bluuebunny/crossref_metadata_2025 huggingface dataset:
A comparative study of low dose vaginal misoprostol and dinoprostone gel for induction of labour at term of pregnancy
Authors: Kalpana . , Sharma Priya , Kaushik Amit , Rao Priyanka , Swaroop Neelam , Singh Neetu
Published: December 2016

Background: The aim of this study was to compare the low dose of vaginal misoprostol and dinoprostone gel for the induction of labour at term of pregnancy.Methods: The study was conducted on 90 women, randomized into two groups, each group having 45 women. First group received misoprostol per vaginally and second group received the dinoprostone gel. The duration of induction to delivery interval, mode of delivery and complications related to labour or foetus were recorded.Results: The mean induction to delivery interval in the misoprostol group was 11.68 ± 4.49 hours and in the dioprostone gel group was 14.85 ± 7.08 hours. Applying the modified t-test, this difference is statistically significant (P value 0.004). Thus misoprostol leads to early labour and early delivery as compared to dinoprostone gel.Conclusions: As shown in this study, vaginal misoprostol is highly effective induction agent with no adverse effect on the outcome of labour as compared to dinoprostone gel.
Knowledge and attitude towards emergency contraception in females of urban area of Lucknow, Uttar Pradesh, India
Authors: Mishra Malvika , Tripathi Shiv Shanker , Verma Manish Kumar
Published: December 2016

Background: Emergency contraception are birth control measures that, if taken after unprotected sexual intercourse, contraceptive failure, incorrect use of contraceptives or in cases of sexual assault may prevent pregnancy. The aim of the study was to assess the knowledge and attitude of female living in urban part of Lucknow district from September 2015 to August 2016.Methods: This was a descriptive, cross-sectional study conducted at RML Hospital, Lucknow from September 2015 to August 2016. A cross sectional study design was conducted and Participants were selected using simple random sampling method. Data was collected by using self-administered questionnaires. Data processing and analysis: The collected data was entered into a computer and analyzed using statistical package of social science version 20.0.Results: In this study it was found that, Out of 385 subjects 54% (209) new the correct time interval for EC to be effective and 91% (350) new that this is for prevention of unplanned pregnancy. Out of 385 subjects 77% (345) reported that they had heard the word EC from different sources, however 23% (90) reported that they never heard about that it means that still there is a scope of health awareness activities and health education to improve the knowledge of EC. Different attitudes of females towards emergency contraception some different pair of questions was asked. Out of 385 subjects 85% (329) were reported that they have positive attitudes in terms of benefits of EC to reduce the risk of unplanned pregnancy. A few number of subjects i.e. 12% (48) reported negative attitudes towards EC where as 3 % (8) did not respond. The more than half subjects i.e. 68% (260) reported that they use EC even if their partners disagreed with them where as 11% (41). Cultural belief was found as an barrier in having negative attitudes towards EC. The Religion, Occupation and educational status affect knowledge and attitudes towards EC.Conclusions: The results show that there is a scope of health awareness activities and health education to improve the knowledge and attitude towards EC.
Fibrinogen levels helps in early detection of abnormal pregnancies
Authors: A. Kanchana , DSS Girijavani
Published: December 2016

