bluuebunny/crossref_metadata_2025 huggingface dataset:
DE PROFESSOR A TUTOR: DESEJO E DISCURSOS NA ARTICULAÇÃO ENTRE PBL E PSICANÁLISE - RELATO DE EXPERIÊNCIA
Authors: Lessa Andrade Filha Lêda , Castro Maria Luiza Sarno
Published: February 2017

Os impasses referentes à transmissão do saber foram sinalizados por Freud na medida em que o interesse na articulação entre a psicanálise e a pedagogia crescia, donde decorreu a sua afirmação sobre o impossível contido nos ofícios de educar, governar e psicanalisar. Este artigo apresenta uma experiência no ensino da psicologia com o uso do método PBL ( Problem Based Learning). O ponto do qual se parte para uma análise é o dos deslocamentos ocorridos quando o professor passa à condição de tutor, e o eixo de abordagem das questões que aí se desdobram é a psicanálise – mais especificamente, os discursos conforme trabalhados por Lacan.  Diante das dificuldades contemporâneas relacionadas à transmissão no âmbito do ensino – aqui, especificamente, o da psicologia –, as autoras pensam ser o PBL uma alternativa interessante de trabalho em face dos métodos tradicionais, uma vez que ele, o PBL, mesmo sem assim o explicitar, permite instaurar o discurso que visa o desejo. Ademais, o dispositivo próprio ao método – abertura e fechamento de problema, estabelecimento de objetivos de pesquisa a partir das discussões entre os alunos, participação do professor na condição de tutor produz incontestáveis deslocamentos na posição de saber, impactando o ato de ensinar e o trabalho de aprender. A experiência com o PBL, se bem conduzida, convoca o aluno à responsabilização pela sua produção, e o professor a declinar da usual conduta de ministrar a lição, de modo que fica valorizado o conhecimento como algo sempre a advir, e que se processa nas trocas coletivas.
The Bohemian Girl de William Balfe y Alfred Bunn a través de algunos fragmentos significativos
Authors: Pérez Fernández Julián Jesús
Published: February 2017

En este artículo se ofrece una visión general de la ópera The Bohemian Girl de William Balfe (música) y Alfred Bunn (libreto). A partir de una presentación detallada del argumento, nos centramos en el análisis musical de tres arias, si bien hacemos referencia a otros fragmentos importantes de la obra. Como conclusión, y teniendo en cuenta sus valores musicales, así como el éxito que tuvo en la época de su estreno, planteamos la recuperación e inclusión de The Bohemian Girl en el repertorio habitual de los teatros de ópera.
El entremés de los romances, atribuido a Cervantes. Edición modernizada e introducción de Alfredo Rodríguez López-Vázquez
Authors: Rodríguez López-Vázquez Alfredo
Published: February 2017

El entremés de los romances, atribuido a Cervantes. Edición modernizada e introducción de Alfredo Rodríguez López-Vázquez
Prevalence of anaemia among the hospitalized children in a rural tertiary care teaching hospital
Authors: Muthusamy Bala Gopal , Venugopal Vinayagamoorthy , S. Sumithra
Published: February 2017

Background: The most important nutritional deficiency (micronutrient deficiency) among children in the present world is iron deficiency. The objective of this study was to evaluate the prevalence of nutritional anemia (iron deficiency anemia) among the hospitalized children in the tertiary care rural hospital. To evaluate the distribution of anemia among various age groups, sex and its association with various systemic illness.Methods: Retrospective (record based) cross sectional study carried out in a tertiary care teaching hospital. Information regarding age, gender, chief complaints, laboratory investigations carried out like total WBC count, haemoglobin was collected. Final diagnosis with system of involvement was documented. These factors were analysed.Results: Data collected from 905 patients were analysed for the study purpose. Out of 270 children in the age group of less than 2 years 72% of children were anemic. In the age group of 2-5 years55.7% of children were anemic. Nearly 2/3 of children in less than 5 years of hospitalized children were anemic. Overall 50% of children between1 month to 12 years were anemic. System wise analysis have shown 57% of respiratory cases, 47 % of gastrointestinal cases and 48% of infectious disease cases were anaemic.Conclusions: Nutritonal anemia is a major health burden in young children in developing countries. Iron deficiency in early life during the period of brain maturation is extensively studied by various research groups. Changes in brain were also reported in animal studies. Understanding the impacts of iron deficiency in terms of its role in cognitive development, intellectual development, motor development, immune function, school performance and physical development this is considered as an important and urgent public health problem in our country.
Role of probiotics in preterm infants: a randomized controlled trial
Authors: S. Sukanyaa , S. Vinoth , S. Ramesh
Published: February 2017

Background: Probiotics are live microorganisms that, when administered in adequate amounts, confer a health benefit on the host. Probiotics are proposed to aid in the quicker colonisation of the preterm gut by various mechanisms thereby providing innumerable health benefits to the preterm infants. Hence we conducted a study to analyse the role of probiotics in preterm babies. Our primary aim was to compare the weight gain pattern among preterm infants: those receiving probiotic and those who did not receive the probiotic.Methods: Preterm/VLBW babies were selected, randomized and placed into two groups. One group was given the chosen probiotic and the other was kept as control. The weight gain pattern and the duration of hospital stay among the two groups was compared at the end of one month of age.Results: The average weight gain in the probiotic group was higher than the control group which was statistically significant. (mean difference: 0.230 + 0.11 95% CI: -0.796 to -0.251 p value <0.000).Conclusions: Our study was yet another evidence proving the utility of probiotics in the field of neonatalogy.
Biochemical parameters (lactate dehydrogenase, serum albumin) as early predictor of severe dengue
Authors: Shankar Poornima , B. Prarthana
Published: February 2017

