bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of repetitive education on cognitive-social factors among type 2 diabetic patients
Authors: Erkoc Arzu , Tan Mehtap
Published: May 2017

Background: Psychological, cognitive and social factors are also effective in helping the diabetes patient show behavioral changes in terms of the treatment process. The purpose of this study was to examine the effect of repetitive education on cognitive-social factors and metabolic control variables among patients with type 2 diabetes (T2DM).Methods: The study was conducted with one group using the same test at pre-determined times.  62 outpatients with T2DM were recruited for this study. The data was collected using a Patient Information Form that was prepared by the researchers, the Turkish multidimensional diabetes questionnaire, and the metabolic control follow-up form. The data was analyzed using SPSS 19 and descriptive statistics (Kolmogorov-Smirnov Test, Paired t Test, and Wilcoxon Signed-Rank Test).Results: While there was a statistically significant difference between the mean scores of interference, severity, positive reinforcing behaviors, outcome expectancies before and after the diabetes education (p˂0.05), a statistically significant difference was not found between mean values of fasting and random plasma glucose, HbA1C, HDL, LDL, triglyceride, waist circumference and body mass index (p˃0.05).Conclusions: Repetitive diabetes education provided to patients with T2DM positively affected other cognitive-social factors except for social support and self-efficacy, but did not affect metabolic control variables except for blood pressure.
Clinical efficacy of clonidine versus nalbuphine as intrathecal adjuvants to 0.5% hyperbaric bupivacaine for subarachnoid block during gynaecological procedures: a double blind study
Authors: Bansal Manoranjan , Agarwal Shikha , Gupta Kumkum , Gupta Prashant K. , Agarwal Salony , Pandey Mahesh N.
Published: May 2017

Background: Regional anesthesia techniques for gynaecological procedures are on increasing trends due to their advantage of postoperative analgesia owing to intrathecal adjuvants. The present study was aimed to comparatively evaluate the clinical efficacy of clonidine with nalbuphine when co-administered intrathecally with 0.5% hyperbaric bupivacaine for gynaecological procedures.Methods: Regional anesthesia techniques for gynaecological procedures are on increasing trends due to their advantage of postoperative analgesia owing to intrathecal adjuvants. The present study was aimed to comparatively evaluate the clinical efficacy of clonidine with nalbuphine when co-administered intrathecally with 0.5% hyperbaric bupivacaine for gynaecological procedures.Results: The onset of sensory block was earlier in patients of Group BN (3.91±2.25 min vs 4.30±0.87 min, p=0.039). The onset of motor block was also earlier in patients of Group BN (p=0.042). The time to first rescue analgesia in patients receiving intrathecal clonidine was significantly delayed (283±14.18 min vs 231.50±26.18 min, p=0.001). Intraoperative hemodynamic changes were comparable and none of the patient suffered from respiratory depression, shivering, nausea or vomiting.Conclusions: Intrathecal clonidine as adjuvant to bupivacaine provided was clinically more effective than nalbuphine for prolonging the duration of analgesia for gynaecological procedures.
Clinical profile, etiology, management and outcome of serum sodium disturbances in children admitted in PICU
Authors: Jayakumar Balaji , Sambasivam Ekambaranath
Published: May 2017

Background: Sodium disorders are common in children who need intensive care, they occur in variety of conditions, may remain unrecognized if not suspected and monitored and result in morbidity and mortality irrespective of primary problem. The aim of the study is to know etiology, management and outcome of sodium disturbances in sick children admitted to pediatric intensive care unit to Institute of Social Pediatrics Stanley Medical College.Methods: This is a hospital based cross sectional study. Two hundred and twenty-seven children in the age group of 1month to 12 years admitted in PICU over the period of 8 months were included in the study. Venous blood sampling is obtained from each patient enrolled in the study and is sent for estimation of electrolytes, blood urea, glucose levels. Serum osmolality (calculated), urine osmolality, urine spot sodium were done in selected patients.Results: Among the 227 children studied, 85 children had sodium disturbances that included both hyponatremia (80 children) and hypernatremia (5 children) The most common cause of hyponatremia is CNS disorder 25 patients (31.25%) followed by poisoning 17.Conclusions: Hyponatremia occurs frequently and should be looked for in all sick children. It is of hypotonic- euvolemic type in almost all the acute infections except diarrhea and should be managed accordingly. They contribute significantly to the mortality and morbidity.
Study of haematological parameters in malaria
Authors: Surve Ketaki Motram , Kulkarni Anjali S. , Rathod Santosh G. , Bindu Rajan S.
Published: May 2017

