bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation and correlation of placental vasculature by three-dimensional power Doppler ultrasonography with umbilical Doppler in normal and IUGR pregnancies
Authors: Choudhary Sumesh , Mishra Vineet , Aggarwal Rohina , Mistry Kavita
Published: August 2018

Background: In recent years there have been significant developments in the use of 3D Power Doppler (3DPD) imaging and quantitative 3DPD histogram analysis to estimate both placental volume and intraplacental vasculature. This study is to evaluate the distribution and variation of placental vascular indices according to gestational age and placental volume and position. Co relate the umbilical Doppler indices with placental vascular indices.Methods: From September 2016 to October 2017, three-dimensional (3D)-power Doppler ultrasound was performed in 200 singalton pregnancies from 20 to 40 weeks of gestation. Using the same pre-established settings for all patients, power Doppler was applied to the placenta and placental volume was obtained by the rotational technique (VOCAL). The 3D-power histogram was used to determine the placental vascular indices: vascularization index (VI), flow index (FI) and vascularization-flow index (VFI). Umbilical Doppler was measured on the free loop of umbilical cord. The placental vascular indices were then plotted against gestational age placental volume, position and umbilical Doppler SD ratio, PI and RI. These values were evaluated in IUGR fetus.Results: Analysis of the results showed that the placental vascular indices estimated by 3D-power Doppler ultrasonography presented constant distribution throughout gestation despite the significant increase in placental volume. Placental position at fundal region shows higher value of VI, FI, and VFI. Placental position with relation to VI, FI, and VFI shows statistically significant with p value <0.01. Placental vascular indices VI, FI and VFI when corelated with systolic/ diastolic ratio, pulsatility index and resistive resistance index of umbilical artery shows poor negative correlation, only VI and FI shows statistically significant with SD ratio as p value is <0.01and <0.04. VFI did not show statistically significant as p value is 0.10(NS). With pulsatility index p value is statistically significant is less than<0.01 with vascular indices. Resistive index p value is statistically significant is less than <0.01 for VI and VFI but not significant with FI as p value is 0.06.Conclusions: Doppler ultrasound assists in the evaluation of placental vascularization in normal and IUGR pregnancies, may play an important role in future research on fetoplacental insufficiency.
A comparative evaluation of post placental intrauterine contraceptive device (IUCD) insertion between normal delivery and caesarean section
Authors: Sarkar Sharmistha , Paul Dhruba Prasad , Ray Jayanta
Published: August 2018

Background: Adverse maternal and perinatal outcomes are related to pregnancies spaced too closely together. Objective of present study was to compare the expulsion rate and complications between post placental IUCD insertion between caesarean section and vaginal delivery.Methods: This study was a prospective comparative study conducted in the department of Obstetrics and Gynecology, at Agartala Government Medical College over 1.5 Years (January 2016-June2017) All cases at term pregnancy delivering by caesarean section and vaginal delivery were divided into two different groups. Sample size of 105 in each group. Subjects recruited from-obstetrics OPD and casualty of Agartala Government Medical College (AGMC) and GB Pant Hospital expulsion rate and complications. Comparative evaluation of Expulsion rate and complications following post placental IUCD insertion between caesarean section and vaginal delivery at the end of six months, one year and one and half year.Results: There was no significant difference in either complications between the two groups (P value-.913) or outcomes (p value-.035). Expulsion rate 18.2% following vaginal delivery compared to those with intracaesarean insertion i.e 3.8%.Conclusions: The complications associated with postplacental Intrauterine device insertion is insignificant, still the awareness, acceptance and continuation are very low. Therefore Information, education Communication activity by the field workers must be enhanced to overcome this knowledge gap.
Study of feto-maternal outcome in previous cesarean section
Authors: Chiniwar Mahantappa A.
Published: August 2018

Background: There is increase in number of primary cesarean sections, leading to more number of women facing the issue of mode of delivery in the current pregnancy. There are reports about success of vaginal birth after cesarean section as well as complications such as scar dehiscence, rupture of uterus, poor maternal and fetal outcome.Methods: A prospective study was done for a period of 1 yr and 9 months at Cheluvamba Hospital attached to Govt Medical College Mysore from October 99 to June 2000. Data regarding previous cesarean section was collected, clinical findings during the present pregnancy were noted.Results: During the study period there were 942 women admitted with previous history of cesarean section. Elective repeat cesarean section was done for 530 cases and trial of labour after cesarean section was planned for 412 cases. Successful vaginal delivery was conducted in 311 cases. Repeat emergency cesarean section was done for 96 cases due to failed trial of labour. Maternal morbidity such as adhesions was seen in 11.25% and obliteration of U V fold in 7.92% of cases. Maternal mortality was seen in 0.15%. Perinatal morbidity was seen in 3.32%, perinatal mortality in 3.96%.Conclusions: With increasing proportion of women with previous cesarean sections, it is essential to counsel these women during trial of vaginal delivery in well equipped hospitals. It is worth to reduce primary cesarean section to avoid complications in consequent pregnancies. Proper and timely decision for repeat cesarean sections will reduce fetal and maternal morbidity and mortality.
Uncomplicated post-dated pregnancy in one horn of bicornis bicollis uterus
Authors: Bedi Preet Kamal , Saini Arunima , Bhagat Nisha
Published: August 2018

