: July 2018

Background: The estimated national prevalence of childhood blindness was 0.8 per 1000. Childhood blindness is a priority area because of the number of years of blindness in the life-time of a child. About one-third of India's blind lose their eye-sight before the age of 20 years making early detection and treatment of ocular morbidity very crucial. This study aimed at estimating the proportion of ocular morbidities among school students in a secondary school in an urban area of West Bengal.Methods: It was a cross-sectional institution-based observational study conducted in August 2017 among 151 school students of 7th to 9th standard in an urban area of West Bengal. Data was obtained using a structured questionnaire followed by checking of visual acuity by Snellen’s chart. Visual acuity of 6/9 or more in any one eye was taken as a sign of visual impairment. Data was analysed using SPSS version 16.0.Results: Out of 151 students, 51.0% were found to have refractive error. The most frequently reported was difficulty in seeing among 43.7% of the students followed by headache while studying (36.4%) and pain in eyes (35.1%). Also, 9.9% of the students reported difficulty in seeing at night. Tests of association revealed that posture and screen time were significantly associated with presence of refractive error.Conclusions: The study revealed that high prevalence of refractive error among school students. Periodic screening of school children and spreading of awareness regarding correct posture and screen time are very essential to improve the quality of eye sight.
Knowledge, attitude and practices regarding emergency contraception among married women in Ludhiana, Punjab, India
Authors: Saini Shipra , Kamra Deepshikha , Singh Shavinder
Published: July 2018

Background: An unwanted and unintended pregnancy is a major concern in a women’s life as it has its adverse social and health outcomes. Emergency contraception (EC) is safe and effective method that gives women a second chance to prevent unwanted pregnancy after unprotected intercourse.Methods: This is a community based cross sectional study done in field practice area under the department of Community Medicine, Christian Medical College, Ludhiana, Punjab. A total of 400 respondents were selected by stratified random sampling from the list of eligible couples residing in the area. The interview was conducted using semi structured questionnaire, after obtaining their informed consent.Results: The mean age of respondents was 31.44±5.67 years. 68.7% of respondents were using some kind of contraception. Majority (68%) of respondents had heard of emergency contraception and for majority (81.3%) source of information about EC was Media (TV). Out of 272 respondents who had heard of emergency contraception 146 (54.1%) had negative attitude towards emergency contraception and only 30 (8%) had used ECP. Practice of ECP was found to have statistically significant association with employment and history of unwanted pregnancy.Conclusions: EC has a potential to curb the menace of unintended pregnancy thereby decreasing unsafe abortion and maternal mortality. In spite of reasonable awareness of emergency contraception, as found in present study there is wide gap for its usage. Hence behavioural change strategies should be considered to bring attitudinal change on use of emergency contraception.
A cross sectional study for utilisation of antenatal care services and its association to birth weight of babies in a tertiary care centre in Western India
Authors: Jogia Priyanka D. , Lodhiya Kaushik K.
Published: July 2018

Background: Low birth weight is a major public health problem in India. Amongst several factors affecting birth weight, the two crucial factors are demographic characteristics of mothers and utilisation of antenatal care services. Identification of these bottlenecks will help in forming suitable strategies to mitigate the problem of low birth weight in developing countries.Methods: This was a cross-sectional study conducted in a medical college hospital of Gujarat. All the mothers admitted in maternity ward for delivery during July 2017 and had given informed consent, were involved in the study. Interview consisted of demographic characteristic of mothers, utilisation of antenatal services and records of pregnancy outcome. Data were entered in excel 2010 and analysed using Epi info 7.2. Strength of association between LBW and risk factors was obtained using odds ratio test.Results: Majority of the mothers had registered for antenatal care within the first trimester (78%) and had taken minimum of four ANC visits (93%). One fifth (18%) of the mothers had babies weighing less than 2.5 kgs. Lower education status of mothers, multigravida, and mothers with less than four ANC visits, preterm births and female foetus were significantly at higher risk of low birth weight as compared to their counterparts.Conclusions: The factors determining LBW were lower education status of mothers, multigravidity, inadequate ANC visits, preterm births and female sex of foetus. We recommend that increasing the education status of masses, particularly of females and ensuring adequate ANC utilisation will reduce the problem of LBW.
The profile of patients’ complaints in a tertiary care hospital in South India
Authors: Nalakath Mohammed Jezeel , Thasneem P. M. , Deepak K. V. , Uvais N. A.
Published: July 2018