Background: Malaria   causing   plasmodia   are   parasites   of   blood   and   hence   induce haematological alterations. The haematological changes that have been reported to accompany malaria include anemia, thrombocytopenia and leucocytosis, leukopenia, mild   to   moderate   atypical   lymphocytosis, monocytosis,   eosinophilia   and neutrophilia.Methods: Total hundred smear positive malaria cases were taken and various hematological parameters and biochemical parameters were studied.Results: Out of 100 smear positive cases, P. vivax was positive in 55 cases while P. falciparum was positive in 45 cases. It was seen in 86.67% of falciparum Malaria patients and in 72.72% of vivax Malaria patients. Severe anemia was seen in 9% of patients. Normocytic normochromic blood picture was the most common type in anaemic patients (51.89%). Thrombocytopenia was seen in 71% of the patients. Mild thrombocytopenia was more common and present in 52% of patients while Severe thrombocytopenia was seen in 19% of cases. In falciparum malaria thrombocytopenia was present in 66.66% of the patients while it was present in 74.54% of the patients in vivax malaria. Total Leucocyte Count was normal in 72% of the patients.Conclusions: Various haematological findings can help in early diagnosis of malaria which is essential for timely and appropriate treatment which can limit the morbidity and prevent further complications.
To study the impact of design considerations on customer satisfaction in a dialysis facility of a super-specialty tertiary care hospital in Delhi, India
Authors: Makkar Namrata , Jain Kanika
Published: May 2017

Background: In recent times, patient focused hospital architecture is gaining attention. The current scenario demands to provide living spaces for families rather than ware houses for the sick. Attitudes, aspiration and values of the society must be clearly understood while planning a facility.Methods: This prospective cross sectional observational study was carried out over a period of one year at the Dialysis unit of a tertiary care, super specialty hospital in North India with the objective to establish that minor structural changes can enhance customer delight which includes patients and their attendants of a chronic disease patient population visiting a health care facility and satisfaction of the staff of the facility. The tool used was a structured 5 point Likert scaled questionnaire including unstructured interviews. These were held with 200 patients availing treatment in the old and new dialysis unit each and who have at least had three dialysis treatments within 6 months in the both the units. Also, for staff satisfaction, 25 staff working for at least one month in the old unit and new unit each. Data was analysed using SPSS 17.0 software.Results: Good design and quality of care were regarded important for patient experience. For patients, overall functioning and efficiency of the processes in the facility dependent on the design of the building was most important. Just over half of all surveyed patients felt that design impacted their relationship with their doctor and the quality of the care received. For attendants, waiting area including billing facility fetched the highest parameter for satisfaction. For staff the importance of access to support services, safety and provision of basic facilities resonated with the patient views presented above. Privacy, confidentiality and patient safety through careful design of waiting room, reception and consulting room were high staff priorities. Design that facilitated communication between team members also emerged as an important area although the change in design did not make much difference in emotional wellbeing and work life balance of the staff.Conclusions: This study did not yield sufficient data to confirm or refute either concept, though clearly this merit further investigation. Some unexpected findings were reported. Specifically, the survey data rated privacy and the availability of comfortable physical conditions as the highest priority for both staff and patients.
Endovascular management of chronic mesenteric ischemia: a single centre experience in Western Rajasthan, India
Authors: Sarda Pawan , Kumar Goutam , Gupta Deepak , Sanghvi Sanjeev , Baroopal Anil
Published: May 2017

Background: Chronic mesenteric ischemia (CMI) or mesenteric angina is a condition characterised by inadequate blood supply to bowel as a result of stenosis affecting   one or more of the three mesenteric arteries: the celiac artery (CA), the superior mesenteric artery (SMA) and the inferior mesenteric artery (IMA).Methods: Ten patients with significant lesion, treated with PTA and stenting were selected for study and were followed at 2 weeks, at 2 months then at 6 months after index procedure to see composite of symptomatic improvement, weight gain and revascularization.Results: On mesenteric angiography, significant ostial stenosis of celiac trunk and superior mesenteric artery in 5 patients, 3 patients had significant ostial stenosis of celiac trunk and ostial stenosis of inferior mesenteric artery and 2 patients had significant stenosis of superior mesenteric artery. Percutaneous transluminal angioplasty (PTA) and stenting was done, final result was good and there was no residual stenosis and dissection. After stenting patients were stable and pain free. There were no post-operative complications. Follow up was done after 2 weeks and 2 months and then at six months. There was no postprandial abdominal pain on follow up and almost all patient had gained weight in 2 months and on 6 months of follow up, no case of repeat revascularization was recorded.Conclusions: Percutaneous transluminal angioplasty (PTA) and stenting to mesenteric artery is good alternative management of CMI. In present series, all cases were susses fully revascularized without residual stenosis and dissection.
Diagnostic spectrum of CSF involvement by malignant cells: three-year experience of tertiary care hospital in CSF cytology
Authors: Rana Vandana , Sidhu Avnit , Jagani Rajat , Singh Giriraj , Singh Rajeshwar , Rathi K. R.
Published: May 2017

Background: Cerebrospinal fluid (CSF) cytology is the diagnostic gold standard test for primary or metastatic involvement of central nervous system (CNS) by malignancy. It is a very important and routinely done test in the laboratory but its sensitivity is low due to many confounding factors and varies amongst type of malignancies. We did retrospective analysis of CSF cytology carried out at our center from January 2013 to December 2015 to find out about spectrum of malignancies being detected on CSF cytology.Methods: From January 2013 to December 2015, three hundred and seventy-five CSF samples were received and processed for presence of malignant cells at our center. The cytospin preparations stained with LG and PAP stains of these CSF samples were analyzed along with any special stain that was available in the records. Clinical details of the patients with positive cytology were correlated from records.Results: The diagnostic spectrum obtained through study of positive CSF cytology included cases of metastatic solid malignancies and hematolymphoid malignancies. Four cases out of ten were of Metastatic Adenocarcinoma with primary origin being Breast, Lung and Stomach. Out of six cases of hematolymphoid malignancies; five were known cases of lymphoma/leukemia and one was primarily diagnosed to have Non-Hodgkin’s lymphoma (NHL) on CSF cytology.Conclusions: Both Epithelial and Hematolymphoid malignancies can be diagnosed on CSF cytology and these are predominantly metastatic in origin; Hematolymphoid malignancies are more common in CSF than solid malignancies. Correlation with clinical details and Neuroimaging is a must.
Fine needle cytology-diagnostic tool for palpable orbital and eyelid lesions
Authors: Rastogi Nupur , Gupta A. , Gupta A.
Published: May 2017