Mullerian anomalies result from abnormal fusion of mullerian ducts (paramesonephric ducts). The prevalence of       1-10% is seen in general population. Patients with uterine anomalies have chances of infertility, miscarriage, preterm labor, cervical incompetence and are an independent risk factor for uterine rupture. Just a few pregnancies are carried forward till term without any maternal and fetal complications. Here we report a rare case of bicornuate uterus bicollis that successfully conceived, carried her pregnancy beyond her expected date of delivery (4 days overdue) and delivered a full-term baby without any significant complications.
ANA immunofluorescence versus profile-how well they perform in autoimmune diseases: an analysis of their clinical utility in a tertiary care centre
Authors: Petchiappan Velammal , Guhan Adityan , Selvam Sumitra , Nagaprabu V. N.
Published: August 2018

Background: While Immunofluorescence assay remains the gold standard for the detection of ANA, Immunoprofile by ELISA is being increasingly utilized in view of easy availability and quick results. The study was done to find out whether ANA profile results are comparable with IFA.Methods: About 100 patients who had undergone both immunofluorescence and Immunoprofile were included. Immunofluorescence correlation with profile and their correlation with the disease were analyzed; sensitivity, specificity and predictive values were calculated.Results: ANA was positive in 78% by immunofluorescence; 73% by ANA profile. 22 patients in whom ANA IFA was negative were picked up by ANA profile. 27 patients who were not detected by ANA profile were tested positive by IFA. ANA testing by immuno profile had a sensitivity of 65% with a positive predictive value of 69% when compared with IFA. Immunofluorescence pattern and ANA profile correlated with the diagnosed disease in 63% and 49% respectively. Immunofluorescence pattern correlated with the ANA profile in only 35% of the study subjects. On correlation with the disease, ANA profile scored less compared to ANA-IFA with a sensitivity and specificity of 46% each; positive predictive value of 59%; negative predictive value of 33%. On analysis of individual disease, ANA profile is as good as IFA in SLE and scleroderma in terms of sensitivity. In Sjogren’s syndrome and MCTD, specificity and positive predictive value of ANA profile is high.Conclusions: ANA IFA performs better than immunoprofile in the diagnosis of autoimmune diseases.
Epilepsy: what do Indian public living in Jammu know?
Authors: Gupta Rajiv Kumar , Singh Parveen , Sharma Pawan , Rani Renu , Kumari Rashmi , Gupta Riya
Published: August 2018

Background: Epilepsy, a neurological disorder, still remains one of the most stigmatising disease. Myths, beliefs and negative attitudes associated with the disease have been ascribed to the low levels of awareness and knowledge among the public. The present study aimed to assess the knowledge, attitudes and practices of the public regarding epilepsy visiting a tertiary care hospital in Jammu city of Jammu and Kashmir, India.Methods: This cross-sectional study was conducted over a period of three months among adult persons (aged 18 years and above) visiting OPD in a tertiary care teaching hospital in Jammu city, J&K, India. A 29-item questionnaire was pilot tested and then distributed to 410 adults during the survey period and 30 of them were excluded as they had never heard about epilepsy.Results: About 92.6% of the surveyed respondents had heard about epilepsy with mass media and family/ friends as the major sources of knowledge. 59.7% knew a person suffering from epilepsy and 30.7% had actually witnessed an attack of seizure. Only one-fourth of the respondents knew the disease to be a neurological disorder. More than half of the respondents would object to their children being associated with epileptic person in the school but surprisingly 63% would accept to work/become a friend with epileptic person. About 41% respondents would take patient in seizure to hospital while 43.5% would put a shoe on his nose.Conclusions: The public knowledge was found to be reasonably good, but attitudes were found to be of mixed type while practices were also not up to the desired levels. Need is for persistent and effective information campaigns to change public attitudes towards person with epilepsy.
Clinical study of perforations among patients at a tertiary care hospital
Authors: S. V. Mahesh , Reddy Dilip Kumar , P. K. Hota
Published: August 2018

Background: Non-traumatic gastrointestinal perforations have received far less attention in the recent medical literature than inflammations, tumoral or traumatic lesions of solid abdominal organs. The objective is to study perforations among patients at a tertiary care hospital.Methods: Patients diagnosed as non-traumatic perforations of the internal organs as diagnosed by authors were planned to be included for the present study. Diagnosis was based on history, clinical examination, and required investigations. All such patients were included in the present study that was enrolled for the present study during the study period. Such 50 patients could be studied. Non-traumatic perforation with regard to age, sex, causes, clinical presentation, diagnostic modalities required was evaluated.Results: Most common age group involved is in 3rd to 4th decade in the present study. Male preponderance (82%) was seen; with a male to female ratio was 4.6:1. The time lapse between onset of symptoms and presentation at the hospital was more than 24 hours in 24% of the study population. Abdominal pain was the most consistent symptom and was seen in 100% of the study population in the present study followed by vomiting (52%) and fever (46%). Distended abdomen was seen in 46% of study population in the present study. Tenderness was seen in all the cases and is more prominent at the site of perforation. Guarding/rigidity and absent bowel sounds were seen in 92% of the study population. Sensitivity of imaging in detecting gas under diaphragm was 72% by USG abdomen and 80% by plain radiography.Conclusions: Risk factors for increased morbidity and mortality in the present study include older age group, delayed presentation and features of shock.
Comparative evaluation of interventional radiology modalities in treatment of liver abscess
Authors: Pandey Jigyasa , Srivastava Anurag
Published: August 2018