Background: Haemostatic failure as an end result of various complications of pregnancy is an important cause of maternal mortality in India. The main aim of this study is to detect the levels of fibrinogen in abnormal pregnancy i.e. Pregnancy induce hypertension (PIH), Intra uterine fetal death (IUFD), Missed abortion, Abruptio placenta.Methods: Study was conducted on 150 in patients joined in Obstetrics ward private hospital, Andhra Pradesh, 50 are control subjects and 100 are study patients, Out of hundred (100) cases, 40 are PIH, 25 are IUFD, 25 are Missed abortion, and 10 are Abruptio placentae. Estimated for fibrinogen, D-Dimer, total proteins, Albumin.Results: The fibrinogen levels in present study decreased significantly. PIH (Control mean 442.0, S.D ±43.38, Test mean 296.0, S.D ±48.03, p<0.001). IUFD (Control mean 442.0, S.D±43.38, Test mean 262.4, S.D±20.06, p<0.001). Missed abortion (Control mean 442.0, S.D ±43.38, Test mean 250.80, S.D±26.13, p<0.001). Abruptio placentae (Control mean 442.0, S.D±43.38, Test mean 210.5, S.D±87.38, P<0.001). D-dimer levels are estimated semi quantitatively and the levels were found to be increased. Total proteins and albumin are decreased in all the cases, but significantly in PIH (T.P-Control mean6.25, S.D±0.65, Test mean 5.25, S.D±1.57, p<0.001, Albumin- Control mean 2.79, S.D±0.34, Test mean 2.23, S.D±0.59, p<0.001).Conclusions: The estimation of plasma fibrinogen is helpful not only in the early diagnosis of haemostatic failure but also to guide replacement therapy during the fibrinopenic state.
Internal jugular vein thrombosis presenting as paraneoplastic syndrome in benign cystic teratoma of ovary: a case report
Authors: Ramalingam Vidhya , Srinivasan Lakshminarasimhan , Kanchana Madurai Padmanabhan
Published: December 2016

Internal jugular vein thrombosis is a rare vascular disease that can be overlooked or misdiagnosed and is generally seen in persons with intravenous drug abuse or in patients with prolonged central venous catheterization due to iatrogenic trauma. The most common germ cell tumour of the ovary is benign (mature) cystic teratoma, occurring in adolescents and young women. We are presenting a case of a 50-year-old premenopausal woman, diagnosed to have right internal jugular vein thrombosis extending into the right subclavian and axillary vein. Her laboratory investigations revealed no predisposing cause of thrombosis. Four months later she was evaluated for menorrhagia and imaging studies showed multiple uterine fibroids with left ovarian mass (ovarian teratoma) with moderate ascites and her tumour markers levels of CA125 was elevated. She underwent staging laparotomy, total abdominal hysterectomy with bilateral salpingo-oophorectomy and pelvic lymph node dissection with infracolic omentectomy. Pathologically, ovarian cyst showed mature thyroid tissue with islands of bone, muscle tissue and fatty tissue consistent with benign cystic teratoma. Postoperatively her tumour marker CA125 level returned to normal levels and there was no reaccumulation of fluid. As there were no predisposing factors for internal jugular vein thrombosis, it was concluded to be a paraneoplastic syndrome preceding the diagnosis of benign cystic teratoma. To the best of our knowledge this is the first case report in the literature with an association between internal jugular vein thrombosis and benign cystic teratoma with raised serum tumour marker CA 125.
Ovarian leiomyoma with torsion: a case report
Authors: Bhageerathy Pallipuram Seshadrinathan , Sebastian Ajit , Thomas Dhanya Susan , Gupta Mayank , Peedicayil Abraham
Published: December 2016

We report an uncommon case of primary ovarian leiomyoma with torsion. Leiomyoma of the ovary is an extremely rare benign solid neoplasm of uncertain etiology. Our patient presented with abdominal pain and imaging showed right adnexal solid mass. All tumour markers except LDH were normal. The patient underwent laparotomy proceed right salpingo-ophorectomy. Intraoperatively, it was found to be twisted right ovarian solid tumour and histopathological examination revealed leiomyoma of ovary.
Successful management of a young patient with yolk sac tumour
Authors: Satia Meena N. , More Vibha , Shilotri Manali P.
Published: December 2016

Yolk sac tumours, synonymous with endodermal sinus tumours, are rare, malignant germ cell neoplasms occurring usually in gonads. Yolk sac tumours are more commonly seen in patients of early age group, the median age being 18 years. We report a case of a yolk sac tumour of the ovary in a 21 year old female, managed by surgery and chemotherapy.
A rare case of cervical tuberculosis mimicking carcinoma cervix
Authors: Singh Sanjay , Seth Atul , Basu Ipsita
Published: December 2016