Background: Fine needle aspiration cytology in orbital lesions gained importance in the last 3 decades. FNAC can be used for aiding the clinician to plan treatment of orbital and eyelid tumors study was undertaken to evaluate the role of FNAC as a diagnostic tool for diagnosis and management of various orbital and eyelid lesions, as it is of great value in the diagnosis of new primary, recurrent and metastatic orbital tumors.Methods: Patients of different age groups presenting with orbital and eyelid lesions were studied over a period of 4 years from March 2013 to Feb 2017. The 75 patients selected for this study were clinically evaluated and then investigated with computed tomograpghy (CT) scanning. Each patient was subjected to FNAC under direct vision/ultrasongraphy guidance with sterile 22 guage needle without anaesthesia. Biopsy was done to confirm the cytological diagnosis.Results: The age of patients varied from 3 years to 70 years. On cytology 61 cases were benign and 14 malignant. Histopathological examination of 53 cases was done which confirmed the cytological diagnosis.Conclusions: FNAC is a useful, rapid, safe and cost effective method for diagnosing orbital and eyelid pathology.
Perceptions of the educational environment at entry and exit of medical students to clinical teaching in a rural medical college
Authors: James Deepsha , Mani Susan , Mathew Anna , Velusamy Saravana Kumar
Published: May 2017

Background: The foundation for good health care to patients is the competence of health care providers. Motivated learners in supportive environments have high levels of self-efficacy. DREEM is considered a valid and reliable tool, globally accepted for assessing the educational environment. The objectives of the study were to elicit the perceptions of first clinical year and final year medical students in a rural medical college using the Dundee ready education environment measure (DREEM) inventory and to find out if there is any difference in the perceptions at entry and exit to the clinical environment.Methods: This was a cross sectional study on 78 students each in first clinical year and final year of this rural medical college. The DREEM inventory was used by the investigator to record relevant data, which was then statistically analyzed using SPSS software. The student t-test was used to compare the total and sub-domain mean scores in the two groups.Results: There was significant difference in perception in the final year students compared to the first clinical year class.Conclusions: The students of both first clinical year and final year have a positive perception about their educational environment. However there is a significant difference in the total DREEM score as well as total sub-domain scores among first clinical year students and final year students. Student perceptions are a valuable resource for institutional curriculum planners to make appropriate changes to enhance student learning.
Psychosocial status and quality of life of adolescent girls in Karnataka, India
Authors: Rajachar Veena , Gupta Manoj Kumar
Published: May 2017

Background: This study was conducted with the objective to assess the psychosocial status and quality of life (QOL) of adolescent girls in Karnataka, India.Methods: This was a cross sectional community based study which was conducted on 400 adolescent girls each in rural (Bellary district) and urban (Bangalore district) areas of Karnataka, India. WHO’s ‘HEEADSSS’ questionnaire and ‘WHOQOL-BREF’ tool have been used to assess psychosocial status and quality of life of adolescent girls, respectively.Results: It was observed that nearly 5% girls were at severe and very severe risk of developing psychosocial abnormalities in both rural and urban study area. The mean QOL score was highest for social relations (7102±21.6) and was minimum for physical domain (49.59±12.63).Conclusions: This calls for urgent community based interventions directed to adolescents and their families having higher vulnerability for psychosocial abnormalities and poor quality of life.
A study of dengue and hepatopathy
Authors: Kumar Surendra , Lakhiwal Rajkumar , Aswal Vinod , Gajraj Suresh , Patel Ishan , Chakranarayan Ashish , Garg Sanjay
Published: May 2017