Background: Liver abscess (LA) is a superlative cavity in the liver resulting from the invasion and multiplication of microorganism. With progress of interventional radiology, alternative to surgery in form of percutaneous drainage (PD) have become popular. PD can be accomplished by either percutaneous catheter drainage (PCD) or percutaneous needle aspiration (PCNA). This study was conducted to assess the PD as a definitive treatment modality for LA and comparison of PCD and PCNA.Methods: The study was conducted in the Radiodiagnosis Department. All patients of LA were evaluated for age, sex, duration of complaints, type of intervention performed, and outcome etc. After diagnosis, patients were managed by PCD or PCNA. Response to treatment, duration of stay, and overall success of both the modalities were evaluated.Results: The duration of this study was 34 months. During this period, 57 patients were evaluated. Of total, 29 underwent PCD and 28 PCNA. Male to female ratio was 2:1. Right lobe was involved in 48. Mean volume of abscess cavity was 356.44 ml. All patients who underwent PCD responded to the treatment; however, 8 patients who were treated by PCNA did not respond completely. Outcome was statistically related to type of treatment modality. PCD was statistically superior to PCNA (P <0.05).Conclusions: PD may be regarded as first line of treatment for LA. It appears that PCD is better as compared to PCNA for successful outcome of patients.
Typhoid ileal perforation: comparative study of ileostomy versus primary ileal repair and associated morbidity and mortality
Authors: Mishra Mayank , Singh Puspendra , Tripathi Alok
Published: August 2018

Background: Enteric perforation is most frequent encountered acute surgical emergency in Northern India and immediate warrants operative intervention. But the kind of intervention, whether primary repair or ileostomy is always a topic of debate for a long era.Methods: Sixty cases of ileal perforation were studied retrospectively from Feb. 2016 to august 2017 and information had been accumulated on clinical presentation, demographic profile and laboratory data. Details were obtained for operative findings and appropriate method of operative intervention done and later postoperative course of the patients in fallow up.Results: Ileal perforation occurred mostly in young males (age 28.2±10.9 years). Male and Female ratio has been found to be 5: 1. In present study 60% of patients had Widal positive supporting typhoid aetiology; Blood culture was positive for salmonella typhi in 21 (35%) cases. 67.3% of patients underwent primary closure, while 32.7% underwent ileostomy. Nature of clinical presentation, laboratory data and operative findings in both groups has been thoroughly analysed.Conclusions: Authors have carried out this study to label some of the preoperative and intraoperative factors, which can serve as a guideline for decision making in operative intervention in a specific patient.
Assessment of effect of various concentration of ketamine-propofol (ketofol) on haemodynamic parameters and LMA insertion conditions
Authors: Jain Sunita , Rathore Raju Singh , Modiwala Ashfaq
Published: August 2018

Background: The purpose of this study is to compare the effect of various concentration of ketamine-propofol (ketofol) on LMA insertion condition and hemodynamic parameters.Methods: Hundred patients of ASA I, II, aged between 18-65 years, were randomized in group A, B, C and D, each consist of 26, 25, 25, 24 patients respectively. They were premedicated with injection GPL, injection midazolam, injection fentanyl and induced with ketofol in 1:1, 1:2, 1:3 and 1:4 ratio in Group A, B, C, D respectively. 60 seconds after induction LMA insertion condition including mouth opening, swallowing, coughing, head and body movements, laryngospasm, ease of LMA insertion, apnea time, and time of LMA insertion were recorded. They were scored 1 to 3. Hemodynamic parameters- heart rate, noninvasive blood pressure and SPO2 were recorded before induction (T1), immediately following induction (T2), immediately after LMA insertion (T3), 5mins after LMA insertion (T4) and 10 mins after LMA insertion (T5).Results: Total 100 patients were included in this prospective randomized double-blind study between April 2017 to March 2018. Pulse rate at (T3) was significantly lower (P-0.06) in group C and D. Diastolic BP was found lower at (T2) time (P-0.04) in group C and D. Apnea time was longest in group A (P-0.002) LMA insertion time was minimum in group B (P-0.008).Conclusions: Addition of low dose of ketamine in propofol favour LMA insertion, due to opposite effect on muscle tone, better relaxation but heart rate, blood pressure remains stable with 1:1, 1:2 ratio of ketofol.
Scrub typhus an emerging public health threat in Eastern Nepal: an analysis from a tertiary centre during two years outbreak
Authors: Yadav Shankar Prasad , Dharel Dinesh , Shah Gauri Shankar , Bhattarai Narayan Raj , Khanal Basudha
Published: August 2018

