bluuebunny/crossref_metadata_2025 huggingface dataset:
Zollinger ellison syndrome due to primary nodal gastrinoma located outside the limits of the conventional gastrinoma triangle: report of a case
Authors: Arsia Ashish , Hazrah Priya , Anwar Shabab , Thomas Shaji , Abbey Pooja , Singh Smita
Published: April 2021

Primary nodal gastrinoma is a rare entity and the diagnosis is often contemplative when no other non - nodal primary site can be identified despite thorough investigations and operative exploration. Here we report one such case wherein a primary nodal gastrinoma was diagnosed as an entity of exclusion. Additionally, the location of the disease outside the confines of the conventional gastrinoma triangle further contributes to the rarity of the presentation. A young male patient had presented to us with history of multiple operations in the past for recurrent upper abdominal pain presumably consequential to peptic ulcer disease viz a trucal vagotomy and gastrojejunostomy, duodenal ulcer perforation surgery and a cholecystectomy. CT scan and endoscopic USG showed a preaortic calcified node located outside the limits of the gastrinoma triangle. A raised serum gastrin level and an endoscopic guided FNAC confirmed the diagnosis of a gastrinoma. A 68 Ga-DOTANOC PET CT revealed an exclusive nodal uptake with no discenable primary lesion. Normalization of gastrin levels after removal of the involved pre-aortic node further pointed to the diagnosis of primary nodal gastrinoma. A high index of clinical suspicion is warranted especially in a history of multiple surgeries for recurrent upper abdominal pain and location of the lesion outside the confines of the ‘Gastrinoma Triangle’ should not be deterrent for the diagnosis.
Current status and progress in the treatment of congenital liver cyst
Authors: Chaoxing Liao , Yuehua Li , Jianping Gong
Published: April 2021

Liver cyst is a relatively common benign liver disease. According to the cause of the disease, it can be divided into two types: non-parasitic liver cyst and parasitic liver cyst. Congenital liver cyst is the most common non-parasitic liver cyst in clinical practice, also known as true cyst, which mainly include simple liver cyst and polycystic liver diseases (PLD). In recent years, with the popularization of ultrasound and other examinations, the detection rate of liver cyst has increased year by year, but there is no unified consensus on the treatment of liver cysts. This article reviews the conservative treatment, puncture drainage, aspiration sclerotherapy, surgical treatment and other treatment options for congenital liver cysts, as well as the technological progress in recent years.
Thyroid function and gallstone disease: is there an association?
Authors: Nair Kharishma P. , S. Siddartha Gowthaman , S. Vinoth , Manickam Ramanathan
Published: April 2021

Gallstone disease, amounts to a significant amount of disease burden to the medical society, more commonly encountered in the West. Various predisposing factors are associated with the development of cholelithiasis, namely age, gender, dietary food habits and haemolytic conditions, but whether or not thyroid dysfunction is a causative factor, till date, is a subject of dispute. Gallstones can be classified into cholesterol stones and pigment stones which are black or brown (with cholesterol) in colour. Thyroid hormones are said to have a direct effect on the sphincter of oddi, thereby aiding in biliary emptying. They also alter the lipid metabolism which is said to cause supersaturation of cholesterol in bile, and hence result in the formation of cholesterol stones. Several studies have tried to establish this hypothesis and have concluded with diversified results. This review article throws light into the concept of the association between thyroid dysfunction and formation of gallstones by evaluating several articles through a systematic approach in order to arrive at a better consensus.
Study on reactive thrombocytosis in febrile young infants with serious bacterial infection in a tertiary care hospital
Authors: Chidhara Nasreen
Published: April 2021

Background: Thrombocytosis associated with multiple, simultaneous causative factors was also reported in many children. Among all patients with infections, osteomyelitis and septic arthritis were associated with higher platelet counts than other infections. This study was done to estimate the prevalence of reactive thrombocytosis among febrile young infants and to assess the utility of platelet count as a potential predictor of serious bacterial infection.Methods: The study was a cross-sectional study conducted in the department of paediatrics, Kanchi Kamakoti child's trust hospital, Nungambakkam, Chennai. 140 children were included in the study. Venepuncture was done in all these children. Blood sample of 3 ml was collected in an EDTA tube for complete blood count and in another tube 2 ml of blood was collected for CRP.Results: The prevalence of reactive thrombocytosis was 65.8% in the population with serious bacterial infection (SBI). The proportion of children having respiratory symptoms in the study population was 70%, which was the most common system affected. Gastrointestinal, CNS and genito-urinary symptoms were seen in 29.29%, 11.43% and 10.00% of subjects respectively. Other miscellaneous symptoms were reported in 4.29% of the patients.Conclusions: The prevalence of SBI was highest (30.2%) in the 4 to 6 months age group. The prevalence of SBI in 1 to 3 months, 7 months and above age groups was 28.6% and 29% respectively.
Febrile infants in the emergency department of a public hospital in India: respiratory infections lead the pack
Authors: Pradhan Pragyan , Mishra Devendra , Juneja Monica , Kumar Surinder
Published: April 2021