Cervical tuberculosis is a rare entity with only limited number of case reports in the literature. A 53 year old, P1, post-menopausal housewife presented with history of one episode of post-menopausal bleeding and whitish discharge per vaginum. Speculum examination revealed an ulceroproliferative cervical growth. Clinically she was diagnosed to have carcinoma cervix. However, cervical biopsy confirmed the diagnosis of cervical tuberculosis. She was treated with anti-tubercular drugs for six months and has been disease free for the last two years. This case emphasizes the fact that though cervical tuberculosis is rare, it should be considered in the differential diagnosis of carcinoma cervix.
Effects of aloe vera gel application on epidermal wound healing in the domestic rabbit
Authors: Kayode Olaifa Abayomi
Published: December 2016

Background: A wound is a breakdown in the protective function of the skin or loss of continuity of epithelium, with or without loss of underlying connective tissues, muscles, nerves, bones following injury to the skin, surgery, a blow, cut, chemicals, heat, cold, friction, shear force, pressure or diseases such as leg ulcers or carcinomas. A study was undertaken to determine the healing properties of Aloe vera gel on epidermal wounds in rabbits.Methods: Twelve adult rabbits were divided into two groups randomly of six each representing the treatment and control respectively. A pair of wounds measuring 2cm x 2cm each was created on the back of each rabbit lateral to the spinal cord. The wounds were treated with homogenized Aloe vera gel while the wounds on control group were treated with normal saline. Wound contraction was measured on days 5, 9 and 12 representing the inflammatory, proliferative and maturation phases of wound healing respectively. Blood samples were collected on days 0, 3, 6, 9 and 12 for analysis.Results: Animals treated with Aloe vera gel had significantly (p<0.05) faster rates of healing with shorter days of scab fall off than the control and showed significant (P<0.05) changes in the packed cell volume, mean corpuscular volume, lymphocyte and neutrophil counts.Conclusions: The study concluded that Aloe vera was effective in treating epidermal wounds in rabbits over the control. An improvement occured in haematological profile of the experimental animals and these findings will go a long way in expanding the horizon of clinical application of this plant in solving wound healing problems in both humans and other animal species.
Evaluation of the pulse wave velocity in African rheumatoid arthritis subjects
Authors: Touré Maïmouna , Ouédraogo Valentin , Dièdhiou Demba , Niasse Moustapha , Thiam Souleymane , Diouf Coumba , Sow Abdou Khadir , Diaw Mor , Tiendrébéogo Arnaud Jean Florent , Seck Aïssatou , Houndjo Salimata Diagne , Ba Abdoulaye , Hallab Magid , Lefthériotis Georges , Samb Abdoulaye
Published: December 2016

Background: Rheumatoid arthritis is a systemic disease with often fatal vascular events. In addition to traditional cardiovascular risk factors, disease-specific elements contribute to this cardiovascular mortality. The aim of this study was to assess arterial stiffness in rheumatoid arthritis and to determine the factors involved.Methods: We have recruited the black African patients followed in rheumatology and had rheumatoid arthritis diagnosis. Only patients between 18 and 60 years and meeting the American College of Rheumatology criteria were included. All controls were healthy. We evaluated the propagation velocity of the pulse wave finger-toe (PWVft) measured by the pOpmètre®.Results: Present study shows that the PWVft was significantly elevated in over half of patients (55.10%). Besides, the mean patients PWVft was significantly higher than that of the control (respectively 9.40±0.51 and 7.22±0.33 p=0.001). In the patients, no factor was significantly involved in the arterial stiffness, but cons in the control group, the PWVft was significantly correlated with age (p=0.023 and r=0.55).Conclusions: Rheumatoid arthritis patients had higher PWVft compared to controls. Due to the importance of its cardiovascular morbidity and mortality, arthritis requires a regular monitoring element as arterial stiffness, which is currently a major vascular parameter monitoring.
Utility of urinary calcium/creatinine ratio in evaluation of urinary stone formers: a Sudanese case control study
Authors: Abdallah Awad Elkarim Hassan , Abusharib Abuobieda Bala , Elbashir Abdulhadi Mohamed , Nourien Ihab Hamed
Published: December 2016