Background: Scrub typhus is an emerging disease in the eastern part of Nepal. Varied clinical presentation and lack of laboratory resources make diagnosis difficult. Epidemic outbreaks have been reported from different parts of Nepal. The objective of this study was to describe the clinical presentation, complications, laboratory profile and outcome of admitted cases with scrub typhus.Methods: The cases (1 month to 15 years) admitted in paediatric ward or intensive care with confirmed serological diagnosis of scrub typhus over a period of two years 2015 and 2016, were retrospectively evaluated from the maintained records. All the clinical and laboratory parameters along with intervention and outcome were analysed by descriptive statistics.Results: There were 52 cases of scrub typhus of which 30 were female and 22 males. The youngest case was 2.5 months old and the median age was 3.6 years, mode being 14 years (7 cases). Majority (>71%) of cases were from the hilly districts. Mean duration of illness at presentation was 7.8±2.7 days and ≥94% of the cases had temperature of ≥102°F. More than half of the cases had hepatomegaly (78%), splenomegaly (53.8%), respiratory symptoms (53.8%) and the classical eschar (55.8%). The mean haemoglobin of the cases was below 10 g/dl and the mean platelet count was below 70,000/cu mm, along with hyponatremia, hypoalbuminemia and elevated liver enzymes. X-rays showing variable infiltrates were seen in 59.6%. Respiratory complications like pneumonia and acute respiratory distress syndrome (ARDS) were seen in 46%, encephalopathy in 12%, myocarditis in 40.2%and acute kidney injury in 7.6%. Twenty percent of the cases required intensive care management. There was 15.4% mortality, and all the cases who succumbed had ARDS and myocarditis.Conclusions: In this study the main clinical features were hepatomegaly, splenomegaly, respiratory symptoms and the classical eschar. Mortality was 15.4%. ARDS and myocarditis were present in all cases who died.
Clinical spectrum of severe acute malnutrition among children admitted to nutritional rehabilitation centre of a tertiary care hospital with special reference to incidence of bilateral pitting pedal oedema in children with severe acute malnutrition
Authors: Prashanth M. R. , Savitha M. R. , Raju H. N. Yashwanth , Shanthi M.
Published: August 2018

Background: Malnutrition is a major cause of morbidity and mortality in under five children globally, according to global nutrition report 2016, forty five percent of deaths in under five children are linked to malnutrition. The objective of this study was to study the clinical spectrum in children with Severe Acute Malnutrition (SAM) admitted to nutritional rehabilitation center of a tertiary care hospital.Methods: Children between the age group of 6 months to 5 years admitted in the nutritional rehabilitation centre during the period of 1 year (from April 2016 to March 2017) meeting our inclusion criteria were included in the study. We retrospectively reviewed the medical records of these children. Clinical spectrum of SAM was compared with comparison group.Results: A total of 100 cases were included in the study. Ninety five percent of children met the criteria of weight for height less than 3SD, 45% of children met the criteria of Mid Upper arm Circumference (MUAC) less than 11.5 cms and 5% of children met the criteria of bilateral pitting pedal oedema. Mean age of presentation of children in the present study was 15.8 months among which 45% were males and 55% were females. Major symptoms of the study group were fever, cough, hurried breathing, loss of appetite and loose stools with 79%, 45%, 27%, 26% and 23% as respective frequencies. Pneumonia (43%) was the major comorbidity among children admitted with severe acute malnutrition. Diarrhoea (21%), meningitis (8%), urinary tract infection (6%) were the other co-morbidities present in the study group.Conclusions: Pneumonia and diarrhoea are the major co-morbidities present in children with SAM. Majority of children fulfil the criteria of weight for height ≤3SD for diagnosis of SAM. There is a low incidence of oedematous malnutrition in the present study.
Effect of antenatal administration of magnesium sulphate and milking of umbilical cord during delivery on the incidence of intraventricular haemorrhage in preterm infants
Authors: Tom Stephy Maria , Manoj V. C.
Published: August 2018

Background: Intraventricular hemorrhage (IVH) is commonly seen in preterm infants. The aim of this study was to look at the effect of antenatal magnesium sulphate administration and milking of umbilical cord during delivery in the incidence of IVH in preterm infants.Methods: A randomized controlled study was conducted in the year 2015 on 80 preterm infants born less than 33 weeks of gestation during the study period. Magnesium sulphate was administrated to 25 pregnant women who were at imminent risk for delivery. Fourteen infants underwent milking of umbilical cord. The primary outcome was IVH detected in cranial ultrasound of day 28.Results: The primary outcome showed only 1 infant who received magnesium sulphate developed IVH, whereas 3 infants with no intervention done developed IVH. None of the preterm infants who had undergone milking of umbilical cord developed IVH.Conclusions: It was found that both antenatal administration of magnesium sulphate and milking of umbilical cord during delivery in preterm infants resulted in a significant reduction in the incidence of IVH. Further studies using more number of samples are required to understand the role of the interventions for long-term implications.
Comparative study of clinic-microbiological profile of fungal and bacterial sepsis in neonates
Authors: Sharma Shruti , Karnawat B. S. , Gupta Shrey
Published: August 2018