Background: Dengue fever (DF) is the arboviral infection with the largest incidence worldwide. Clinical expression of dengue virus infection varies from no symptoms to severe dengue with shock. It is the most rapidly spreading vector borne disease in the world. Nearly 100 million cases of Dengue fever and between 250,000 and 500,000 cases of severe dengue are annually reported to the WHO. The objective of this study was to study aims at determining the LDH and serum albumin levels as early parameter to predict the severity of Dengue illness.Methods: A observational clinical study conducted at K.I.M.S hospital, Bangalore, Karnataka, a tertiary care hospital. Children admitted in KIMS Hospital, Bangalore, Karnataka, a tertiary care hospital, Serum LDH and serum albumin levels are measured using the blood sample taken on the 3rd day of fever after confirmation of dengue fever (NS1 Ag- positive).Results: Study enrolled 150 patients with confirmed infection of Dengue virus who were admitted to paediatric unit between July 2014 and December 2016. Serum samples taken 72-96 hours within onset of fever were used for biochemical tests. Of 150 patients, 40 developed Severe Dengue (SD). Cases of SD had higher levels of lactate dehydrogenase (LDH) and low levels of serum albumin. Multivariate analysis showed that early alterations of LDH levels i.e.  Out of 40 patients who developed severe dengue, 37 patients i.e. 92.7% had raised levels of LDH with levels more than >600 IU and<3 levels of serum albumin 13 patients i.e 32.5% of severe dengue cases with P value of < 0.001, which showed significant association.Conclusions: Early alterations of biochemical parameter like LDH and serum albumin can predict Severe Dengue in patients with acute dengue illness.
Prevalence of road traffic accident in children: retrospective study in tertiary centre
Authors: G. P. Mallikarjuna , G. S. Latha , D. V. Veeresh Babu , H. K. Thejraj
Published: February 2017

Background: Road traffic accidents (RTA) are the leading cause of unnatural deaths in the world and a major burden on the world’s economy. The aim was to study the prevalence of road traffic accident among children.Methods: It is a retrospective cross sectional study. Data collected from the hospital records in PICU. Children studied are either admitted directly for road traffic accident or referred to our centre for complicated injuries. children of 1 to 18 years are studied, details of address, locality (either rural, urban) road safety precautions used, mode of injury, type of vehicle, type of injury, number of passengers, complications, outcome of injury are collected and entered in prescribed proforma, and impact of each one is analysed and magnitude is studied. Study period was from June 2014 to June 2016.Results: This study shows that road traffic accident prevalence is more in 15-18 year age group (31%), and males are affected more commonly (79.5%), among these majority of children were from rural area (73%), more common type of injury were complicated injuries (85.1%). Children travelling in 2 wheelers were affected more (74.9%). Results analysed with age of victims and type of injury, p value <0.05 is considered significant.Conclusions: To bring the mortality rate down, children especially with rural background should be made aware about the importance of strict compliance to traffic rules and regulations. Government need to start implementing traffic rules awareness programme among rural people.
A study of clinical and laboratory profile of scrub typhus in children in a tertiary hospital in South India
Authors: Kumar Radha , Srinivasan Purusothaman
Published: February 2017

Background: Scrub typhus is an acute febrile illness caused by infection with Orientia tsutsugamushi. The present study was conducted to study the clinical features, laboratory profile, complications and response to therapy among children suffering from scrub typhus in a tertiary health care institution of Tamil Nadu, India.Methods: The study was conducted at Saveetha Medical College Hospital, Tamil Nadu, India. Duration of the study was from August to December, 2015 in the Department of Pediatrics. Children with clinically suspected Scrub typhus were subjected to detailed clinical examination and investigation. Diagnosis of scrub typhus was confirmed by IgM ELISA. Results: 34 patients were diagnosed as suffering from scrub typhus. Common symptoms noted were fever, headache, cough and cold, chills, rigor, myalgia and vomiting. The common complications noted were thrombocytopenia in 16 children (47%) and features of meningoencephalitis and hepatitis were present in 2 children (5.8%). Eschar was identified in 24 (70.5%) patients. Mixed infection was seen in 4 (11.7%) children who had concurrent culture positive Urinary Tract Infection.   Conclusions: Scrub typhus is an acute febrile illness which requires high index of suspicion for early diagnosis, monitoring of the clinical and laboratory parameters and prompt treatment which may help in complete cure without further complications and morbidity.
Morbidity pattern and outcome of children admitted to a paediatric intensive care unit of Eastern India
Authors: Sahoo Bandya , Patnaik Sibabratta , Mishra Reshmi , Jain Mukesh Kumar
Published: February 2017