Background: Hypercalciuria is a common cause of urinary stone formation in both children and adults; one of the components of the comprehensive evaluation of stone formers is to measure 24 hours urinary calcium, which is a complicated method especially in children, therefore some physicians depend on calcium creatinine ratio instead of it. The objective of this study was to assess the utility of calcium/creatinine ratio as an evaluation tool for hypercalciuria in urinary stone formers.Methods: This was a case control study in which forty patients of urinary stone formers along with fifteen healthy controls group were enrolled; after fulfilling specific inclusion and exclusion criteria a questionnaire was filled, then an early morning urinary samples were collected for calcium and creatinine measurement to calculate the calcium creatinine ratio.Results: The results showed significantly higher mean value of calcium/creatinine ratio in the stone formers group compared with controls one. Also there were statistically insignificant differences in the urinary calcium between the two groups. Moreover this study showed higher mean values of both calcium and calcium/creatinine ratio in recurrent stone formers when compared with first time stone former.Conclusions: This study concluded that calcium/creatinine ratio is a useful and easier method for the initial evaluation of stone formers.
Effectivity of the PGA rapid Atramat® and PGA Atramat® sutures for the closure of minimal invasion and abdominal-inguinal wounds in surgery
Authors: Granados-Romero Juan José , Barrera-Mera Baltazar , Ceballos-Villalva Jesús Carlos , Estrada-Mata Aranza Guadalupe , Espejel-Deloiza Mariana , Sordo María Isabel Mayen , Valderrama-Treviño Alan Isaac
Published: December 2016

Background: The use of suture materials for the closure of wounds is a practice described in Egyptian parchments since 3500 b.C. through the use of linen, animal hair, vegetable fiber, silk, leather and others. The election of the ideal suture material has to be based in the appropriate resistance to traction, tissue biocompatibility and resorption rates..Methods: An open longitudinal clinical trial was performed with data recollection in a prospective way, in which was calculated the incidence of complications; dehiscence, wound seroma, surgical site infection hemorrhage and abscess when PGA Atramat® and PGA rapid Atramat® was employed in laparoscopic and open surgery for treatment of inguinal and umbilical plasties.Results: During the period from January 2016 to August 2016, the procedures included: 31 laparoscopic cholecystectomies, 18 laparoscopic fundoplications, 45 laparoscopic appendicectomies, 12 abdominal plasties and 16 inguinal plasties. This series shows the null incidence of complications in 31 cholecystectomies, 18 fundoplications, 16 inguinal plasties and 12 abdominal plasties.Conclusions: The employment of the PGA Atramat® and PGA rapid Atramat® sutures maintains the features of a braided, absorbable suture, and it also results a feasible and secure resource for its use in minimal invasion surgery, abdominal and inguinal plasties, showing low incidence of surgical site infection.
Diagnostic value of computed tomography in the patients of abdominal tuberculosis
Authors: Salooja B. S. , Mukhi Sadhan
Published: December 2016