Background: The objective of study was to find the etiology, signs and symptoms of fever of 4-7 days in the age group of 91 days 2 years and their outcome following treatment in a tertiary care hospital.Methods: This was a prospective study conducted at the Emergency Department (ED) of a public hospital in New Delhi between April, 2018 and January, 2019. 150 children aged 3 months to 2 years with 4-7 days of fever were included. Demographic, clinical and diagnostic data were collected, and children were managed using ACEE-INDIA guidelines, telephonic follow-up was done for those discharged from ED.Results: Out of 150 children, respiratory tract infections were most common etiological group (64%), followed by gastrointestinal infections (16.7%) and CNS infections (9.3%). Fever with cough (with respiratory distress-27.3%) was the most common symptom in these children. Overall, 61% were admitted; majority (58%) being with respiratory problems. Median (IQR) duration of stay in admitted children was 2 (0, 3) days. Mortality was observed in 12 (8%) children. Mortality was 4 times higher in children with CNS infections as compared to other conditions [RR=4.14 (1.4 to 12.4); P=0.01].Conclusions: Fever in the ED among Indian infants at a public hospital was mainly due to respiratory infection, which could be managed on outpatient-basis in the majority using the ACEE-INDIA (Academic College of Emergency Experts in India) guidelines. However, among those admitted, neurological conditions were the most common cause of death.
Study on effect of duration of mechanical ventilation on retinopathy of prematurity in low birth weight neonates admitted to neonatal intensive care unit
Authors: N. Madhu G. , H. Anil
Published: April 2021

Background: There has been an increase in morbidity in low birth weight infants, since the advancement in field of neonatology. Various resuscitation methods and life saving interventions are associated with adverse effects. One such intervention is mechanical ventilation and if prolonged, it is known to cause various morbidities like bronchopulmonary dysplasia, retinopathy of prematurity, vocal cord injury. In this study we are considering the effect of duration of ventilation on retinopathy of prematurity.Methods: This study is a prospective study, an observational study. The study was conducted in Kempegowda Institute of Medical Sciences, Bangalore. Total of 60 low birth weight infants (<2500gm) who were admitted to the Neonatal Intensive Care Unit (NICU) and were on mechanical ventilator support were included in the study. The study was conducted for a duration of 18 months, between January 2019 to June 2020.Results: Retinopathy of prematurity (ROP) was seen in 19 cases and was the most common complication associated with increasing duration of mechanical ventilation, which accounted for 48% of total complications, followed by abnormal otoacoustic emission (OAE) 17.95%, pneumothorax 10.26%, apnea 7.69%, pneumonia and bronchopulmonary dysplasia 5.13% and Hypoxic ischaemic encephalopathy (HIE) and seizures 2.46%.Conclusions: In this study, we were able to know the common complications involved in prolonged mechanical ventilation. This provides us to think about needs for measures to reduce the duration of mechanical ventilation and thereby reducing morbidities associated with it.
Variation of platelet parameters in preterm neonates
Authors: P. Chandrakala , G. S. Krithika
Published: April 2021

Background: Platelets play a crucial role in hemostasis and phagocytosis. These functions of platelets are acquired gradually from foetal life to infant life. Larger, immature platelets are more reactive and hence platelet mass indices may be indicative of the thrombotic potential of platelets.Methods: This study was conducted in Kempegowda institute of medical sciences and research centre attached hospital in Bengaluru, Karnataka, India between January, 2019 and July, 2020. Platelet count, mean platelet volume (MPV), platelet distribution width (PDW) was obtained from automated analyzer reports (SYSMEX XT 1800i). The statistical association between the gestational age, birth weight and gender of preterm and their platelet parameters, was then assessed.Results: In this study, the effect of gestational age, birth weight and gender on platelet parameters was studied. A significant correlation between PDW (platelet distribution width), MPV (mean platelet volume) and gestational age was found. It was found that with increasing gestational age, both PDW and MPV decreased. With respect to birth weight, the mean, median PDW significantly decreased with increasing birth weight. None of the platelet parameters were different between male and female preterm neonates.Conclusions: There still remains a paucity of studies regarding the correlation between platelet mass indices and gestational age and birth weight. While some studies show positive correlation, some studies show no correlation and this study shows negative correlation. Hence, this calls for more studies, with larger sample sizes, to be undertaken.
Strategies for neonatal care during the COVID-19 pandemic: a lower middle-income country perspective
Authors: Grover Rajat , Shubham Shantanu , Basu Sriparna
Published: April 2021

COVID-19 has transformed into an all-encompassing pandemic affecting all levels of healthcare throughout the globe. The strains on healthcare systems have been evident even in the most developed countries. Low and middle income countries (LMICs), especially India, find themselves in a precarious situation due to limited resources, poor healthcare worker population ratios and a bigger population. Multiple factors can exponentially increase the actual effect of a pandemic on the vulnerable neonates and infants even though the disease itself may be less lethal for them. The situation was complicated by the implementation of lockdowns. We discuss the implications for neonatal care that such a pandemic has in LMICs and elucidate the strategies we have implemented to provide continuity of care during the pandemic. We also share our experience of providing neonatal care and summarise the patient load witnessed in a specific context of a level-3 NICU in a government multi-speciality hospital of an LMIC. Keywords: Covid-19 pandemic; Low- and middle-income countries; Neonatal care
Medical and obstetric factors associated with preterm deliveries among women of childbearing age at Pumwani maternity hospital, Nairobi County, Kenya
Authors: Mwangi Daniel K. , Waithaka Stanley K. , Odongo Alfred O.
Published: April 2021