Background: Dengue is a major international health concern that is prevalent in tropical and sub-tropical countries. It is 2nd most common arthropod borne disease in India. There are certain clinical features that are associated with Dengue in addition of the classical features. Previously organ impairment has been only considered under set up of severe disease. On the recent years, several studies have suggested the possibility of early involvement of the liver in dengue. Further due to its atypical presentation often dengue missed out as a differential diagnosis.Methods: A total of 50 patients were selected to be a part of study after applying inclusion and exclusion criteria. Only those patients were included in the study who had classical features of dengue- fever with chills, body ache, headache, rash, bleeding manifestations and thrombocytopenia and had a positive ELISA test i.e. IgM antibodies against dengue virus. Patients who had malaria and enteric fever were excluded from the study. All patients were subjected to a detailed history and a thorough clinical examination. A complete blood count, liver function tests, renal function tests, chest X-ray and USG abdomen were also done.Results: An analysis of 50 patients suffering from dengue showed liver dysfunction was present in all patients. Vomiting was an important symptom present upto 70% of patients. SGOT levels were higher than SGPT levels. Hepatosplenomegaly and ascitis were also present in significant number of patients. An analysis of these patients revealed that patients typically demonstrate high grade fever, body ache, rash, thrombocytopenia and bleeding tendency, there were other features such as liver dysfunction including a preferential rise of SGOT, hepatosplenomegaly, ascitis, pleural effusion and leucopoenia.Conclusions: This study showed that dengue fever was seen in the third decade and that AST and ALT levels were raised in the majority of these patients. It was also found that AST levels were more than ALT levels. So, AST and ALT can be a useful early marker to assess the severity of the disease which can thus lead to early recognition of high risk cases. The presence of raised liver enzymes in all patients, ascitis, hepatosplenomegaly, elevation of SGOT more than SGPT, should be kept in mind when evaluating patients with suspected dengue.
How aware are we regarding vector borne diseases? A community based study in a slum of Kolkata, India
Authors: Sahoo Sanjaya Kumar , Taraphdar Pranita , Mallick Ashok Kumar , Dasgupta Aparajita , Preeti P. S. , Biswas Dhiraj
Published: May 2017

Background: Vector borne diseases (VBDs) form a major part of the communicable diseases in India. Ignorance and impoverished conditions of people contribute in creating source and spread of vector borne diseases and hinder disease control strategy. Slums are more vulnerable to vector borne diseases because of poor environmental condition, standard of living, poverty and ignorance of the people. This study is a small endeavour to highlight the awareness of residents of slum area of Chetla, Kolkata, West Bengal, India regarding vector borne diseases. Objectives were to assess the awareness of the study population regarding different vector borne diseases and to find out the association of awareness with relevant demographic variables.Methods: A community based observational, cross-sectional study was conducted among adult population in a slum area of Chetla, Kolkata, West Bengal, India. Multivariate logistic analysis was done to find out association of awareness with relevant variables.Results: Awareness regarding malaria was good and that of dengue was satisfactory while awareness regarding other vector borne diseases was poor. Age, sex, caste, education and social class were found significantly associated with satisfactory awareness. Younger population i.e. age ≤35years, males, general caste people, literacy status above primary school and social class III and above had better awareness regarding vector borne diseases.Conclusions: This study uncovered the lacunae regarding awareness of the study population regarding vector borne diseases. It can be concluded that intensified efforts towards creating public awareness and mobilizing the community regarding the identified issues should be addressed.
A study on prevalence of metabolic syndrome in general population in Western Uttar Pradesh, India
Authors: Bansal Shivani , Paliwal Ankit , Verma Virender , Chauhan Jaba
Published: May 2017

Background: A global transition in the disease pattern has been observed, where the relative impact of infectious disease is decreasing while chronic disease like cardiovascular disease and diabetes are increasingly dominating the disease pattern. Metabolic syndrome (MetS) is a complex web of metabolic factors that are associated with a 2-fold increased risk of CVD and 5-fold risk of diabetes.Methods: A total of 350 patients were included and a cross sectional study was conducted to identify metabolic syndrome prevalence and to evaluate risk factor for development of metabolic syndrome.Results: 48% of participants were male and 52% were female our results showed a BMI of 22.11±3.57 in male and 22.16±2.82 in females. The overall prevalence of overweight was 31%. This study also showed significantly higher rate of metabolic syndrome in older age group i.e. 9.38% in age group of 30-39 years and 26.98% in 60-70 age group. Proportionally more subjects with MetS (74%) have sedentary life style as compared to those without MetS (54%).Conclusions: The prevalence of Metabolic syndrome varies among ethnic groups. Indians are at high risk for ASCVD and their predisposition. The high prevalence of overweight and obesity was one of the major driving force in the development of MetS.
A prospective, randomized, double blind study to evaluate and compare the efficacy of lidocaine, ramosetron and tramadol pre-medication, in attenuating the pain caused due to propofol injection
Authors: Zahoor Ifra , Mir Aabid Hussain , Qazi Mohmad Syed , Jan Zahoor Ahmad , Yousuf Abida , Rasool Ajaiz
Published: May 2017