Background: Abdominal tuberculosis (ATB) is a rare form of extra-pulmonary tuberculosis which is clinically challenging. It remains difficult to diagnose due to the non-specific presentation, variable anatomical location and lack of sensitive diagnostic tools. To evaluate the diagnostic value of computed tomography (CT) in the patients of abdominal tuberculosis.Methods: This was a retrospective diagnostic study design. The study was conducted among adults aged>18 years of either gender with clinical suspected ATB. The detailed demographic and clinical history was noted on pre-designed proforma. After obtaining the history, the patient was subjected to general physical and systematic examinations. The patients were then subjected to radiological evaluation that included chest X-ray, X-ray of abdomen and CT.Results: A total of 55 clinically suspected adult cases of abdominal tuberculosis were enrolled in the study. 45 (81.8%) were found to be abdominal tuberculosis on final diagnosis. The abdominal tuberculosis was found to be higher in the age groups 21-40 years (64.4%).The abdominal tuberculosis was observed to be higher among female patients (62.2%) than males (37.8%). CT findings showed that the bowel wall thickening & narrowing and dilatation was found in 64.4% patients.Conclusions: ATB is still a diagnosis to consider in individuals presenting with abdominal symptoms in the developing world, particularly in patients from ethnic minorities. Diagnosis can be challenging and requires a multidisciplinary approach with involvement from Radiology, Microbiology, Gastroenterology, Surgery, Infectious Diseases and Respiratory teams.
A cross-sectional study of impaired glucose tolerance amongst undergraduate medical students
Authors: Singh Kavisha , Malgaonkar Aniruddha A. , Samel Dinesh R.
Published: December 2016

Background: Diabetes is an important chronic disease both in terms of prevalence and associated morbidity and early mortality. Mortality rates in diabetics are two- to threefold higher than those without diabetes. Type 2 Diabetes Mellitus is preceded by a period of abnormal glucose homeostasis and hence early diagnosis is important in decreasing this morbidity and mortality. The oral glucose tolerance test (OGTT) is currently the gold standard for the diagnosis of diabetes.Methods: This cross sectional single observer study was conducted amongst all the undergraduate students and interns of a municipal medical college to assess the point prevalence of impaired glucose tolerance and the factors predisposing to the same. After necessary permissions, participants giving written informed consent were interviewed and participants were subjected to an oral glucose tolerance test (OGTT) and their heights, weights were measured.Results: None of the participants had an increased fasting blood glucose but 30 min, 60 min and 90 min post OGTT blood glucose levels were increased in 9 (11.84%) participants and 120 min post OGTT blood glucose was increased in 15 (19.73%) participants. Increase in Body Mass Index (BMI) shows a positive correlation with fasting (r=0.155) and 120 min post OGTT blood glucose (r=0.042). Increase in weekly junk food servings shows a positive correlation with fasting (r=0.014), 90 min (r=0.004) and 120 min post OGTT blood glucose (r=0.009).Conclusions: Impaired glucose tolerance was present in a substantial number of non-diabetic students and had a correlation with BMI, exercise and junk food intake.
A profile of heart failure patients in a tertiary care centre in Eastern India
Authors: Majumder Biswajit , Bahuguna Yatindra Mohan , Chatterjee Sharmistha
Published: December 2016

Background: Epidemiological data regarding profile of heart failure in India is lacking. So this study was done to assess the epidemiological profile of heart failure patients in eastern India. Aim of the study was to assess the epidemiological profile of heart failure patients in this part of country.Methods: Total 1000 outdoor and indoor patients presented with symptoms and signs of heart failure according to Framingham criteria were studied.Results: Age of onset of HF is lower than western country. IHD is the commonest cause of HF. Diabetes and hypertensions are important risk factors.Conclusions: Earlier detection and treatment of hypertension and diabetes mellitus might have greater impact in reducing the burden of HF in this part of country.
A retrospective evaluation of acne patients treated with isotretinoin
Authors: Aksu Fusun Eser
Published: December 2016