Background: Complaints from patients and their carers are important indicators of problems in a healthcare system and provide valuable insights into safety-related problems within healthcare organisations. The objectives of the present study are to identify the frequency distribution of the people complained about, the units complained about and the total number of complaints.Methods: We employed a descriptive, cross-sectional study to conduct this research. The research population included cases registered at the complaints unit of a tertiary care hospitals in selected months of May 2017 to August 2017. The data were collected through observation of available documents. Excel software program was used for data analysis.Results: The administration received 692 complaints between the study period. The highest rate of complaints was filed against admission process (30.06%) and the lowest rate of complaints are filed against staff (2.51%). Our study results showed a significantly less complaints against nursing staff and no complaints against medical staff, indicates that the nursing and medical staff of the hospital might be observing medical ethics and professional commitment to a high standard and communicating well with the patients. High rate of complaints against admission unit, house keeping unit and high billing amount indicates the unrealistic expectations prevailing in the minds of clients from the health care provider.Conclusions: The current study generated the profile of patient’s complaints in a tertiary care hospital running in a charitable model. Such data can be utilised to identify common problems and to plan strategies.
Evaluation of obesity and its risk factors among rural adults in Tamil Nadu, India
Authors: R. C. Karthik , S. Gopalakrishnan
Published: July 2018

Background: Obesity is a largely emerging multi-factorial non-communicable disease, which is caused due to accumulation of fat cells either by an increase in the size or number. World over, obesity has been proven to be the leading cause for several non-communicable diseases like diabetes, hypertension, cancer, etc. This study was done to evaluate the prevalence and risk factors of obesity in a rural population of Tamil Nadu.Methods: This cross sectional study was carried out among 600 adults residing in Sripuram, a rural field practice area of our medical college. Data was collected by systematic random sampling method, using a structured questionnaire, to assess the socio-demographic characteristics, anthropometry and physical examination findings. Body Mass Index was calculated and classified as per WHO classification for Asians. SPSS Software Version 17 was used to analyze the data.Results: Among the 600 total study subjects, 317 subjects (52.8%) were males and 283 subjects (47.2%) were females. The age distribution among the study population ranged between 20-60 years. Prevalence of overweight (BMI>23) was 25.3% and prevalence of obesity (BMI>25) was 25.5%. About 11.5% of the study subjects were underweight (BMI>18.5) and 37.7% of the study population had normal weight. Sibling obesity and presence of thyroid disorders were significantly associated with the risk of overweight and obesity.Conclusions: This study highlights the need for periodic screening to detect obesity at its incipient stages. It is pertinent that awareness is created periodically to modify the diet and lifestyle risk factors in order to prevent further complications of obesity.
Assessment of gadgets addiction and its impact on health among undergraduates
Authors: Kumar Aravind K. , Sherkhane Mayur S.
Published: July 2018

Background: Technology has made our youth the most vulnerable group among today’s population, because of their accessibility and addiction to newer gadgets, which are cheap and easily available. Society has always been worrying about the term ‘Drug Addiction’ of our youth but ‘Gadget Addiction’ is a more critical area of concern in the present era and is a threat to the social infrastructure in the future. Addiction is an irrepressible urge which is accompanied by loss of control leading to lower emotional intelligence indirectly deteriorating the academic and professional performance as well as hampering their family life leading to life threatening problems in future.Methods: Cross sectional study was done among 200 undergraduates using predesigned and pretested questionnaire. Gadget dependency was analysed using 5-point Likert-scale. Descriptive statistics and chi-square test was used for analysing the data collected.Results: 71% belonged to 21-24 years age group. 73.5% were males and 43.5% belonged to class I socio-economic status and 70% had normal BMI. 72.5% of subjects had first gadget at 16-20 years and 90.5% were using smart-phones as a common gadget, of them, 50.2% were using for more than 7 hours a day. 61% had difficulty in day to day work performance. Females were more prone compared to males (p=0.008).Conclusions: High level of dependency was present with gadget addiction. Health action to be taken in form of counselling about the pros and cons in the early phase can prevent future complications.
Extreme leukocytosis in a healthy young man and use of polymerase chain reaction for detection of BCR‑ABL
Authors: Joob Beuy , Wiwanitkit Viroj
Published: July 2018