Background: Propofol is a popular induction agent, especially for short cases, day care surgeries and when a laryngeal mask is to be used. It produces a good quality of anaesthesia and rapid recovery. Pain on injection of propofol has been reported and is an important limitation of its use. A multitude of interventions: pharmacological as well as non-pharmacological, have been tried for the attenuation of pain caused due to propofol injection. In our study, we evaluated and compared the efficacy of lidocaine, ramosetron and tramadol in attenuating pain on propofol injection.Methods: A total of 180 patients belonging to American Society of Anesthesiologists (ASA) grade I and II,  of either sex, aged between 21 to 50 years undergoing elective surgery under general anaesthesia, were taken up for the study and were divided into group A, B and C. Group A received 2ml of 2% (40mg) lidocaine, Group B received 2ml of ramosetron (0.3mg) and Group C received 1mg/kg of tramadol in 0.9% normal saline to make a total solution of 2ml. Venous occlusion was done by compressing forearm with tourniquet to increase the local concentration of drug after establishing an intravenous access. The study drug was injected over 10 seconds and then occlusion was removed after 60 seconds, followed by giving 25% of the total calculated dose (2.5mg/kg) of propofol (1% w/v in lipid base) injected over 20 seconds. This was followed by asking the patient about the severity of pain felt. The intensity of pain was graded using verbal rating scale (McCrirrick and Hunter) and was assessed at 0, 5, 10, 15 and 20 seconds, as after 20 seconds, the patient would be under the influence of propofol.Results: Lidocaine showed the best efficacy in attenuating propofol injection pain amongst the 3 groups recorded at 5 (95%), 10 (91.7%) and 15 seconds (98.3%). In addition to reducing the incidence of pain, it also reduced its severity, with majority of patients experiencing only mild pain. Ramosetron ranked 2nd in the overall reduction of propofol pain, with lowest incidence of propofol pain amongst 3 groups, recorded at 0 (98.3%) and 20 seconds (95%) of propofol injection. However, ramosetron failed in reducing severity of pain, with a significant number of patients experiencing moderate and severe pain. Tramadol ranked 3rd in the overall attenuation of propofol pain and showed lowest incidence of pain at 0 seconds (93%) of propofol injection.Conclusions: All the three study drugs viz lidocaine, ramosetron and tramadol cause a significant decrease in propofol injection pain with lidocaine as the most efficacious drug amongst the 3 drugs followed by ramosetron and tramadol. Lidocaine has an added advantage of decreasing incidence and severity of pain associated with propofol and ramosetron prevents postoperative nausea and vomiting.
The possible significance of trisomy 8 in acute myeloid leukemia
Authors: Vaniawala Salil N. , Patel Monika V. , Chavda Pratik D. , Zaveri Shivangi H. , Gadhia Pankaj K.
Published: May 2017

Background: Acute myeloid leukemia (AML) is a heterogeneous disorder that results from a block in the differentiation of haematopoietic progenitor cells along with uncontrolled proliferation. Trisomy 8 is the most common recurring numerical chromosomal aberrations in acute myeloid leukemia (AML). It occurs either as a sole anomaly or together with other additional chromosomal aberrations. The prognostic significance of trisomy 8 in presence of other additional chromosomal abnormality depends on clonal cytogenetic changes. The patients with trisomy 8 had shorter survival with significantly increased risk with other chromosomal abnormality.Methods: Total 139 patients were screened between January 2016 to November 2016 who were suspected of AML cases. Bone marrow cultures were set up using conventional cytogenetic methods. Chromosomal preparation was made and subjected to GTG banding technique. Banded metaphases were analysed and karyotyped for further analysis.Results: Cytogenetic evaluation of karyotyped of 139 suspected AML patients showed 52 with t(8;21)(q22;q22), 36 with t(15;17)(q22;q12), and 11 with inv(16)(p13;q22). The rest 40 cases found with additional chromosomal abnormalities, of which 16 were sole trisomy 8 and 24 cases were found with other chromosomal abnormalities In addition, only one person found with t(8;21) and trisomy 8, while  three person having t(15;17) with trisomy 8.Conclusions: AML is considered to be one of the most important cytogenetic prognostic determinants. Recurrent chromosomal translocation with trisomy 8 varying 1.9% for t(8;21) and 8.3% for t(15;17). In the present study trisomy 8 in AML with known favourable anomalies is very small. Therefore, it cannot be taken as a prognostic marker.
Cardiac troponin I as mortality predictor in acute exacerbation of chronic obstructive pulmonary disease
Authors: Gupta Seema , Saini Varinder , Kaur Jasbinder , Jaswal Shivani , Kaur Harjeet , Kaur Sumeet
Published: May 2017

Background: Comorbidities are important determinants of outcome and quality of life of patients with chronic obstructive pulmonary disease (COPD). The risk of cardiovascular events in COPD patients is three to five-fold high. COPD is often associated with right ventricular hypertrophy and pulmonary hypertension. Various studies have associated levels of cardiac troponin I (cTnI) with severity and duration of acute exacerbation of COPD (AECOPD). The objective of the present study was to assess the usefulness of serum cTnI as mortality predictor in AECOPD patients.Methods: An observational, prospective and non interventional study was conducted in 50 patients with AECOPD admitted in the pulmonary medicine emergency or ward of a tertiary care hospital of Northern India. AECOPD was diagnosed according to Global Initiative for chronic obstructive lung disease guidelines. cTnI levels were estimated within 24 hours of admission by method based on chemiluminiscence along with routine investigations. Levels ≥ 0.01ng/ml were taken as positive. The patients were followed up for 30days for outcome in terms of mortality and morbidity. Data was entered and analyzed by SPSS package and two sided p values<0.05 were considered statistically significant.Results: The serum cTnI was found to be positive in 34% of patients with AECOPD. The in- hospital mortality was significantly low in patients having cTnI <0.01ng/ml as compared to patients with cTnI ≥0.01ng/ml. The patients with cTnI levels ≥0.01ng/ml had significantly higher mean PaCO2 levels and higher requirement for invasive or noninvasive ventilation during hospital stay as compared to patients having cTnI <0.01ng/ml (p=0.04 and 0.016 respectively).Conclusions: Levels of cTnI≥0.01ng/ml may be considered as a biomarker to predict mortality in AECOPD patients.
Prevalence of viral (HBV, HCV and HIV) co-infections among apparently healthy blood donors in Ranchi, Jharkhand, India
Authors: Kumari Sushma , Kiran Asha , Kumar Ritesh , Shrivastava Ramesh K.
Published: May 2017