Background: Although systemic isotretinoin offers more effective alternatives for treatment, as the drug has several side-effects, physicians are hesitatant to recommend the drug. The aim of this research was to retrospectively evaluate the effectiveness, side-effects and validity of systemic isotretinoin treatment on patients with acne, to thereby present experimental data relevant to future usage by patients suffering from acne.Methods: Patients diagnosed with acne in the Dermatology Polyclinic of the Medical Faculty of KSU between January 2004 and September 2008 was identified from the polyclinic records. Patient data were retrieved from the archives and recorded in the pre-prepared format. A retrospective evaluation was made of the safety and effectiveness of isotretinoin treatment, and the clinical and laboratory test side-effects.Results: A total of 241 patients were prescribed systemic isotretinoin treatment and started treatment. Of these, 129 of these patients attended regular follow-up examinations and completed the treatment. Systemic isotretinoin was determined to be effective on acne during a treatment period of 23.47±4.5 weeks with a total average dose of 113.73±22.4 mg. There were no serious laboratory test or clinical effects of an intolerable level tolerated which would lead to termination of the treatment.Conclusions: Systemic isotretinoin treatment is effective and safe for acne vulgaris patients with nodulocystic and papulopustular types of lesion. However, it is essential that the laboratory parameters of hepatic function tests and the lipid profile are checked regularly.
Prevalence of psychiatric co-morbidity in patients presenting with chronic daily headache: a hospital based cross sectional study
Authors: R. C. Bhuvana
Published: December 2016

Background: Headache is a common neurological disorder and most disabling conditions in the worldwide. Psychiatric disorders can occur with at least two to three-fold greater frequencies among the patients presenting with headache than among general population. The presence of psychiatric co-morbidity further complicates headache management and portends a poorer prognosis. Therefore, the present study of prevalence of psychiatric co-morbidity in patients presenting with headache and to know the nature and extent of psychiatric co-morbidity associated with headache among the patients was undertaken.Methods: Present sample consists of 100 patients who presented with the complaints of headache to the department of Psychiatry and Medicine from November 2012 to June 2014 was included in the study. MINI 5.0.0 was applied to elicit the presence of any Axis I and Axis II disorders respectively.Results: In this study 74% of the patients presenting with headache had co-morbid psychiatric disorders. Out of 74% of the psychiatric illnesses; 28% had affective spectrum disorders, 16% had anxiety disorders 16% had psychotic disorders, 12% had other neurotic stress related disorders, and 2% had personality disorder among the patients presenting with headache.Conclusions: Patients presenting with headache have high levels of co-morbid psychiatric disorders and the presence of headache in these patients was associated with increased severity of the co-morbid psychiatric conditions. In view of the present findings, the management of patients presenting with headache should include the detail assessment of coexisting psychopathology and treatment of both coexisting conditions.
A clinical study of arrhythmias associated with acute myocardial infarction and thrombolysis
Authors: Mhatre Mayuri A. , Sirur Freston M. , Rajpal Deepali R. , Shah Manhar R.
Published: December 2016

Background: Arrhythmias are a common occurrence in ACS. This study was undertaken to analyze the incidence, frequency and type of arrhythmias in relation to the site of infarction to aid in timely intervention to modify the outcome in MI and to study the significance of Reperfusion arrhythmias.Methods: 100 patients were evaluated. ECG and cardiac enzymes were studied. Arrhythmias complicating AMI in terms of their incidence, timing, severity, type, relation, reperfusion and results were studied.Results: Of the 100 cases, 74% were males and 26% females of which incidence being common between 4th to 7th decades of life. AMI was common in patients with Diabetes and Hypertension (23% each). Incidence of AWMI (58%) is higher than IWMI (40%). Out of all arrhythmias, Ventricular Tachycardia was seen in 24% cases with 50% mortality and preponderance to Antero Lateral Myocardial Infarction. Sinus Tachycardia was seen in 23% of cases with preponderance to Antero Lateral Myocardial Infarction and persistence of Sinus Tachycardia was a prognostic sign, mortality being 22%. Complete Heart Block and Sinus Bradycardia were seen with IWMI, incidence being 53.8% and 100% respectively. Bundle Branch Block was common in AWMI (31%) than IWMI (10%). Among 64 thrombo-lysed cases, 21 had Reperfusion Arrhythmias without any mortality, whereas remaining 43 without Reperfusion Arrhythmias had mortality of 18.6%.Conclusions: According to the study, Tachy-arrhythmias are common with Anterior Wall Myocardial Infarction and Brady-arrhythmias in Inferior Wall Myocardial Infarction. Reperfusion Arrhythmias are a benign phenomenon and good indicator of successful reperfusion.
Maternal vegetarian diet in pregnancy, a predisposition to hypospadias?
Authors: Ghosh Soumyodhriti , Shukla Ramendra , Mujalde Vikram Singh , Chaturvedi Vinita , Barolia Dinesh Kumar
Published: December 2016