Background: In developing countries, there is scarce data on paediatric critical care. This makes modification of practices to improve outcome, difficult. The above study was done to highlight the lack of facilities and concept of pediatric critical in the eastern part of India so that modification of management can lead to better outcome of critically ill children.Methods: A retrospective study of the demography, clinical profile, diagnosis, treatment and outcome of children admitted to the PICU of Kalinga Institute of Medical Sciences from January 2014 to December 2015 was done. Results: A total of 848 children were admitted to the PICU with male and female children being 61.3% and 38.7% respectively. Diagnoses included infectious diseases (20.7%), respiratory disease (19.1%), central nervous system diseases (14.3%), cardiovascular diseases (10.8%), gastrointestinal diseases (7%), surgical problems (4.7%) haematological (4%), renal (3.3%), poisonings (1.4%), and others (14.3%). Out of 848 admitted children, 4.1% died and (1.4%) left against medical advice (8.5%) children received mechanical ventilation, among which (62.5%) improved, 34.7% died and 2.8% children left against medical advice. Multiorgan dysfunction syndrome (MODS) and co-morbidity were present in 25% and 22% respectively. The proportion of death among patients admitted to PICU was 4.1%.Conclusions: The leading cause of admission was infectious and respiratory diseases. Children with MODS and co-morbidity had higher mortality. The overall mortality rate in our PICU was low. We conclude, a well-equipped intensive care unit with modern and innovative facilities leads to a good outcome.
Effect of multimodal therapy on children with attention deficit hyperactivity disorder
Authors: Mhtare Priti , Gajre Mona , Karia Sagar , Chheda Nidhi , Saroj Dinesh , Sousa Avinash De
Published: February 2017

Background: Attention deficit hyperactivity disorder (ADHD) is the most common neurobehavioral disorder affecting school aged children. Multimodal treatment is the most effective form of treatment which includes multiple elements like parent and child education about diagnosis and treatment, specific behaviour management techniques, medications and appropriate educational programs. This study was planned to study effect of multimodal intervention i.e. medication along with behavioral modification therapy and occupational therapy given to children with ADHD.Methods: This was a longitudinal, prospective study carried out from January 2014 to October 2014, in which children coming to pediatric neuro-developmental centre and diagnosed as ADHD were included. Cognitive behavior therapy (CBT) was given along with required medications to these children. Improvement in symptoms was checked by Conner scale 3TM long form given to both parents and teachers. Results: 41 out of 50 children complied with our study and majority were of ADHD- combined type (92.6%). 31 out of 41 students achieved non-significant, T- score at the end of 6 months on Global score of Conner Scale.Conclusions: Multimodal intervention was found effective in treating children with ADHD.
Audiological screening of high risk infants and prevalence of risk factors
Authors: M. Regina , Moideen Sanu P. , M. Mohan , M.T.P. Mohammed , Afroze M. Khizer Hussain
Published: February 2017

Background: Hearing loss in early life can have deleterious effects on child’s psychosocial, scholastic and social-emotional development. Early identification and timely intervention can provide the child with better speech and language development. This study has been done to estimate the prevalence of hearing impairment among high risk infants as per Joint Committee on Infant Hearing (JCIH) criteria and to study the risk factors associated with neonatal hearing impairment.Methods: This multicentric observational study was conducted among 613 high risk infants admitted and discharged from neonatal intensive care units (NICU) of Academy of Medical Sciences, Kannur, Kerala and Sri Siddhartha Medical College and Research Centre, Tumakuru, Karnataka, India (level III neonatology units with an NICU admissions of average around 1200 per year), during the period August 2015 - August 2016 (12 months). The babies were selected based on the JCIH 2007 criteria. All babies were subjected to behavioral audiometry (BA) and Oto Acoustic Emissions (OAE), preferably within 3 weeks. Those failing OAE were reevaluated at 6th week and with Auditory brain stem response (ABR) within 3 months time. Results: A total of 613 high risk babies were screened. 42 (6.76%) among them were having hearing impairment. The most common risk factors associated with hearing impairment was NICU stay for more than 24 hours, prematurity, low birth weight and meningitis/sepsis etc.Conclusions: Hearing impairment among high risk babies is not a rare condition. In our study, the prevalence was 6.76%. Low birth weight, admission to NICU for more than 24 hours, low APGAR, meningitis/sepsis, maternal and neonatal complications are significant risk factors for hearing impairment among neonates. This highlights the need for neonatal screening. Though we recommend a universal screening program, at least a targeted approach should be practiced in neonatal care. Those babies who are found to have hearing impairment should be closely followed up with early intervention and rehabilitation.
Clinico-microbiological profile of health-care associated infections in a paediatric intensive care unit of tertiary care hospital
Authors: Udawat Priyanka , Gupta Shalu , Manchanda Vikas , Saikia Diganta
Published: February 2017