Background: Apparently healthy blood donors may carry double viral co-infections that might be more fatal than viral mono-infection for the donor himself as well as recipient later on.Methods: All blood samples were screened for HIV-I and II (4th generation kit), HBV and HCV (3rd generation kit) by using chemiluminescence technique (Manufacturer- Abbott, Model-Architect i 1000SR).Results: On screening of 41307 blood units, 829 (2.0%) donors were found positive for one of the viral infection (HBV, HCV and HIV). Highest prevalence was for HBV (417 donors- 1.0%) followed by HCV (324 donors- 0.78 %) and HIV (88 donors- 0.21 %).Conclusions: Apparently healthy blood donors might carry, life threatening, double viral co-infections in their blood. Failure to diagnose and treat co-infection at an early stage results in serious complications and sequelae. For safe blood transfusion all blood units should be tested for compatibility and TTI’s with reduction in unnecessary blood transfusion.
Study of soft tissue sarcomas over a period of 3 years
Authors: Prabhakar Jenna , Sushma J. , Kartheek B. V. S. , Lakshmi A. Bhagya , Vaibhav Chapara
Published: May 2017

Background: Soft tissue malignancies constituted a heterogeneous group of rare solid tumors of mesenchymal cell origin with distinct clinical and pathological features. The aim of the study was to know the prevalence of soft tissue sarcoma, sex, age and site distribution, histopathology and various treatment options adopted with follow up.Methods: A total of 26 cases of soft tissue sarcoma were analyzed for a three-year period. Clinical presentation, age and sex distribution, histological type and treatment modalities adopted were recorded and analyzed.Results: Out of 26 cases 44% of cases were between 30-50 years and 44% of tumors were situated in lower extremity. The commonest histological type was liposarcomas and ﬁbrosarcoma. Lymph node metastasis was seen in 4% of cases. Distant metastasis was present in 3 cases, 2 with lung metastasis and l with lung and liver metastasis. Surgery was the main modality of the treatment. 12% of the cases presented with recurrent tumor, the duration between surgery and recurrence was 6 months. Only 38% turned for follow up, 2 patients succumbed to death because of multiple pulmonary secondaries and chest infections.Conclusion: In the present study, all the cases of soft tissue sarcoma presented in late stage of the disease due to illiteracy and lack of health education. Recurrence was seen in 12% of cases. The overall survival rates and quality of life of the patients can be improved by frequent health camps at primary health centers for early detection of the disease, providing adequate health education, diagnostic and management facilities.
A study on clinical evaluation of chronic dacryocystitis
Authors: Panda Prangya , Sadangi Bijaya Kumar , Jena Dhaneswari
Published: May 2017

Background: Chronic dacryocystitis is an unpleasant disease. It is a common condition presenting with watering from the eye. Usually there is a block at the nasolacrimal duct where it opens into the inferior meatus. The study was done to do a clinical analysis of the cases of chronic dacryocystitis.Methods: 51 cases of clinically diagnosed chronic dacryocystitis were taken and, clinical analysis of the cases regarding age, sex, presenting symptom, nature of discharge was done. LPI was done in all the cases. DCR or DCY was done as treatment.Results: Common age of presentation was third decade or fourth decade. Female were worse sufferer. Discharge from eye was present in all the cases.Conclusions: A female in third or fourth decade having discharge from eye since years, chronic daryocystitis is to be ruled out. DCR is an effective method of treatment.
Impact of institutional educational program on compliance of implementation of surviving sepsis campaign guidelines, total ICU and hospital mortality
Authors: Agrawal Kapil H. , Ausim Syed M. , Awode Rhishikesh M. , Katiyar Sarika R.
Published: May 2017

Background: To determine whether educational program based on the surviving sepsis campaign (SSC) guidelines affects the compliance of implementation of SSC guidelines, total ICU and hospital mortality.Methods: A prospective observational study conducted in adult patients with severe sepsis or septic shock admitted to 11 bedded adult medical and surgical ICU of Bhopal Memorial Hospital and Research Centre, Bhopal, Madhya Pradesh, India. In pre-education period all patients in ICU were daily screened according to severe sepsis screening tool and followed up daily during their entire period of ICU stay. Outcome measures were compliance of implementation of SSC guidelines, total ICU and hospital mortality noted. Education program of resident doctors of the ICU, emergency department, medical and surgical units was carried out. Post-education period data noted similar to the pre-education period. Comparative statistics applied by using Chi-square test and paired Student t-test.Results: Compliance to all resuscitative measures in SSC guideline both 3 hour and 6 hour bundles significantly improved after education program (P-value 0.014). In pre-education period 33.3% patients were treated with complete implementation of SSC Guidelines Bundles compared to 63.6% in post-education period. Total ICU mortality and hospital mortality did not change significantly after education program during study period. Total ICU mortality during pre-education period was 29.52% as compared to 25.45% in post-education period (P-value 0.44) while total hospital mortality in pre-education period was 5.18% as compared to 5.62% in post-education period (P-value 0.07).Conclusions: The Institutional educational program has significant impact on increasing compliance to both 3 hour and 6 hour bundles in SSC guideline but failed to show any significant impact on decreasing overall total ICU and hospital mortality.
Basal cell carcinoma- a prospective clinico epidemiological and pathological study
Authors: Ammasaigoundan V. , Shariff V. N. S. Ahamed , Ramesh A.
Published: May 2017