Background: Neonatal sepsis both bacterial and fungal sepsis is a major cause of neonatal mortality in India. This study is an attempt at determining the spectrum of fungal and bacterial infections in our NICU and ways to differentiate fungal from bacterial sepsis.Methods: All culture positive cases of bacterial and fungal sepsis from neonates in nursery of JLN hospital Ajmer from November 2016 to November 2017 were included in the study. The bacterial and fungal cases were compared for clinical and laboratory features, complications and outcome. Chi square test was used.Results: Culture positive sepsis was found in 391 cases out of total 2190 cases (17.8%) out of which 84.9% were bacterial (EONS 30% and LONS 70%) and 15.1% fungal (EONS 33.8% and LONS 66.1%). Fungal sepsis was found more in lower gestational age (55.9% versus 31.3%; p value 0.003) and in lower birth weight babies (76.2% versus 62.9%; p-value 0.004). Mortality rate was higher in fungal group (40% versus 19.5%; p-value: 0.0003). WBC count of <5000, platelet count <1.5 lac, reactive CRP, hyperglycemia, NEC, ventilation was significantly higher in fungal sepsis. While meconium stained liquor, per vaginal exams >3, maternal fever, mode of delivery, hypoglycemia, increased serum creatinine, respiratory distress, deranged CRT, temperature instability, intra cranial haemorrhage and length of hospital stay were found to be insignificant.Conclusions: In this study fungal sepsis when compared with bacterial sepsis, was found to be associated more with complications and mortality.
Intentional tremors: a rare complication of enteric fever in a child
Authors: Sharma Neetu , Verma Avadhesh
Published: August 2018

Enteric fever is a common infections disease of the tropical world. Characteristic presenting features include fever, relative bradycardia, diarrhea or constipation and abdominal pain. Complications like clinically significant jaundice, hepatitis, splenic abscess, neurological complications relatively uncommon. However intentional tremors associated with enteric fever never have been reported. Here, we report a 14-year-old boy with enteric fever who presented with acute hepatitis, splenic abscess, acute cerebellar ataxia and intentional tremors. Following treatment with appropriate antibiotics, the patient showed complete recovery over the next 2 weeks.
A cross-sectional study on knowledge, attitude and practice of infant feeding practices among reproductive age women attending outpatient department of obstetrics and gynecology in Dr. B. R. Ambedkar Medical College and Hospital, Bengaluru-45
Authors: Jabeen Bushra , Suryanarayana S. P. , Puttaswamy M.
Published: August 2018

Background: Adequate nutrition during infancy and early childhood is essential to ensure the growth, health, and development of children to their full potential. Lack of knowledge, wrong attitude and faulty practices among mothers in some aspects of infant feeding can lead to infant mortality. Thus, appropriate infant feeding practices and following recommended practice of exclusive breastfeeding could help in improvement of health of child and mother and also improve IMR. The objective of the study was assessment of knowledge, attitude and practice of infant feeding practices among reproductive age women.Methods: An institutional based, descriptive cross sectional study was conducted among reproductive age group (15 to 49 years) women attending OPD of OBGY department for various reasons. A semi structured questionnaire along with software tools like EpiInfo7, MS Excel and SPSS version 23 are used for data analysis.Results: A total of 98.5% of women consider breast milk as best nutrition and 77% were aware regarding exclusive breastfeeding. Weaning was most commonly started with mashed cereals (68.5%) with other food items at lower percentage. Participants are aware that breastfeeding is beneficial to both mother and child, and should not be avoided in any condition unless advised by treating doctor.Conclusions: Through the mothers under study had adequate knowledge regarding feeding practice but in this study it was observed that the appropriate practice worsens with increasing parity of mother.
Assessment of dietary pattern of school going adolescents in a metro city: a cross sectional study
Authors: Meher Sabita , Nimonkar Ravi
Published: August 2018

Background: Childhood is considered as one of the most vulnerable age group, since, in developing country like India due to poverty and a particular socio-cultural pattern. Epidemiological evidences suggest a strong link between maternal and early childhood undernutrition and increased adult risk of various chronic diseases. The present study aims at assessment of assessment of dietary pattern of school going adolescent.Methods: The present cross-sectional study was conducted among 440 school going children of class 9th,10th,11th,12th in a Government School at Kolkata, over a period of 6 months. The study participants were interviewed and their responses regarding their dietary patterns, habits, and knowledge about healthy dietary practices were noted down using pre-validated case record proforma. Their anthropometric records were also noted. Statistical analysis used: All the data was entered using Microsoft Excel software and analyzed using appropriate statistical tests with the help of SPSS statistical software.Results: Majority of children (50%) belonged to age group of 15-16yrs. The present study finds 48% prevalence of overnutrition and 12% undernutrition in school children.Conclusions: Developing countries like India shows the double burden of nutritional disorders, undernutrition as well as overnutrition due to limited availability of resources on one hand and western food habits, junk/fast food habits on the other hand respectively.
Assessment of knowledge, attitude and practice about diabetes among diabetic patients of tertiary care centre in central India
Authors: Nagar Vivek , Prasad Pankaj , Mitra Arun , Kale Saket , Yadav Kriti , Shukla Mukesh
Published: August 2018