Background: The study was undertaken to determine the total burden of health-care associated infections, microbiological profile and their impact on length of stay and mortality in a PICU of a tertiary care Hospital by prospective surveillance.Methods: All children ≥ one month and ≤ twelve years of age admitted in PICU for more than 48 hours from December 2009 to November 2010 were followed according to CDC/NHSN surveillance definitions of HCAI. Incidence rates, incidence densities and device utilization ratio were measured for different HCAI. Length of stay and mortality of HCAI were compared with non-HCAI patients. Antibiotic susceptibility pattern of isolated micro-organism was analyzed. Results: Out of total 618 patients admitted in PICU during study period 324 fulfilled study criteria. In those 324 patients 58 patients developed 68 episodes of HCAI. The CIR and IDs’of HCAI were17.9/100 patients and 22.14/1,000 patient-days, respectively. Of the 68 episodes of HCAI, there were 36 VAP, 17 BSI, 8 UTI, 2 pneumonia, 2 LRI-LUNG and 1each of SSI-MED, SST-Skin and GI-IAB. The most common microorganism isolated was Acinetobacter spp. followed by Pseudomonas spp. HCAI increased the average length of PICU stay (20 days versus 5 days, P<0.01) and Hospital stay (28 days versus 12 days, P<0.01). Overall mortality was significantly higher in patients who developed HCAI than non-HCAI (50.9% versus 21.3%, P<0.01).Conclusions: HCAI rates were higher than developed countries. VAP was the most common HCAI followed by BSI. HCAI increased the length of stay and mortality (P<0.01). Organisms isolated in HCAI were more resistant than non-HCAI isolates.
Verbal autopsy to determine the timing and causes of infant deaths in the northern state of India
Authors: Parashar Anupam , Barall Deepesh , Gupta Anmol , Chauhan Tripti , Kumar Devender , Kumar Arvind , Kumar Sanjay , Sharma Gopal Ashish , Kumari Sunita
Published: February 2017

Background: Data on timing and probable causes of infant deaths are very important for the design of intervention to reduce mortality because of very limited study in the state. This study was undertaken to determine the timing and causes of infant deaths in our state using verbal autopsy. The suggestions and recommendations can be used to strengthen and improve the existing facilities and services for the better outcome of life in the early childhood.Methods: A cross sectional study was conducted in 180 selected clusters by WHO cluster sampling method, using validated verbal autopsy tool for timing and causes of infant deaths.Results: Verbal autopsy was done for 45 infant deaths. 37.8% infant deaths were early neonatal, 15.5% in late neonatal and 46.7% in post neonatal period with mean age of 5.79±6.35 days in neonatal period while it was 5.07±3.38 months in post neonatal period. Of all the infants 57.78% were females. The major causes of death were severe infection (15.5%) in neonates, pneumonia (13.3%) in post neonates followed by LBW with prematurity (11.1%) and diarrhea (11.1%). No specific cause could be determined in 13.3% cases.Conclusions: The major causes of infant deaths are preventable. It emphasizes for the robust reporting mechanism to determine the exact causes of all infant mortality, strengthening of comprehensive health care delivery and ensuring the accessibility to the health care services to have a healthy infanthood.
Comparative analysis of cerebrospinal fluid adenosine deaminase levels in infective meningitis of different aetiologies
Authors: Rashid Mohsin , Mushtaq Sheikh , Manzoor Junaid , Bhat Javaid Ahmad , Chaman Shilakha , Hamid Abdul
Published: February 2017

Background: Meningitis can be caused by bacteria, viruses, parasites, and fungi as well as by non-infectious conditions including inflammatory disorders (e.g., systemic lupus erythematosis or Kawasaki disease) and neoplasia (e.g., leukemic meningitis). The objective of this study were to study cerebrospinal fluid (CSF) adenosine deaminase (ADA) levels in infective meningitis of different aetiologies. And to assess the role of cerebrospinal fluids (CSF) adenosine deaminase (ADA) levels in differentiating tubercular from non-tubercular meningitis.Methods: The study was conducted on 70 patients of meningitis at Postgraduate Department of Paediatrics, in G. B. Pant Hospital, an associated hospital of Government Medical College Srinagar. Out of 70 patients included in the study 27 cases were Aseptic Meningitis (AM), 14 cases partially treated pyogenic -meningitis (PTM), 19 cases pyogenic meningitis (PM), and 10 cases were tubercular meningitis (TBM). ADA activity of CSF was quantified by colorimetry.Results: In our study we observed a significant high level of ADA 30.0±3.2U/L (20.0, 54.0) among the tubercular meningitis (TBM) patients and its respective level among Aseptic Meningitis (AM), was 8.1±0.3U/L (4.0, 11.5), partially treated pyo -meningitis (PTM) was 7.6±0.4U/L (5.0, 11.0), pyogenic meningitis (PM) was 11.6±0.5U/L (8.0, 14.5). In total Non-TBM ADA level was 9.1±0.3U/L (4.0, 14.5) units/liter. At cut off of > or equal to 10U/L sensitivity was 100% specificity66.67% positive predictive value33.33% negative predictive value of 100% diagnostic accuracy 71.43%. At a higher cut off of > or equal to 12U/L sensitivity was 100% and specificity increased to 81.67% positive predictive value 47.62% negative predictive value100% diagnostic accuracy was 84.29%.Conclusions: The sensitivity and specificity of CSF ADA activity is markedly high in differentiating TBM from non-TBM. Hence CSF ADA activity may be used as a simple, cost-effective and reliable test for early diagnosis of TBM.
Anti-snake venom induced reactions among children with snake envenomation
Authors: V. Poovazhagi , S. A. Ravikumar , A. Jagadeeswari , P. Arulganesh , S. Prabhu Raj , S. Anupama
Published: February 2017