Background: The rate of pre-term birth (PTB) in Kenya stands at 12.3%. Preterm deliveries are associated with high neonatal mortality and have a huge financial burden on the parents and the government. Prematurity is also associated with chronic diseases like diabetes and hypertension in adult life. The study objective was to determine the medical1and obstetric factors1associated1with preterm deliveries among women of childbearing age (15-49 years) at Pumwani maternity hospital (PMH).Methods: A hospital-based cross-sectional study was conducted among 191 mothers of reproductive age (15-49 years) who delivered at PMH during the study period. Data was collected using a questionnaire and a data abstraction tool. Descriptive statistics were used to summarize categorical variables. Chi-square was used to test for the strengths of associations. Prevalence adjusted odds ratios (PAOR) were used to estimate the strengths of associations.Results: The study found that the association between past pregnancy (p=1.0), history of surgery (p=1.0), medication (p=1.0), urinary tract infection (p=0.453), miscarriage (p=1.0) and chronic disease (p=0.395) and preterm delivery among women of child bearing age (15-49 years) at PMH was not statistically significant. The association between premature delivery (p=0.021), parity (p=0.000), premature rapture of membranes (PROM) (p=0.000), antepartum hemorrhage (APH) (p=0.045), cervical incompetence (p=0.001), pre-eclampsia toxemia (PET) (p=0.000), and placenta abruption complications (p=0.009) and preterm delivery was statistically significant.Conclusions: The association between premature delivery, parity, PROM, APH, cervical incompetence, PET and placenta abruption complications and preterm delivery was statistically significant.
Role of training to reduce stress among health professionals during COVID 19: an analytical study in Meerut
Authors: Dave Anuradha , Nasser Kaynat , Pant Bhawna , Dave Sanjev
Published: April 2021

Background: A healthy job is likely to be one where the pressures on employees are appropriate in relation to their abilities and resources, to the amount of control they have over their work, and to support they receive from people who matter to them. Experiencing an infectious disease outbreak can cause fear, anxiety and stress.Methods: A cross sectional study was conducted in Subharti Medical College, Swami Vivekanand Subharti University, Meerut in the month of September 2020–October 2020 on 127 health care professional (69 doctors and 58 nurses) who were interviewed randomly working in the level III COVID hospital using professional stress score by David Fontanna.Results: Training received by the doctor and nurses during COVID-19 pandemic for infection prevention was more significantly associated with mild professional stress (p<0.00) than moderate professional stress (p<0.027).Conclusions: Training showed positive impact by enhancing their confidence level to manage stress during pandemic situation.
An epidemiological study on knowledge, attitude and practice of married women about menopause and hormone replacement therapy
Authors: John Nimmy N. , Juan Riya , Danam Manchu S.
Published: April 2021

Background: Women all over the world now have to spend almost 1/3rd of their lives in menopausal years. Therefore, menopause now is a concerning matter to maintain and improve women’s health. Hormone replacement therapy (HRT) is an effective treatment for menopausal symptoms. This study was conducted to determine knowledge, attitude and practice toward menopause HRT among women. Objective of the study was to determine the level of knowledge, attitude, and practice related to menopause and HRT among women.Methods: This cross-sectional study was carried out in May 2020 to July 2020 in a rural area of Ernakulam district of Kerala, India. 150 women were interviewed using a predesigned, pretested questionnaire.Results: In the present study, 42.6% of menopausal women had knowledge of menopausal symptoms. 31.3%, 38% and 26% knew that menopause increases risk of cardiovascular, osteoporosis and breast cancer respectively. 16.6% think menopausal women should consult a physician, only 42% of menopausal women are aware of HRT. 60.6% think menopausal symptoms affect quality of life. 50.6% think that menopause means end of sexual life. 42.6% think that absence of menstruation is a relief. 48.6% think physical changes of menopause are inevitable, hence acceptable. 35.3% had consulted a physician at the onset of menopause. 80% preferred natural approaches when compared to HRT. 76% and 86% think that HRT has many complications and side effects hence should be avoided respectively.Conclusions: The study concluded that the knowledge and attitude of the participants towards menopause and HRT was poor in the study population.
Awareness about breast feeding practices and vitamin A deficiency among mothers in Srikakulam district of Andhra Pradesh, South India
Authors: Sappati Vasantha Rao , Krishnaiah Sannapaneni , Sapur Suneetha
Published: April 2021