Background: Diabetes mellitus (DM) is one of the major fast growing non-communicable disease (NCD) and causes threats to global public health. Prior to initiating an educational program or interventions for diabetic patients, their current level of knowledge (K), attitude (A), and practice (P) should be evaluated. The purpose of this study was thus to determined current diabetes-related knowledge, attitude, and practices (KAP) of adults with Diabetes mellitus..Methods: Current study was cross sectional study from August to December 2014 in medicine outpatient department of Tertiary care hospital of Bhopal. A semi‑structured interviewer administered questionnaire was used for data collection, and it consisted of four sections.Results: A total of 150 study participants were enrolled for the study. Among them, 58% were male and 425 were female diabetic patients. Around 16% of the participants having good level of knowledge, 34.6% of participants have poor knowledge and 49.3% having moderate knowledge. Out of the total participant 43.3% have positive attitude and only 34% patients had positive practice.Conclusions: In our study most of the patients belong to moderate and poor knowledge score as well as negative practice and negative attitude that emphasizes the need for increasing diabetes awareness activities. The efforts should be more focussed on female patients, younger patients and those who have no family history of diabetes.
Does copper deficiency predispose children to otitis media with effusion?
Authors: Amizadeh Maryam , Molaei Moghbeli Sareh , Reihani-Kermani Hamed , Reihani Amir
Published: August 2018

Background: Both otitis media with effusion (OME) and copper or selenium have been associated to the immune system, hence it could be proposed that cooper and/or selenium deficiency predisposes children to OME through immune cells dysfunction. The aim of this study was to determine the serum levels of Copper and Selenium in an immundeficient-linked disease - OME – in childhood.

Methods: This cross-sectional study was conducted between July 2015 and December 2016 including 80 patients age 1 to 8 years old who were divided into two groups: otitis media with effusion (OME) consisted of 40 patients and the control (n=40). Patients who did not recover after three months conservative treatments were included. Serum levels of Copper and Selenium were measured using graphite furnace atomic absorption spectrometry.  

Results: Statistical analysis showed no significant differences regarding age and sex were noted between groups. Patients with OME had significantly lower serum copper levels than the control group (p=0.007). However, there was no statistically significant difference in serum selenium levels between groups. The analysis also showed a significant positive correlation between serum copper level and age (correlation coefficient=0.348, p=0.028), whereas, there was no correlation between the measured selenium level and age.

Conclusions: The results of the present study showed that serum level of copper might play a role on development of otitis media with effusion in childhood.
Study of anatomical variations of ostiomeatal complex in chronic rhinosinusitis patients
Authors: Senniappan Shivakumar , Raja Komathi , Tomy Ammu Lizbeth , Kumar Chinnu Sudha , Panicker Anjali Mahendra , Radhakrishnan Shankar
Published: August 2018

Background: Anatomical variations like nasal septal deviations, concha bullosa, paradoxical middle turbinate, pneumatized or medially bent uncinate etc. can encroach upon the ostiomeatal unit and narrow ostiomeatal channels. The aim of the study was to study the anatomical variations of ostiomeatal complex commonly associated with paranasal sinus disease among patients with chronic sinusitis using computed tomography.

Methods: A prospective longitudinal study was conducted in the ENT department of our hospital for a period of one year. All the adult patients with complaints suggestive of chronic rhinosinusitis for a period of more than 12 weeks, patients with acute exacerbation of chronic rhinosinusitis and with persistent chronic rhinosinusitis requiring surgical intervention are included in our study. Based on our inclusion and exclusion criteria a total of 138 patients were involved in the study.  

Results: In our study we saw the association between various sinusitis and the anatomic variations of the ostiomeatal complex and we found that concho bullosa found to have a strong significant association with maxillary sinusitis (43.6%) and anterior ethmoid sinusitis (42.1%). Most of the patients with posterior ethmoid sinusitis (53.8%) had a statistical significant association in developing deviated nasal septum type of anatomical variant and majority of the patients with sphenoidal sinusitis had a onodi cell type of anatomical variant and their association was found to be statistical significant (p<0.05).

Conclusions: The importance of CT scan and nasal endoscopy is emphasized in patients with persistent symptoms to identify the anatomical variations that may contribute to the development of chronic sinus mucosal disease. 
Peak nasal inspiratory flow: a comparative study in our day to day practice
Authors: Kumar Vijay , . Harshvradhan , Bhavana Kranti , Bharti Bhartendu
Published: August 2018

Background: The peak nasal inspiratory flow is an objective measurement of nasal airway obstruction. It also helps in assessing response to treatment regardless of etiology. With this background this study was undertaken to establish diagnosis and monitoring treatment efficacy of PNIF in patients of allergic rhinitis and deviated nasal septum.

Methods: This prospective observational study involved 150 subjects who were selected among the patients attending the outpatient department of ENT and Head-Neck surgery, All India Institute of Medical Sciences, Patna. Thorough history was taken of all patients followed by general systemic and ENT examination. Each subject was asked to complete a SNOT 20 questionnaire. SPSS software was used for data analysis.  