Background: Snake envenomation in children is a neglected tropical condition with high morbidity and mortality. Life threatening neurotoxic and hemotoxic envenomation in children demands timely Anti Snake Venom (ASV) administration to improve the outcome.Methods: This was a prospective observational study undertaken at the pediatric intensive care unit of tertiary care referral center at Chengalpattu. All the 26 children with evidence of snake envenomation were recruited after informed consent of the caregivers during the study period. Clinical presentation and ASV related reactions were studied.Results: In this study of 26 children with envenomation, neurotoxic envenomation was more common. Foot was the common bite site. 10 of the 18 children (55.5%) had nocturnal bites. Ptosis, local swelling, hypotonia, headlag, vomiting and shock were the common clinical features. Polyvalent antivenom was used in all these children. ASV reactions of varying severity was encountered in 18 of the 26 children (69.2%). All the acute ASV reactions were encountered in the first 30 minutes. All the 18 children had rashes to begin with. Rashes and itching were the common feature of ASV reactions. Among children with reactions shock was seen in 50 %. Overall mortality was 3.85% (one child). None died due to anaphylaxis. The administration of ASV in primary and secondary centers was not carried out in time and the occurrence of anaphylaxis were not managed with inj adrenaline prior to referral. Inj pheniramine maleate, atropine and hydrocortisone were used by those centers. Referral after ASV reactions led to delay in completion of ASV administration.Conclusions: Occurence of ASV reactions is high in children (69%). There is an undue delay in ASV completion with ASV reactions. There is an urgent need for prevention of ASV reactions either by monovalent venoms or premedication prior to ASV administration.
A mother’s management of rectal prolapse in a Nigerian toddler
Authors: Joel-Medewase Victor Idowu , Onigbinde Michael Olaniyan , Oyedeji Olusola Adetunji
Published: February 2017

A 20 months old Nigerian girl who had rectal prolapse was subjected to sitting on a hot ‘sitz’- like bath as a home management of the prolapse. Gluteal, perineal and upper thigh burns and sepsis; also, febrile convulsion and spontaneous passage of 5 ascaris worms were the sequellae.
Congenital lobar emphysema presenting as recurrent pneumonia in an infant
Authors: M. D. Balaji , S. Sowmya , K. S. Naveen
Published: February 2017

Congenital lobar emphysema (CLE) is a developmental anomaly of the lower respiratory tract, which is characterised by hyperinflation of one or more lobes of lung. CLE is potentially reversible, though possible life threatening cause of respiratory distress in neonate. Here we present a 4 months baby who presented with respiratory distress related to CLE.
Bilateral spontaneous chylothorax in a newborn and response to octreotide therapy
Authors: Azam Md. Nawad , Majhi Subrat Kumar , Mishra Baikuntha Narayan , Joshi Ranjit Kumar , Pahi Prabin Prakash
Published: February 2017

Chylothorax is an abnormal collection of milky white fluid called chyle in pleural space, and is an uncommon cause of respiratory distress in neonates. There is high morbidity and mortality, if not managed appropriately. Here we report a rare case of congenital bilateral chylothorax presented with respiratory distress in our NICU on day one of life. Thoracocentes revealed chyle on both the sides. In view of high drainage of chylous fluid, besides TPN, Octreotide infusion started and the baby responded well.
Neonatal chikungunya with facial pigmentation and encephalitis
Authors: Yadav Ajeet Kumar , Dewan Vivek , Meena Ramkesh , Y. M. Bhavika
Published: February 2017

Neonatal Chikungunya infection in postnatal period is a rare entity. Clinical presentation varies from a simple febrile illness with or without centrofacial hyperpigmentation to symptoms like poor feeding, lethargy, apnea and seizures. Here, we report a case where chikungunya infection was suspected and confirmed by IgM serology, which was positive in the baby and negative in mother.
Ecthyma gangrenosum in a neonate
Authors: K. Vindhiya , C. Lakshmi Charan , D. Aishwarya , M. Sindhu
Published: February 2017

Ecthyma gangrenosum (EG) is a rare skin infection caused by pseudomonas aeruginosa. It typically occurs in immunocompromised and critically ill patients but can occur rarely in healthy children. 28 days old neonate presented with widespread vesiculobullous lesions which ruptured to form punched out gangrenous ulcers with black eschar. Blood and pus culture grew Pseudomonas aeruginosa and diagnosis of EG due to pseudomonas was made. Despite appropriate measures, baby succumbed to the illness. Rapid progression of the lesions and high mortality rate emphasize the importance of early suspicion and proper treatment.
Acquired colonic atresia in a 4-month old term male infant: a rare case report
Authors: Rattan Kamal Nain , J. Gurupriya , Bansal Shruti , Kapoor Rohit , Yadav Roomi
Published: February 2017

Acquired colonic atresias are very rare but, are known in association with necrotizing enterocolitis. We report a case of a 4-month term male infant with recurrent episodes of abdominal distension, bilious vomiting and constipation off and on, without the history of necrotizing enterocolitis. Exploratory laparotomy was performed, an inflammatory mass with multiple dense interloop adhesions were found in the mid-transverse colon. These adhesions were lysed to identify the proximal dilated and distal blind end of the colon.  Rest of the gut was normal.  This case is unique for the fact that, it is a case of acquired colonic atresia without history of necrotizing enterocolitis, unlike other reported cases of acquired colonic atresia.
Study of group education interventions for people with low back pain
Authors: Gupta Rishabh , Mahajan Shavi , Dewan Deepika , Gupta Rajat
Published: February 2017