Dear Editor,chronic myeloid leukemia (CML) is a common myeloproliferative disorder seen in adult. The difficulty in diagnosis of the case is usually in case without overt blood picture finding. Here, the authors report a case of young male (24 years) who had routine blood examination before starting a job. His complete blood count was within normal limit except for an extremely high white blood count (more than 30,000). The blood smear examination showed leukocytosis without observation of abnormal blast cell. The immunological flow cytometry test result was negative. The patient was to have further diagnosis. The patient denied for bone marrow aspiration for cytological study selected to have an alternative peripheral blood test for real-time quantitative polymerase chain reaction (RQ-PCR) for BCR-ABL, and the result showed positive result. This case was finally diagnosed to have CML and the patient received oral nilotinib treatment. The repeated examination at 6 months showed major molecular response. The patient was still alive at present (2018, 5 years after the first diagnosis). This case is an example of early diagnosis of a CML case in healthy patient with the use of the new RQ-PCR test for BCR-ABL, which is considered the most available sensitive test at present. The test might be considered as a tool for additional screening for any case of unexplained asymptomatic extreme leukocytosis in asymptomatic healthy population. In fact, the use of the 65new molecular technique becomes the new useful test in oncohematology that can increase the chance of early diagnosis and reduce the unnecessary invasive harmful medical procedure to the patient. The other good example is the JAK2 test that can help diagnosis of polycythemia. In our countries, where the situation is still a developing country, the great concern for further management is the cost of the test. How to reduce the cost of the test to increase the affordability of the test to support the patient is the future goal.
POSSIBLE REGULATORY EFFECTS OF APPLICATION OF ALPHA LIPOIC ACID AND INSULIN AGAINST CADMIUM EXPOSED DIABETIC RATS
Authors: Kılıç Neşe , Akyüz Fahrettin , Tekin Neslihan
Published: July 2018

OBJECTIVE: Environmental exposure to the cadmium
(Cd), is associated with hyperglycemia and reduced
serum insulin. This investigation was planned to
assess the effects of Lipoic Acid (LA) and insulin on
glycolytic enzymes, liver marker enzymes and lipids in
Cd exposed diabetic rats.
MATERIAL AND METHODS: Male Wistar rats were
separated into 7 groups (n=8 in each group). Groups were
designed as control, diabetic control, diabetic + CdCl2,
diabetic + insulin, diabetic + CdCl2 + insulin, diabetic +
CdCl2 + LA, anddiabetic + CdCl2 + insulin + LA groups.
Type 1 diabetes was established by intraperitoneal
(i.p.) injection of streptozotocin (STZ) (65 mg/kg) into 6
groups. Insulin (4 IU/kg/day) was given subcutaneously
(s.c.) to insulin treated groups. CdCl2 (1,2 mg/kg/day) was
given s.c. to CdCl2 treated groups. LA (100 mg/kg/day)
was given i.p. to LA treated groups. CdCl2, LA, and insulin
treatment were started 2 days after intraperitoneal STZ
injection and continued for 3 weeks. Serum glucose, AST,
ALT, BUN, LDL, HDL, and TG levels and liver hexokinase
(HK), pyruvate kinase (PK), whole blood HbA1c level, and
Na+/K+ATPase activity were evaluated.
RESULTS: In diabetic group, serum glucose, HbA1c, TG,
LDL, AST, ALT, ALP, and BUN levels were higher than cont- rol, but HDL was lower. In liver tissue, activities of Na+/
K+ATPase, HK and PK activities were decreased in dia- betic control group. PK, HK and Na+/K+ATPase activities
were increased in liver in diabetic+CdCl2 and Diabeti- c+Insulin+CdCl2 groups. An increase was determined in
activities of HK, PK, and Na+/K+ATPase in insulin and LA
treated groups compared with diabetic control group.
CONCLUSIONS: These results suggest that application
of insulin and LA could be an effective therapeutic
intervention against liver injury caused by Cd and STZ.