Results: Out of total 150 subjects, 50 had deviated nasal septum (DNS), 50 had allergic rhinitis and 50 were normal subjects. Normal subjects had mean PNIF value 80 liter per minute with a range of minimum to maximum; 60 L/min to 150 L/min. Patients with symptomatic deviated nasal septum (DNS) had mean PNIF value 50 L/min with a range 20–80 L/min. Patients with symptomatic allergic rhinitis had mean PNIF value 65 L/min with a range of minimum 40 L/min to maximum 90 L/min.

Conclusions: On OPD basis, measurements of PNIF using Youlten peak flow meter can easily suggest anatomical & pathological variations in the nose and nasal cavity and can correlated well with patient’s symptoms and severity.
Chondroma of the mandibular condyle- rare location of a common benign cartilage tumour: case report and review of literature
Authors: Goil Pradeep , Midya Manojit , Sharma Pankaj , Prakash Gautam
Published: August 2018

Chondroma is a benign tumour of mature hyaline cartilage.It is common in the tubular bones the hands and feetand conspicuous by its rarity in the mandible. We hereby present an interesting case of chondroma of the mandibular condyle that was managed in our department. The antecedent radiological findings and postoperative histopathological peculiarities of the case are discussed. This case also focuses the negligent attitude of our society towards one’s health problems until they are fraught with beliefs of cancer. Chondroma of the mandibular is a rare, benign slow growing tumour. Condylectomy is considered adequate treatment for all condylar masses. Surrounding margins of healthy soft tissue is also excised to prevent recurrences. 
Efeito da política de mobilização do setor naval no Rio Grande do Sul: uma análise sobre a arrecadação municipal
Authors: Lima Shauana Bobadilha Rodrigues de , Teixeira Gibran da Silva , Abdallah Patrízia Raggi , Halmenschlager Vinícius , Leivas Pedro Henrique
Published: August 2018

Resumo: Com o presente trabalho teve-se como objetivo analisar o impacto da expansão do setor naval em razão do Programa de Mobilização da Indústria Nacional de Petróleo e Gás Natural (Prominp) no Brasil, instituído em 2003, sobre a arrecadação de impostos dos municípios afetados pela política, tendo como foco de análise o Estado do Rio Grande do Sul, onde os investimentos no setor se intensificaram a partir de 2006. Tem-se então, um painel de dados em nível municipal com as variáveis de interesse para o período de 2000 a 2012. O método utilizado para avaliar o impacto foi o de diferenças em diferenças com efeito fixo de município. Os resultados encontrados, ao considerar o principal grupo de controle da análise, o Conselho Regional de Desenvolvimento da Região Sul (Corede Sul), mostram que a expansão do setor naval impactou de forma positiva a arrecadação do Imposto Predial e Territorial Urbano (IPTU) e do Imposto sobre a Propriedade de Veículos Automotores (IPVA), tendo este, no ano 2006, um aumento de 25,8% e 30,8%, respectivamente.Palavras-chave: Setor Naval. Política Pública. Tributação. Diferenças em Diferenças. Effect of the Policy of Mobilization of the Naval Sector in Rio Grande do Sul: an analysis on the municipal collection  Abstract: This study aims to analyze the impact of the expansion of naval sector due to Programa de Mobilização da Indústria Nacional de Petróleo e Gás Natural (Prominp) in Brazil, established in 2003, on the collection of taxes from the municipalities that received the intervention, focusing on the analysis for the state of Rio Grande do Sul, where the investments in the sector increase from 2006. Has a panel of municipal-level data with the variables of interest for the period 2000 to 2012. The method used to measure this impact was the differences in differences with fixed effect of municipalities. The results, considering the main control group analysis, Conselho Regional de Desenvolvimento da Região Sul (Corede Sul), show that the expansion of naval sector positively impacted, in 2006, the collection of the Urban Land and Territorial Tax (IPTU) and Property Tax on Motor Vehicles (IPVA) in 25.8% and 30.8%, respectively.Keywords: Naval Sector. Public Policy. Taxation. Differences in Differences.
A influência da gestão de integração e de mecanismos culturais no desempenho de projetos: o caso de construção civil no segmento farmacêutico
Authors: Navarro Dorizon Alberto , Rabechini Júnior Roque , Moutinho José da Assunção
Published: August 2018