Background: Backcare education administered in a group situation is one of the most effective and economic methods of treating back pain. It is based on available scientific knowledge of the physiology and mechanics of the spinal structures and their relationship to daily activities. It provides the patient with a better understanding of the problem, aiming primarily at helping the patient take responsibility for his or her back pain, while relieving pain and functional disability.Methods: This study was carried out on 100 patients of chronic low back pain, attending the OPD of Post Graduate Department of Orthopaedics, Government Medical College Jammu for a period of one year. Assessment was carried out before the treatment and after the treatment at four weeks, three months & six months post treatment. The following scales were used to measure the therapeutic response: the Modified Oswestry low back pain disability index, Visual analogue score (VAS), and clinical parameters like finger to floor distance and straight leg raising.Results: The patients showed significant improvement at 1 month, 3 months and 6 months post treatment when compared to base-line data (p<0.001).Conclusions: It was concluded that all chronic low back pain patients would benefit from a group program of back care education.
A cross-sectional study on internet addiction among medical students
Authors: S. Cynthia Subhaprada , P. Kalyani
Published: February 2017

Background: Proliferation of the internet has provided better opportunities for communication, information and social interaction. The excessive undisciplined use by individuals has led to the emergence of the concept of internet addiction. Psychological and environmental factors in the lives of college students may leave them disproportionately vulnerable to Internet addiction. The main objective of this study was to measure prevalence of internet addiction and the usage pattern among undergraduate medical students.Methods: The present cross-sectional study was carried out among 95 undergraduate students of II MBBS, selected by simple random sampling, in Kurnool Medical College, Kurnool, Andhra Pradesh, from January to February, 2016. A 20 item Young’s Internet Addiction test which is a Likert scale based interview schedule was used to measure the prevalence of internet addiction. Data was entered in MS Excel 2007 and analyzed. Chisquare test was applied and p value <0.05 considered significant.Results: Among the 95 study subjects, 62.2% were males and 37.8% were females. Males were more addicted to internet than females. The prevalence of internet addiction among the study subjects in the present study was 52.63% mild, 24.21% moderate, while 23.16% students reported normal internet usage. It was found that severity of internet addiction is inversely proportional to academic performance.Conclusions: Internet addiction is a growing health problem among medical students, hence necessary preventive and therapeutic interventions are vital to promote healthy and safe usage of Internet.
Quality of life among breast cancer patients: a cross sectional study
Authors: Kanayamkandi Jeseena , Sunderam Shalini
Published: February 2017

Background: Breast cancer is the most common cancer in women globally. Over the last decade, Quality of life (QOL) has become an important outcome measure in the treatment of cancer patients. Aim and Objective-.1) To evaluate the Quality of life among Breast cancer patients; 2) To describe the socio-demographic profile of Breast cancer patients; 3) To find out association between socio-demographic characteristics of patients and Quality of life.Methods: It was a cross sectional, descriptive and hospital based study. Total duration of study was 6 months (April 2015-September 2015), conducted in Rajendra Institute of Medical Sciences (RIMS), Ranchi, Jharkhand 84 breast cancer patients were selected as study subjects and were interviewed by a validated questionnaire.Results: A total of 84 breast cancer patients were included in the study, most of the patients were between 40-60 years, mean age being 43.32±10.2. Most were non tribal, belonging to Hindu Religion. Majority were married. None of the participants had above average or significantly high QOL. 20.2% had average QOL, 51.2% had below average and 28.6% had significantly poor QOL. Married patients were found to have a significantly better QOL (p<0.05). QOL had no association with age, ethnicity, religion, education, occupation or socio-economic status of participants (p>0.05).Conclusions: Present study showed that majority of Breast cancer patients had poor QOL. Married patients were leading a comparatively better QOL than unmarried.
The correlation of obesity, smoking, fried foods consumption pattern and food intake with lipid profile in civil servant in Yogyakarta, Indonesia
Authors: Sudargo Toto , Sari Fahmi Tiara , Naomi Novita Dian
Published: February 2017

Background: Dyslipidemia is an abnormal change in the levels of lipid profile such as increased levels of total cholesterol, LDL, triglycerides or decreased levels of HDL. The proportion of the Indonesian population (> 15 years old) with a total cholesterol level above the normal value amounted to 35,9%.  Objective: To determine the correlation of obesity, smoking, fried food consumption pattern and food intake with lipid profile in civil servant in Yogyakarta.Methods: This study is an observational study with cross sectional design at employees of Gadjah Mada University who perform medical check-up at the GMC-Health Center Yogyakarta. There are 179 respondents in the study.  Subjects are categorized to have dyslipidemia (based on NCEP ATP III criteria) if it meets ≥ 1 of the following criteria: (1) Total cholesterol ≥ 200 mg/dL; (2) LDL cholesterol ≥ 130 mg / dL; (3) HDL cholesterol < 40 mg / dL; and (4) Triglycerides ≥150 mg / dL. Fried food consumption patterns and food intake is obtained using semi-quantitative food frequency questionnaire (SQ-FFQ). Data were analyzed by Chi Square, Independent t test and Mann Whitney test (adjusted for scale variables used) with a confidence level of 95%.Results: One hundred and fifty five of 179 respondents (87.3%) diagnosed with dyslipidemia. There are 52% abnormal cholesterol, abnormal LDL 67%, 43% and 28.5% with abnormal HDL and abnormal triglycerides, respectively. The statistical test showed the correlation of obesity (p=0,022), smoking (p=0,013), the type of fried food (p=0.047), the amount of fried foods (p=0,013) and fat intake from fried foods (p=0.036) has significant association with lipid profile levels.Conclusions: There is significant correlation between obesity, smoking, type of fried food, amount of fried foods and fat intake from fried food with lipid profile levels.
Assessment of knowledge regarding menstruation and practices related to maintenance of menstrual hygiene among the women of reproductive age group in a slum of Kolkata, West Bengal, India
Authors: Santra Sutanuka
Published: February 2017