Background: Basal cell carcinoma is the most common malignant tumour of the skin worldwide. The objective was to find out the age and sex incidence of basal cell carcinoma in patients attending the outpatient department of dermatology and to find out the various clinical and histopathological features of basal cell carcinoma.Methods: It was a prospective observational study carried out in a tertiary care hospital, Chennai, Tamilnadu, India. Patients with clinical diagnosis of basal cell carcinoma were included in the study after thorough history, clinical examination, routine and special investigations like skin biopsy.Results: Out of 20 patients with basal cell carcinoma 6 were males and 14 were females with a male to female ratio of 1:2.33. Most commonly affected age group was 50-70 years (70%). Distribution of BCC in our study was confined to head and neck area. Most common morphological subtype encountered in this study was nodular/nodulo-ulcerative BCC (70%), followed by pigmented type (25%) and superficial BCC (5%). The most common histological variant observed in present study was nodular type (55%), followed by pigmented variant (25%), adenoid (5%), basisquamous (5%), superficial BCC (5%) and BCC with sebaceous differentiation (5%).Conclusions: This study highlights a paradoxically increasing trend of BCC with female predilection. Early detection and treatment of lesions are crucial to decrease the functional and cosmetic disfigurement and also this study highlights the importance of improving awareness among general practitioners, public health workers and general population.
Microbial spectrum of urinary tract infections and its antibiogram in a tertiary care hospital
Authors: Yadav Monika , Pal Rohan , Damrolien Shan , Khumanthem Sulochana D.
Published: May 2017

Background: Urinary tract infections are one of the major health problem effecting both sexes of all age group. UTIs are often treated with different broad-spectrum antibiotics. The aim of this study was to determine the prevalence of bacteria causing urinary tract infections and their susceptibility pattern from patients reporting in RIMS Hospital.Methods: Mid stream urine (MSU) specimens sent to the laboratory from October 2014 to September 2016 were collected and inoculated onto blood agar and MacConkey agar and incubated at 37ºC for 24 hours. Identification and antibiotic susceptibility test was done following standard operative procedures.Results: 25.66% (1142/4450) samples showed a significant growth out of which 42% (479/1142) were male and 58% (663/1142) were female. E. coli has been found to be the major pathogen causing UTI which account for 61% (696/1142) followed by Staphylococcus aureus 12% (137/1142), CONS 7% (79), Enterococcus spp. 6% (67), Klebsiella spp. 5% (57), Proteus spp. 2% (22), Pseudomonas spp. 2%, Acinetobacter spp. 2% and Candida spp. 3%. Imipenem was the most susceptible antibiotic for Enterobacteriaceae, E. coli (85.9%), Klebsiella spp. (89.4%) and Proteus spp. (95.4%). Vancomycin is 100% sensitive while Linezolid, Nitrofurantoin and Gentamicin are also highly sensitive for both Staphylococcus aureus and CONS.Conclusions: These data may be used to determine trends in antimicrobial susceptibilities, to formulate local antibiotic policies in order to assist clinicians in the rational choice of antibiotic therapy to prevent misuse, or overuse, of antibiotics.
A study of the effectiveness of school health education programs on selected mosquito borne diseases: school based cross-sectional study
Authors: Sureshbabu Jayanthi , Vasudevan Senthilvel , Raj Priyanka
Published: May 2017

Background: School health education programs provide a convenient platform for engaging the students in health promotion activities. Public health problems like mosquito borne diseases cannot be controlled without active participation of the community and students are a resourceful component of the community who can be encouraged to take up activities to control mosquito borne diseases in the community.Methods: School-based cross-sectional study was conducted in December 2010 to March 2011 among 508 school students selected at random from students studying in the eighth to tenth standard. P < 0.05 was considered as statistically significant.Results: Totally 508 students were included in this study. The number of students unaware of the stages in the mosquito life cycle and the mosquito’s resting habits reduced from 420 (82.68%) to 19 (3.74%) and 103 (20.28%) to 13 (2.56%) respectively. The number of students with correct knowledge of the biting habits of the female mosquito and personal protection (PP) measures increased from 31.69% to 97.05% with statistically highly significant (p <0.0001) and 52.95% to 74.21% respectively.Conclusions: The present study suggested that the school health education program is effective in creating awareness and increasing the knowledge regarding mosquito borne diseases among school children and possibilities of successfully engaging the community at large in the fight against mosquito borne diseases. The need would be to sustain this activity and implement it in schools as part of the vector borne disease control programme.
Trial of vitamin D supplementation to prevent asthma exacerbation in children
Authors: Krishnan Elango , Ponnusamy Venmugil , Sekar Sathiya Priya
Published: May 2017