Resumo: O objetivo com esta pesquisa foi investigar a influência da gestão de integração de projetos e dos mecanismos culturais no desempenho de projetos de construção civil na indústria farmacêutica. Como estratégia de pesquisa, recorreu-se ao estudo de caso múltiplo para analisar os elementos da investigação nas filiais de uma empresa farmacêutica no Brasil e na Rússia. A revisão da literatura, sobre o tema abordado, possibilitou a formulação de oito proposições teóricas.  Os resultados indicam diferenças entre a influência da gestão de integração e mecanismos culturais no desempenho de custo e de prazo dos projetos em cada contexto analisado. A contribuição teórica com este trabalho foi estabelecer um diálogo entre conceitos gerenciais de naturezas distintas. De um lado, a gestão de integração, cuja característica é incorporar consistentemente áreas de conhecimento, e, de outro, os mecanismos culturais e suas influências em diferentes unidades gestoras. A contribuição prática foi apresentar subsídios para a elaboração de uma lista de atividades, tomando-se como base a gestão da integração e os mecanismos culturais para potencializar os efeitos positivos nos resultados de um empreendimento.Palavras-chave: Gestão da integração. Mecanismos culturais. Desempenho em projetos. Projetos globais. Gerenciamento de projetos. Influence of the management of the integration and cultural mechanisms in the project performance: the case of construction in the pharmaceutical segment Abstract: The objective of this research is to investigate the influence of project integration management and cultural mechanisms in the performance of civil construction projects in the pharmaceutical industry. As a research strategy, the multiple case study was used to analyze the elements of the investigation in the branches of a pharmaceutical company in Brazil and Russia. The review of the literature on the subject addressed allowed the formulation of eight theoretical propositions.  The results show differences between the influence of integration management and cultural mechanisms on the cost and time performance of the projects in each analyzed context.  The theoretical contribution of this study was to establish a dialogue between management concepts of different nature. On the one hand the integration management, whose characteristic is to consistently incorporate areas of knowledge and, on the other hand the cultural mechanisms and their influences in different management units. The practical contribution was to contribute to the preparation of a list of activities, taking as a base the integration management and the cultural mechanisms to increase the positive effects in the results of an enterprise.Keywords: Management mechanisms. Cultural mechanisms. Project performance. Global projects. Project management.
Synthesis of Some New Benzimidazole Derivatives Containing Chlorine and Investigation of Their Antioxidant and Anti-urease Activities
Authors: KARAALİ Nesrin
Published: August 2018

In this work, the synthesis of 2-substituted
benzimidazole compound containing chlorine
(1) was carried out and then
converted to the ester (2) and hydrazide (3) derivatives respectively. In the
next steps, the hydrazide compound (3)
was reacted with the appropriate reagents to give the thiadiazole (8-10) and triazole (11-13) derivatives. Synthesis of the
compound 4 was carried out as a
result of the interaction of the ester derivative compound (2) with morpholine. The structures of
all synthesized compounds were elucidated by FT-IR, 1H NMR, 13C
NMR and elemental analysis spectroscopic methods. Also, the antioxidant and
urease enzyme inhibition properties of these compounds were also investigated.
Treatment of the nevus of Ota with the 1064-nm Q-switched Nd:YAG laser
Authors: AKPINAR KARA Yeşim
Published: August 2018

Nevus of Ota is a benign hamartoma which presenting as
blue-gray hyperpigmented patches on the face and mucous membranes usually
within the distribution of first and second branches of the trigeminal nerve. It
may occur at birth or during adolescence and the nevus of Ota is very common seen
in Japan and east countries. The pigmentation varies and can be dark brown to blue
to black-blue. We report a 31-year-old female patient with the nevus of Ota. The
Q-switched Nd:YAG laser, had a spot size of 3 mm, an 8 Hz repetition rate, 720 mj/cm2
fluence. The patient's lesion improved in a rate of 60% with a single session. The
Q-switched Nd:YAG laser has a significant effect in treating the nevus of Ota.
STEM Buddies EN by Z. Soufan
Authors: Germain Raven
Published: August 2018

Soufan, Ziad. STEM Buddies EN. Project Hikaya, 2018. Vers. 1.1.2. Google Play Store, https://play.google.com/store/apps/details?id=com.stem_buddies.en

This educational application uses a combination of multimedia elements such as video, audio, and text to create an engaging and interactive storytelling experience that teaches children about Science, Technology, Engineering, and Maths (STEM) topics.

The app consists of three parts: an animated story, a short quiz, and downloadable colouring pages. Upon opening the app, the user is prompted to watch the animation first, with learning objectives presented for the chosen topic. After the short, subtitled, five-minute video, in which the viewer has the opportunity to pause and rewind, the user is then directed to either the quiz or the colouring pages, which reflect the material presented in the video. This intuitive and logical organization ensures that the informative video is a precursor for the interactive activities and consequently enables learning through reflection and repetition.

Through accessible language, the current module, “Water Cycle,” seamlessly integrates an original, engaging story and memorable characters with pedagogical elements that explain how rain forms (evaporation, condensation, precipitation), the importance of water, and the problems associated with the lack of rain. The simple, five-question quiz contains multiple question types and uses audio, text, and pictures to provide children with multiple avenues for identification and learning. Through the quiz, children are required to make intelligent decisions regarding what they have learned. Feedback is given in the form of gamification, with correct answers being positively reinforced by the attainment of gold stars, and completion of the quiz resulting in a personalized certificate of achievement for that module. A myriad of colouring pages, available for use within the app or for individual download, reflect familiar themes and characters and continue to provide some interactivity after the module has been completed.

Available in English and Arabic, this new, free application currently only contains one subject module, with more scheduled to be released in the future. With superior graphic design, no ads, and no in-app purchases, the possibility for distractions and unintended purchases are removed. Despite these desirable features, the video and narrative itself could be more interactive on the textual and visual level by incorporating hotspots for touching, swiping, and exploring. I would recommend it for use in public libraries and by teachers in elementary schools for children aged 5 to 9.

Recommended: 3 out of 4 stars Reviewer: Raven Germain

Raven Germain is a second year MLIS student at the University of Alberta with a love of children’s literature. When not studying, she enjoys travelling, playing piano, and immersing herself in fantasy novels.