Background: Menstruation is a normal biological process and a key sign of reproductive health. Unfortunately, the taboo surrounding menstruation prevents women from articulating their needs. There is lack of awareness on the process of menstruation and hygienic management of the same. So, the problem of poor menstrual hygiene still persists in society. Objectives: 1) To elicit the knowledge regarding menstruation among the women of reproductive age group 2) To find out the practice of menstrual hygiene among them.Methods: A community based, observational, cross-sectional study was conducted at Baghbazar slum, Kolkata. A total of 160 menstruating women of the age group between 15-45 years were included. The data were analysed using IBM SPSS version 20.  Results: Only 32 women (20%) had idea before menarche regarding menstruation. 65% women used only sanitary pad and 30% used only cloth pieces where as 5% used both pad and cloth piece. Prevalence of sanitary pad use was significantly higher among those aged <25 years (p<0.05). With increasing literacy status as well as socio economic status, use of sanitary pad was also found to be increased and this difference was statistically significant (p<0.05). About 42% of the cloth piece users reused cloth piece. All those, who reused cloth pieces, washed the used cloth pieces with soap and water and 50% of them dried those under sunlight. All the women practised some kind of restriction during menstruation. About 4% individuals did not take regular bath during their bleeding period.   Some women (37.5%) suffered from reproductive tract infection during or just after menstruation. Most of the study subjects (95.6%) disposed used napkins in municipal vat.Conclusions: Awareness should be increased regarding maintenance of good menstrual hygiene through health education programme.
Prevalence of alcohol use among high school students, the pattern of consumption and the physical circumstances associated with alcoholism in an urban area of Kerala, India
Authors: S. S. Mini , U. Anuja , S. Shaheer Khan , K. Shameel K.
Published: February 2017

Background: The present study was conducted to estimate the prevalence of alcoholism among high school   students, the pattern of consumption and the physical circumstances lead them to alcoholism.Methods: This study was done as a cross sectional study in the high schools of Pagappara PHC area which is the urban health training centre attached to Government medical college Thiruvananthapuram, Kerala, India. Sample size was calculated based on the prevalence of a previous study conducted in Kottayam district Kerala and estimated as 300. Data was collected using a pre tested questionnaire through interview technique. Data entry was done in SPSS 16 and percentages were calculated to express the results.Results: The prevalence of drinking among the high school students was 21% and 1% of students were regular drinkers. Among those consumed alcohol 38.15 have used it before the age of 10 years. 61.9% started drinking for experimentation and beer was commonly used type (71%).Conclusions: According to this study 21% of students have consumed alcohol and 1% is regular users of alcohol. Thus, there is a dire need to intervene.
Assessment of under-five immunization coverage among the population of slum areas in Mangalore taluk, India
Authors: Kumar Saurabh , Prabhu Sudhir , Jose Arun P. , Bhat Sowmya , Souza Oliver D. , V. Narayana
Published: February 2017

Background: Immunization coverage is better in urban than rural areas. However, we anticipate and argue that within the urban areas disparities and inequities persist in immunization coverage and that the socioeconomically disadvantaged, particularly those who reside in slum areas are more vulnerable and may contribute to the lower uptake of immunization. The objectives of the study were to assess the under-five immunization coverage amongst the households in slums of Mangalore taluk and to identify determinants of full immunization uptake among under 5 in the slums population and to know the reasons for non-immunization or partial immunization of children.Methods: Community Based Cross sectional study was conducted in the notified slum areas of Mangalore during August-November 2015. Information was collected from the parents regarding vaccination of their children and sociodemographic variables using a semi-structured interview schedule.Results: 88 (57.7%) of under 5 children were fully immunized, 62 (41.3%) were partially immunized in the slum areas of Mangalore, Karnataka, India. Mean age of the children in our study was found to be 35.15 months. Immunization coverage was found to be associated with the presence of immunization card, occupation of mother, knowledge about universal immunization programme (UIP), knowledge about protection offered by vaccines.Conclusions: Unfortunately, the immunization coverage was found to be very bad in the slum areas of Mangalore city, Karnataka, India. There is an urgent need to ensure that regular health education sessions are conducted. Secondly, slum areas should be the target of RCH programme with special focus on immunization related activities e.g. ensuring that all households with children should have immunization cards, as the slum areas remain the neglected section of the society due to various reasons.
A study to determine the awareness and behavioral patterns/practice about road safety measures among undergraduate medical students, Bangalore, India-cross sectional study
Authors: M. S. Ramya , Jadhav Jyothi , T. S. Ranganath
Published: February 2017