Background: To assess the awareness about breast feeding practices and to assess the knowledge, attitude and practice about the signs and symptoms of vitamin A deficiency (VAD) and vitamin A rich foods intake among mothers of children below 5 years in the Srikakulam district of Andhra Pradesh (AP) in South India.Methods: A population based cross-sectional study was conducted on 284 mothers (age range 14 to 36 years) during June 2011 and September 2011. A combined simple and systematic random sampling strategy was used to select mothers from one tribal, rural and semi urban area with a representative sample of the Srikakulam district. A standardized structured questionnaire that was developed and validated by the National institute of nutrition, Hyderabad was utilized for this study.Results: The awareness of vitamin A and night blindness was 68.7% (95% confidence intervals (CI): 62.9–74.0) (n=195) and 93.7% (95% CI: 90.2–96.2) (n=266) respectively. The knowledge of signs and symptoms of vitamin A deficiency (VAD) was nil among illiterate mothers and low among literates; with primary education, adjusted odds ratio (OR): 0.01 (95% CI: 0.00, 0.06) and with secondary education, OR: 0.19 (95% CI: 0.06, 0.62) compared to mothers with graduation and above.Conclusions: There is a need to increase the awareness and knowledge about VAD among mothers with children below 5 years in the southern state of AP.
Assessment of status of psychological well-being and its determinants among adolescent school students residing in Raipur city, Chhattisgarh
Authors: Shalini Shweta , Gupta Shubhra A. , Sharma Mini , Verma Smita , Verma Nirmal
Published: April 2021

Background: Psychological well-being is a multidimensional concept, including both individual capacities of the adolescents and social competencies. Good overall adjustment and a sense of psychological well-being are very crucial factors for the adolescent’s positive contribution to the society. The objective of this study was to assess the status of psychological well-being and its socio-demographic determinants among adolescent school students of Raipur city.Methods: A cross-sectional observational study was done on 576 adolescent school students of Raipur city to assess their psychological well-being using Ryff’s scale of psychological well-being along with their socio-demographic characteristics. Association and regression analysis were done.Results: Overall, 79.9% of study subjects were scored as having average psychological well-being followed by 20.1% study subjects having good psychological well-being according to Ryff’s scale. Study subjects with female gender, studying in english medium, private school, following non-state board syllabus, belonging to unreserved category, having educated father or mother, working father or mother, at least one parent working at distant place, residing in joint family whose parents are living together, who gets attended by someone after returning from school are having higher psychological well-being than the other group.Conclusions: Socio-demographic determinants has a significant role to predict the psychological well-being of the study subjects. These determinants are mostly non modifiable displaying the need for integrating key behavioural factors on positive health promotion policies and programs.
COVID-19 lockdown impact on physical activity and anxiety levels among physiotherapy practitioners, teaching faculty and students in Mumbai: a cross-sectional web-based e-survey study
Authors: Kamdin Farzan , Khemani Kruti , Varghese Annamma
Published: April 2021

Background: Coronavirus (COVID-19) has spread rapidly throughout the world leading to an emergency global pandemic. Among the varied affected sections of the population and healthcare, physiotherapy is no exception. To what extent, both the physical activity and anxiety levels have been affected amongst the physiotherapy practitioners, teaching faculty and students is not completely known. Hence, this study was undertaken.Methods: Among a potential 400 participants, 357 responded (response rate=89.25%). Cross-sectional web based open e-survey was sent using google forms via emails and social media platforms such as Whatsapp, facebook, instagram and linkedin messenger. The primary outcome measures were international physical activity questionnaire-short form (IPAQ-SF) for self-reported physical activity and general anxiety disorder (GAD-7) questionnaire for measuring self-reported anxiety.Results: Out of the 357 participants, 40 were inactive (<600 METs/week), 175 were minimally active (600-3000 METs/week) and 142 were health enhancing physically active (>3000 METs/week). The GAD-7 score showed a significant proportion of participants (74%) to have mild to moderate anxiety and only 26% had moderately severe to severe anxiety. Physiotherapy students were found to do least amount of physical activity in a week (mean METs/week of 2590) and were also more anxious with an average GAD-7 score of 7.7. Practicing physiotherapists and teachers had better scores of 3285 and 3028 METs/week and also better mean GAD-7 scores at 6.4 and 5.3, respectively.Conclusions: The lockdown caused by the COVID-19 pandemic has affected the physical activity levels and mental wellbeing of physiotherapy students more than the physiotherapy practitioners and teaching faculty.
An epidemiological study of the prevalence and determinants of overweight and obesity in women of reproductive age (15 to 49 years) group in an urban slum
Authors: Mulik Pratibha U. , Suryawanshi Sudam R.
Published: April 2021

Background: After comparing data of NFHS-3 and 4, prevalence of overweight and obesity in women of an urban population almost doubled in 10 yr. So, the causes of increasing prevalence need to be studied as public health concern. Objective of the study is to determine prevalence of overweight and obesity among reproductive age group (15-49 years) of women in an urban slum of Mumbai.Methods: Total 220 women were selected among 11 sectors from A to K by simple random method and data collected by using validated questionnaire. WHO’s classification was used to classify as overweight and obese.Results: Out of 220 women participated in study, 14 (6.36%) were obese, 75 (34.09%) were overweight according to BMI and 17 (7.7%) were found to be obese according to waist to hip ratio. From the present study it was seen that age group of the women, socio economic class, education, history of hypothyroidism, family history of obesity, types of work women do, hours of television watching, calorie and fat intake, had a significant relationship with BMI, whereas physical exercise they used to do and tendency to sleep in the afternoon and hours of sleep in the night had non-significant relationship with BMI.Conclusions: Obesity and overweight is found to be a growing public health problem and can be preventable. Interventional measures include developing healthy eating habits, regular moderate physical exercise, sleeping habits, health camps for screening of overweight and obesity.
A study to assess the prevalence of common physical health problems among senior citizens at Sarojininagar, Lucknow
Authors: Pandey Vinita , Gunasekaran Sathiyaseelan , Tiagi Chandini
Published: April 2021