Background: To assess the level of vitamin D in children with bronchial asthma and to study the effects of vitamin D supplementation in asthmatic children who had vitamin D deficiency in terms of asthma control test score and Number of exacerbations.Methods: This interventional study was conducted in Department of Paediatrics, KAPV Government medical college, Trichy, Tamil Nadu, India from September 2016 to February 2017. 96 asthmatic children of age group 5-12 years who attended outpatient department and admitted in ward for asthma exacerbation were selected. After assessing their Vitamin D level, Vitamin D supplementation given along with standard treatment for asthma. Outcomes measured were ACTS (Asthma control test score), number of emergency room visits, number of hospital admissions and reliever medication use.Results: Out of 96 children, 83 (86.4%) children had vitamin D deficiency. There was significant correlation between vitamin D level and absolute eosinophil count (p-value-0.037), asthma severity (p-value<0.001) and asthma control (p-value<0.001). Significant reduction in emergency room visits, (p-value<0.001) reliever medication use (p-value<0.001) and improvement in asthma control test score (p-value-0.008) occurs after vitamin D supplementation.Conclusions: There is a significant correlation between vitamin D level, asthma severity and its control. Asthma exacerbation in terms of emergency room visits and reliever medication use were further reduced by vitamin D supplementation.
Clinicopathological study of testicular tumors: an experience in a tertiary care hospital in Kashmir valley, Jammu and Kashmir, India
Authors: Beigh Ambreen , Junaid Sheikh , Beg Arshi , Farooq Summyia , Wani Lateef Ahmed , Manzoor Farzana
Published: May 2017

Background: Testicular and paratesticular neoplasia are rare type of tumors affecting adolescents and young adults in India, as observed by paucity of published data. This study was undertaken to analyze the patterns of testicular tumors at a tertiary level hospital in Kashmir valley, Jammu and Kashmir, India highlighting the patient’s demography, clinical presentation, diagnostic evaluation and pathological finding.Methods: This 5-year (retrospective and prospective) study was performed in the Department of Pathology, Government Medical College Srinagar, Jammu and Kashmir, India from January 2012 to December 2016. For the retrospective study, all cases of testicular tumors, their histopathological reports and required clinical details were searched from records maintained in the Department of Pathology, GMC Srinagar, Jammu and Kashmir, India. For the prospective study, the orchiedectomy specimens received in our department were subjected to routine histopathological processing followed by a detailed gross and microscopic examination. Tumour typing and subtyping was done according to WHO classification (2004).Results: A total of 37 cases of testicular and paratesticular neoplasia were included in present study with a mean age of 35.1 years. Out of these 37 cases, 31 (83.78%) were malignant and 6 cases (16.22%) were benign. Right testis was affected in 70.3% of cases. The most common clinical presentation was scrotal swelling. Germ cell tumor was the most common type accounting for 89.2% of tumors followed by lymphomas (8.1%).Conclusions:It is concluded that despite new techniques in imaging and tumor marker assay, the diagnosis of testicular tumors is dependent upon histopathological examination. The present study fairly provides an insight into the clinical presentations, prevalence and patterns of testicular tumors.
Profile of accidental injuries and poisoning in children and analysis of the predisposing factors
Authors: M. S. Meenakshi , R. Senthilprabhu
Published: May 2017

Background: Accidents continue to be the leading cause of death and disability between 1 year and 15year age group. Trauma lurks both developed and developing nations but in different guises. The aim is to determine the epidemiology, clinical profile and outcome of children with accidental injuries and poisoning and to analyse the factors predisposing to accidents in children.Methods: This was a prospective cohort study done at Institute of Social Pediatrics, Govt. Stanley Medical College, Chennai, Tamil Nadu, India between September 2006 to August 2007.Results: Most common age group for occurrence of accident is less than 3 years n=68 (37.8%).  Male children 108 (60%) outnumbered female children 72 (40%). Among the accidents falls accounted for 32.8% cases which were the commonest followed by Road Traffic Accident (RTA) 22.2%, poisoning 21.1%, Foreign body 7.8%, Burns 6.1%, Drowning 1.7 % in decreasing order of frequency. In and around Home n=114 (63.3%) was the commonest place of occurrence of accident followed by 26.7% in streets, 3.9% in schools and 3.3% in playground. Sunday contributes to more accidents (20%) than any other day. Accidents were common between 3PM to 6 PM (36.1%). Among RTA and fall, skeletal injuries accounted for 49.9% followed by head injury 27.4%, and soft tissue injuries 25.6%. Among burns, the most common site involved was limbs and deep burns were more common than superficial burns. 86.7% of cases recovered completely, 5% had permanent residual deformity and death in 1.1% of cases. The various social factors were analyzed as risk factors for accidents using multivariate logistic regression analysis and was found that nuclear family had ODD’s ratio of 2.232 (95% C.I 1.004 -4.961), age of the mother <25years with ODD’s ratio 1.252 (95% C.I 1.085-3.025) and socio-economic class III and IV together with ODD’s ratio 1.603 (95% C.I 1.064 - 3.379).Conclusions: Accidents and poisoning lead to significant morbidity in children in this study. Comprehensive prevention strategies need to be implemented to bring down the rate of accidents.