Background: Road traffic accident’s (RTA’s) is an important global public health problem causing 20 to 50 million non-fatal injuries and 1.25 million deaths annually, currently the 8th leading cause of death globally and predicted to become the 5th leading cause of death by 2030. RTA is one of the leading cause of death among the most productive age group (15-29 years) costing billions of dollars to deal with its consequences. The present study is aimed to determine the awareness and behavioral patterns about road safety measures among undergraduate medical students, Bangalore.Methods: A cross-sectional study was conducted among 540 undergraduate medical students in a medical college, Bangalore from August to October, 2015 by universal sampling technique using a semi-structured, pre-tested questionnaire.Results: Majority of the study participants were aware of traffic signal rules 99.2% and helmets usage 98.8%. 87.7% knew that alcohol consumption is dangerous while driving/riding, 67% were aware of seat belts usage and only 64.8% were aware of usage of hands free devices while driving/riding. Among the 392 two wheeler and 188 four wheeler users, 36.2% and 50% regularly used helmets/seatbelts respectively and 70% followed lane rule. The risky behaviours like jumping traffic signals, riding hands free, drag racing and drunken driving were noted.Conclusions: In order to restrict the epidemic of RTA’s undertaking proper road safety measures are the best available interventions. The overall knowledge and practice of road safety measures was high except in certain areas the practice levels were not desirable which has to be strengthened.
Treatment outcomes among tuberculosis patients at an urban health centre, Goa, India- eight year retrospective record based study
Authors: Akarkar Nikhil S. , Pradhan Saili S. , Ferreira A. M.
Published: February 2017

Background: India contributes the highest TB burden globally and DOTS being the key strategy of RNTCP needs evaluation. The objective of this study was to assess treatment outcomes in TB patients on DOTS in terms of success rates in new and retreatment cases.Methods: Retrospective record based study was conducted at urban health centre, Santa Cruz Goa, India including 135 TB cases registered from January 2008 to January 2016 for DOTS. Data on treatment outcomes was analysed using appropriate statistical methods and percentages were calculated.Results: Out of total 135 TB cases, 64.4% had pulmonary while 35.6% had extra-pulmonary TB. Percentage of new cases was 84.4% whereas 15.6% were retreatment cases. Success rate (cure rate plus treatment completion rate) for new cases was 84.2% and for retreatment cases was 76.2% while the overall success rate was 83%.Conclusions: Successful treatment outcome was lower compared to the RNTCP norm.
Assessment of quality of life of stroke survivors in a rural area of North Kerala, India
Authors: Chandran Priya , Shenoy Dhanya , Thavody Jayakrishnan , P. Lilabi M.
Published: February 2017

Background: With increase in prevalence of stroke and life expectancy the quality of life of stroke survivors assumes importance. Despite advances in diagnosis and treatment of cerebrovascular accidents the survivors continue to experience low Quality of life (QoL) especially in developing countries. The objective of this study was to assess the quality of life among stroke survivors and the prevalence of depression among them.  Methods: Cross-sectional population based study was conducted in a rural area of North Kerala. Stoke survivors were interviewed at home to assess the quality of life and depression status. QOL was assessed using the Medical Outcomes 36-Item Short-Form Health Survey (SF-36), functional status using the modified barthel index (MBI), and mood using the Beck’s Depression Inventory (BDI).Results: A total of 40 patients (65.5% men, mean age 70.58±10.7 years) were interviewed.  The mean MBI was 55.25±2.79, and the prevalence of unrecognized depression was 90%. 95 percent of patients needed varying degrees of care for their activities of daily living. The SF-36 scores of the patients were considerably lower than that to that of the general population especially in the areas of role limitation and physical functioning. Depression was more among older subjects and Depressed patients had lower MBI scoresConclusions: A significant proportion of stroke survivors continue to face limitations in their physical activities. In addition, majority have unrecognised depression that affects their QOL adversely.
A study on status of water contamination of the tube wells in a rural block of North 24 parganas district of West Bengal, India
Authors: Lahiri Saibendu Kumar , Paul Abhishek , Malick Suresh Chandra , Bhattacharjee Somdipta , Mondal Shatanik , Saha Partha , Sau Arkaprabha
Published: February 2017

Background: In India, about 85% of rural drinking water supply depends on groundwater. National Sample Survey, 65th round showed that 55% of rural households were served by a tube well.  But ground water pollution has drastically increased in last decade due to increased human activities. In India around 1.5 million children die of diarrhea and 37.7 million people are affected by waterborne diseases annually. The study was conducted to find out the prevalence of contamination of the tube well water and the factors associated with it.Methods: A cross-sectional study was conducted in nine randomly selected villages of the Amdanga Block, North 24-Paraganas district, West Bengal. Water samples of 90 tube wells were tested for the bacteriological contamination using K020 HiH2S Test Strips (Modified) and factors associated with contamination were identified using logit model.Results: The prevalence of tube well water contamination was estimated to be 45.6%. Bacterial contamination of water was found to be significantly (p<0.05) associated with the absence of casing, presence of bad odor in water, presence of habitation within 15 m area and presence of sanitary latrine within 15 m area of tube wells.Conclusions: Ground water pollution is increasing because of human activities, suboptimal maintenance and poor environmental management around the sources.  Routine surveillance of water sources, a sustainable system of maintenance and repair, and an effective waste management system in rural areas is required. Emphasis should also be given to household purification of water before consumption.