Background: Aging is a universal process. Aging is generally defined as a process of deterioration in the functional capacity of an individual that results from structural changes, with advancement of age. Aging is a normal, inevitable, biological and universal phenomenon, and it affects every individual irrespective of caste, creed, rich and poor. It is the outcome of certain structural and functional changes takes place in the major parts of the body as the life years increases.Methods: A quantitative research approach and a non-experimental descriptive cross sectional research design was used. The sample size of 150 senior citizens was selected by using non-probability purposive sampling technique. Initially the investigator Obtained permission from concerned authority of Sarojininagar, primary health care (PHC), Lucknow. The tools used were, Performa of demographic variables, checklist to screen the history of common physical health problems and checklist to assess the existing common physical health problems of senior citizens.Results: The results of the study revealed that majority of the elders were suffering from vision problem (93.3%), hearing problems (56.0%), hypertension (42.7%), diabetes mellitus (42.7%) and obesity (30.7%).Conclusions: The study concluded that majority of the elders were suffering from one or the other common health problems while only few reported to be completely healthy. There was a need to create awareness regarding the reasons for common physical health problems, to encourage practicing a healthy lifestyle.
Assessment of Anti-SARS CoV-2 seroprevalence in habitants of Assam (AASSHA): report of the first serosurvey in Assam
Authors: Pathak Jyotismita , Das Mridusmita , Siddique Khalil
Published: April 2021

Background: Today, there is a pressing need to identify the proportion of people immune to the infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) so that public health policies can be formulated accordingly for the ongoing COVID-19 pandemic. Keeping this in mind, we designed a serosurvey in Assam with aims to estimate the prevalence of infection as well as the infection to case ratio of the novel coronavirus in Assam.Methods: A total of 9 districts belonging to three different strata of districts were randomly selected for the study. In these selected districts, blood samples were collected from a sample of population and were checked for the antibodies (IgG type). Those testing reactive for the mentioned antibodies were considered to have been infected ever before the onset of the study.Results: A total of 2390 study subjects were tested for the presence of antibodies against the SARS-CoV-2. The proportion of people harboring antibodies against the infection was found to be 23.7 percent.Conclusions: The serosurvey revealed that the proportion of people having antibodies was lower than that required for attaining herd immunity levels in a population. The case to infection ratios reveal that there is a large chunk of population who didn’t know about their infection.
Effectiveness of structured teaching programme on knowledge regarding rubella vaccine among parents of children, 1-12 year
Authors: Goswami Chirag Giri , Kumawat Shalini Raj , Pandya Hardik
Published: April 2021

Background: Rubella also known as German measles is a mild viral disease characterized by mild fever and maculopapular rash. During 2000-2018, measles vaccination prevented an estimated 23.2 million deaths. Routine measles vaccination for children combined with mass immunization campaigns in countries with high case and death rates, are key public health strategies to reduce global measles deaths. The aim of the study is to assess the effectiveness of structured teaching programme on knowledge regarding rubella vaccine among parents of children (1-12 year).Methods: Pre experimental one group pre-test post-test design. Total 60 parents were taken who have children (1-12 years); purposive sampling technique was used to select the parents. A structured knowledge questionnaire was prepared by the investigator. Informed consent was taken from each participant prior to data collection and Descriptive and inferential statistics i.e., frequency, percentage, paired’ test, chi-square test was used for analysis.Results: Pre-test knowledge score of parents regarding rubella vaccine revealed that 53.33% parents had inadequate knowledge, and 46.66% parents had moderately knowledge. After structured teaching programme, the posttest knowledge scores of parents shows that 13.33% parents had adequate knowledge, 83.33% parents had moderately adequate knowledge and 3.33% have inadequate knowledge.Conclusions: The structured teaching programme (STP) through flash cards, charts and roller board etc. found to be very effective in improving the knowledge among parents who have children (1-12 year) on rubella vaccine.
A community-based study for assessment of growth and development of low-birth-weight infants, in Sanwer Tehsil of Indore, Madhya Pradesh
Authors: Sharma Neelima , Wavare R. R. , Gautam Pooja , Sharma Preksha , Sharma Neha
Published: April 2021

Background: The objective of study was to assess the growth and development of low-birth-weight (LBW) infants.Methods: The study was conducted in community health center of Sanwer Tehsil (Indore District) in the state of Madhya Pradesh under the department of community medicine of Sri Aurobindo medical college and PG institute, Indore. A total of 150 babies were registered and followed up for study.Results: Male preponderance was observed in our study with 70 males and 66 females. Out of total 80 LBW neonates (44 males and 36 females), 6 were home deliveries, while similar equal distribution among primipara and bipara (34 and 30 respectively) was noted. It was found that maximum number of LBW infants (11.76%) were found in the mothers age group of 21 and 25.Conclusions: c2 value suggested that parity was not significantly correlated to LBW but multiparas with >3 deliveries were more prone to deliver a low-birth-weight baby. National programmes targeting to address low birth weight are the need of the hour.
The road to universal health coverage: an overview of global and Indian scenarios
Authors: John Anugraha , Avirneni Hari Teja , Swaminathan Sinthu Sarathamani
Published: April 2021

The declaration of World Health Assembly in the year 2005 paved the way for all the member states to plan for the transition towards universal coverage to their respective citizens. This was underpinned by the notion that access to quality basic and essential health services has to be made available for everyone to combat poverty and to achieve the developmental goals worldwide. This global movement towards universal coverage is considered as one of the greatest transitions in health, the other being the demographic transition and epidemiological transition. Since the adoption of Universal Health Coverage (UHC), the road taken by each country to achieve UHC is diverse and unique to its culture, needs of people and health systems in the respective country. However, all these approaches have a commonality of promoting and providing health insurance as an important mechanism to achieve UHC. Providing health insurance to ensure health coverage for all the citizens has been well tested and proved to be a viable option. But, addressing other needs and requirements of health systems such as expansion of health infrastructure, reinforcement of the health care workforce and reorganization of the existing health systems in line with newer policies is also extremely important.
A clinical study of new cases of Hansen’s disease at a tertiary health care centre in post elimination era
Authors: Thimmappa Raghu Mudigere , Deshpande Shreya S. , Maheshwarappa Yogendra , Ramesh Rakesh Yelahanka
Published: April 2021

Background: Leprosy, in 2016, globally a total of 214,783 new cases were reported over half of them were from India (135,485) alone. However, 16 other countries with pockets of high endemicity were reported. On the other hand, actual numbers of people affected by the disease is likely to be far higher than statistics show as there still prevails lack of awareness about the disease, lack of skills of general health staff in leprosy diagnosis, inadequate active case findings, lack of inclusion of cases from private sector and presence of high stigma in the community. Aims and objectives were to study the number of increasing new cases of Hansen’s disease in post elimination era.

Methods: A prospective observational study of number of new cases of leprosy presented at a department of DVL, BMCH, Chitradurga, Karnataka, from 2017 April-2018 September. A total of 91 cases were detected.

Results: Series of 91 cases were detected, and based on WHO classification were classified as multibacillary (MB)-72 cases and paucibacillary (PB)-19 cases. The maximum number of cases were detected between 20-29 years of age. The male to female ratio was 1.2:1. 46 (50.54%) cases were diagnosed to have borderline tuberculoid (BT). Patients mainly belonged to low socioeconomic status (89.1%). Deformities were seen in 21 (23.07%)) cases. 7 patients presented with type-I reaction and 13 patients with type-II reactions.

Conclusions: Even with MB-MDT and monitoring, some high endemic pockets of leprosy may continue to persists in India. Every year new cases are increasing and causing morbidity from neglected cases. We should not be complacent at this stage because it may become a serious health problem again.
Lobular capillary haemangioma arising from a vascular malformation
Authors: Udhayini K. V. , Srinivasan Shreya , Danny Celestin Geo , Manoharan D.
Published: April 2021

Lobular capillary haemangioma also known as granuloma pyogenicum or pyogenic granuloma, refers to a common, acquired, benign, vascular tumor that arises in tissues such as the skin and mucous membranes. The occasional eruption of a lobular capillary haemangioma from vascular lesions like haemangiomas or existing port-wine stains suggests abnormalities in blood flow.
Linear lupus panniculitis of scalp: a case report from north-east India
Authors: Thokchom Nandakishore , Salam Erika , Bhattacharjee Nandita , Kongbam Linda
Published: April 2021

Lupus panniculitis of scalp is an uncommon manifestation of lupus erythematosus, which presents as non-scarring linear, arched, or annular alopecia along the lines of Blaschko. A 7 year old child presented with localised linear non-scarring alopecia on scalp. Examination revealed a single linear alopecic patch on the left parietal scalp. There were no associated systemic complaints. Skin biopsy showed atrophic lining epithelium, diffuse and nodular lymphocytic and plasma cells infiltrates in the superficial and deep dermis, lobular inflammatory infiltration of lymphocytes, histiocytes and plasma cells, with minimal involvement of septa in the subcutaneous tissue. Antinuclear Antibody (ANA) and anti-ds DNA tests were negative. Patient responded well with regrowth of terminal hair within 3 weeks to a combination treatment of hydroxychloroquine, topical and intralesional steroids, and topical calcineurin inhibitor. Linear lupus panniculitis of scalp should be considered in cases of patterned, non-scarring alopecia. Regular follow-up is also essential due to the possibility of recurrence and development of systemic lupus erythematosus.
Asignación de responsabilidades, herramientas y procesos de monitoreo óptimos para un adecuado desempeño y transparencia en asociaciones público-privadas
Authors: García Canales Fernando , Guijarro de Vicente Félix , Llorente Galán Fernando , Calandria García Luis
Published: April 2021

Con el apoyo de Gobiernos e instituciones de investigación de América Latina y el Caribe, desde el BID desarrollamos en 2020 la Red de Análisis y Buenas Prácticas en Asociaciones Público-Privadas (Red APP), con el objetivo de mejorar el desarrollo de infraestructura en la región en términos de calidad, sostenibilidad, competitividad, y eficiencia. La Red APP nace con el objetivo de A) conectar las demandas públicas de conocimiento con la investigación aplicada desarrollada (en otras palabras, que los trabajos analíticos en materia de APPs respondan a lo que los desarrolladores de políticas y proyectos quieren saber sobre qué funciona y qué no); B) sistematizar la información: mediante la generación de información sistematizada para el análisis de proyectos, desde las decisiones de inversión hasta las de financiamiento; C) generar y coordinar la evidencia existente: mediante el desarrollo de trabajos analíticos a partir de información pública disponible generada por la red, así como conectar la investigación aplicada regional para potenciar sinergias en la generación de conocimiento. A comienzos de 2020, y partir de una Consulta Pública a Gobiernos de la región, se determinaron una serie de temas de interés comunes en el desarrollo de infraestructura mediante APP en torno a cinco grandes áreas: Regulación e Institucionalidad, Factibilidad y Estructuración de Proyectos Sostenibles, Financiamiento de Proyectos, Gestión de Riesgos y Monitoreo, y Evaluación, Desempeño e Impacto. El presente trabajo “Asignación de responsabilidades, herramientas y procesos de monitoreo óptimos para un adecuado desempeño y transparencia en Asociaciones Público-Privadas” responde a dicha demanda y ha sido seleccionado dentro del área de monitoreo, a través de una convocatoria competitiva de propuestas.
Optimal Location of Sectionners and Distributed Generation Resources to Improve Reliability in Distribution Networks
Authors: Lorenzini Giulio , Kamarposhti Mehrdad Ahmadi , Solyman Ahmed Amin Ahmed
Published: April 2021

In traditional distribution networks, due to the radial structure and subscriber power supply, in the event of errors in the main feeders, downstream subscribers experienced a long blackout, which reduced the reliability level of the network. With the expansion of the use of scattered generations, storage resources and the use of load response methods, load retrieval is provided in the downstream area. In this paper, a method is proposed for locating sectionners and distributed generations in distribution networks with the aim of creating flexible micro-grids. By creating an island, disassembling and restoring loads of more importance in the distribution network, on the one hand, it reduces the amount of fines paid by the distribution company to Subscribers and economic interests of the distribution company, and, on the other hand, by improving reliability, provides customer satisfaction.
Modelling Trip Distribution Using the Gravity Model and Fratar's Method
Authors: Naser Ishraq Hameed , Mahdi Mohammed Bally , Meqtoof Fatin Hadi , Etih Hiba Akrm
Published: April 2021

Trip Distribution is a difficult and significant model in the urban transportation planning process. This paper creates and assesses a satisfactory model of the trip distribution stage for the Nasiriyah city by using two models, Gravity and Fratar methods. A large sample was used for developing the model. The research methodology depends on discussing the theoretical fundamentals of the various methods for estimating the trips distribution and examining the suitability of these fundamentals for the conditions of the selected study area. Two different models had been used, namely; Frater and Gravity model. These models were calibrated using real data. The study tests the accuracy of the models, including overall statistical assessments of the predicted movements. Finally, the study recommended to use Fratar Method. These results had been confirmed to the literature that, if the area is a homogenous growth, the best model is the growth factor (Fratar's method) and if the area is experiencing rapid changes. The gravity model will produce satisfactory results because it takes into account the competition in different land uses.
Balancing and Simulation of a Double Crank-Rocker Engine Model for Optimum Reduction of Shaking Forces and Shaking Moments
Authors: Albaghdadi Anwr M. , Baharom Masri B. , Sualiman Shaharin A.
Published: April 2021

In this paper, a new configuration of Crank-Rocker (CR) model has been proposed by duplicating its mechanism. The method has been implemented to overcome vibration problem on a single-piston Crank-Rocker engine caused by system unbalance. The new method suggests combining conventional method of adding counterweights to reduce shaking forces and eliminating the inertial moments on system by implementing the new layout. A dynamic study of the new model is presented, then the objective function is derived and implemented to perform the optimization process. Related design variables and system constraints are introduced to determine attached counterweights optimized characteristics. For results validation, the simulation, dynamic analysis, and optimization process were conducted using ADAMS VIEW® software. The output results were presented and discussed to verify the validity of the suggested method. It was noticed that the method was very effective and has managed to reduce the total shaking forces by about 91%, shaking moment by about 66%; and the driving torque by 27%.
Tuberculosis en Argentina: desigualdad social y de género
Authors: Bossio Juan Carlos , Arias Sergio Javier , Fernández Hugo Roberto
Published: April 2021

Este artículo se propone describir la distribución de la tuberculosis en Argentina y analizar la desigualdad social y de género de la distribución en el período 1990-2011. Para ello, se emplearon las cifras oficiales de notificación de casos de tuberculosis del país, se calcularon tasas por 100.000 habitantes por jurisdicción y departamentos, por grupos de edad y por sexo. La desigualdad en la distribución se analizó mediante el índice de Gini y su asociación con las condiciones sociales mediante el índice de concentración y el índice de efecto; la tendencia se estudió mediante regresión exponencial. Los resultados muestran que las tasas de tuberculosis son mayores entre los 20 y 34 años de edad y son superiores en varones. Existe una marcada desigualdad entre jurisdicciones (índice de Gini = 0,273) y es mayor por departamentos (índice de Gini = 0,391), superior en mujeres (0,411) que en varones (0,394). La distribución de la tuberculosis se asoció a peores condiciones sociales (índice de efecto = -0,212), y esta asociación fue mayor en las mujeres (índice de efecto = 11,4; 6,4; 16,4). La tendencia del problema al descenso entre 1990 y 2011 no ha contribuido a reducir las brechas entre jurisdicciones y departamentos ni tampoco a reducir la desigualdad en la distribución de la tuberculosis asociada a las desfavorables condiciones sociales de la población.
Változásfolyamatok a magyarok és ukránok által lakott kárpátaljai Izsnyéte közösségében
Authors: Doszpoly Roland
Published: April 2021

I started my research in Izsnyéte, Transcarpathia, in 2012 with an anthropological research group. Initially, we were curious about the coexistence mechanisms of the local settlement, the cultural peculiarities of the ethnic groups living there, but due to the war situation, we had to stop our empirical research sooner before 2015. In 2017, as a doctoral student, I continued my empirical research in Izsnyéte, where Hungarians represent an absolute majority against the state-forming Ukrainian ethnic group. The basic research concept was to choose a local settlement close to the border where two or three different ethnicities have lived together for decades. In my study, I examine the process of ethnicity production and the processes of image and change of the living ethnicities of the settlement and their applicability to each other in comparison with the data of previous research, reflecting on the changes, mainly in the light of assimilation. Already the results of the 2012 research showed spatial isolation, in many cases dissimilation was experienced among coexisting ethnicities, but with many other factors and aspects several years later, it caused diverse processes.
Comparison of Sequential Organ Failure Assessment (SOFA), Acute Physiology and Chronic Health Evaluation II and IV (APACHE) Scoring System Validity as Mortality Predictors in ICU Patients with Multiple Organ Dysfunction Syndrome in Sepsis
Authors: Swamy Akshay Hiryur Manjunatha , Kumararadhya Girish Bandigowdanahalli , Thammaiah Srinivas Hebbal , Siddagangaiah Nanda Karikere , K.G Shiva Kumar
Published: April 2021

BACKGROUND Multiple organ dysfunction syndrome (MODS) has recently been considered as a defining syndrome of sepsis and is responsible for a high mortality rate among the patients in the intensive care units (ICUs). Prognostication of the ICU patients is an integral part of the management of the critically ill patients and many scoring systems, for that matter, have been devised and compared for their efficiency at predicting mortality. This study was conducted to evaluate and compare the validity of sequential organ failure assessment (SOFA), acute physiology and chronic health evaluation (APACHE II) and APACHE IV as mortality predictors in intensive care unit (ICU) patients suffering from MODS in sepsis. METHODS Hundred patients diagnosed with MODS in sepsis were carefully examined, followed by relevant laboratory investigations. The SOFA score was calculated daily, and the APACHE II and IV scores were calculated on the day of admission. The scores were further compared among the survivors and the non-survivors, followed by receiver operating characteristic (ROC) curve analysis of the SOFA D1, D2, and D3 and the APACHE II and IV scores to estimate their capability of mortality prediction. RESULTS The means of the APACHE II, IV and SOFA D1 were 16.57 ± 6.49, 71.91 ± 16.19 and 8.75 ± 2.20, respectively. There was a statistically significant difference in the mean APACHE II scores (14.23 ± 5.20 vs. 21.12 ± 6.38) and the mean APACHE IV scores (67.27 ± 13.21 vs. 80.91 ± 17.77) in the survivors and the nonsurvivors. A statistically significant difference was also evident in the mean ages of the survivors and the non-survivors (52.82 ± 14.67 years vs. 63.25 ± 16.98 years). The SOFA score was high among the non-survivors than the survivors right from day-1 (10.24 ± 2.08 vs. 7.98 ± 1.86) to day-20 (15.00 ± 0.00 vs. 3.14 ± 0.38). Furthermore, ROC analysis showed that the best discrimination was provided by SOFA D3 followed by the APACHE II and SOFA D1 scores, with APACHE IV score showing the least. CONCLUSIONS SOFA score on day 3 provides the best mortality prediction in patients with MODS in sepsis, as compared to APACHE II and IV scores. KEYWORDS SOFA, APACHE II, APACHE IV, Multiple Organ Dysfunction Syndrome, Sepsis