Background: Hypospadias constitutes one of the commonest surgically treated patient subset in a pediatric surgery set up. The causative factors have always been multifactorial. Maternal age and diet during pregnancy have been attempted to be correlated with the prevalence of hypospadias.Methods: The current study aims to find a correlation between the rises of hypospadias with increased maternal vegetarian diet taken during pregnancy. The mothers of patients presenting with hypospadias were allotted structured self-completed questionnaires. Obstetric history, dietary patterns and lifestyle information during pregnancy was obtained.Results: The mothers of patients presenting with hypospadias who had been on a vegetarian diet had an increased incidence of babies presenting with hypospadias as shown in the chart.Conclusions: Diet during gestation may play a role in the etiology of hypospadias. Although this study is limited by less number of cases, it does show the trend of increased incidence of hypospadias amongst vegetarian mothers.
A case of human parvo virus B 19 infection with erythroid hypoplasia and Idiopathic thrombocytopenic purpura in an immunocompetent child: a case report
Authors: Patti Ganesh , Y. S. Raju , D. Swaroopa Reddy
Published: December 2016

Human parvo virus B19 (B19V) is a small (5.5kb) single stranded DNA (deoxy ribo nucleic acid) virus with known tropism and cytotoxicity for erythroid progenitors. Human parvovirus B19 infection is associated with various hematological disorders like aplastic crisis, erythroid hypoplasia and idiopathic thrombocytopenic purpura. Here we are presenting a rare case of parvo virus B19 infection with erythroid hypoplasia and idiopathic thrombocytopenic purpura occurring simultaneously in a 13year old girl who presented with fever and bleeding manifestations. A 13 year old girl presented with fever of 5 days duration, epistaxis and bleeding gums spontaneously of one day duration. On admission she had pancytopenia. Her B12 and folate levels were within normal range. Bone marrow aspiration suggestive of normal cellularity with paucity of erythroid precursors, myeloid: erythroid ratio 9:1 and gaint basophilic pronormoblasts with intra-nuclear inclusions, with no further maturation, as well as increased megakaryocytes with few hypolobate forms suggestive of erythroid hypoplasia and idiopathic thrombocytopenic purpura. Parvo virus B19 DNA PCR by nested polymerase chain reaction was detected in serum. She was treated with blood component support and with steroids for idiopathic thrombocytopenic purpura. She recovered and her cell counts are improved. This case highlights the morphology of Human parvo virus B19 inclusions and its association with simultaneous presentation of erythroid hypoplasia and idiopathic thrombocytopenic purpura in immunocompetent child, which is very rare.
Clinical and laboratory profile of children with tubercular meningitis admitted in tertiary care centre of Kumaun region, Uttarakhand, India
Authors: Goyal Garima , Arya Ajay Kumar
Published: December 2016

Background: Tuberculous meningitis (TBM) is an important cause of hospital admission, death and neurological disability in India. Delay in diagnosis is an important cause of morbidity and mortality.Methods: 80 cases with meningitis 1 month-16 year were enrolled, 44 diagnosed as TBM, studied in detail about clinical and laboratory profile. The data was analyzed by statistical test SPSS 21 and Chi square test was applied.Results: Peak age incidence 11-16 year. Youngest patient 3 month. Male: female ratio 0.8:1. Majority of patients had fever, altered sensorium, vomiting, headache, seizures. Neurological deficit found was loss of speech, right sided weakness, and diplopia. 36.3% patients were comatose. Cranial nerve palsy was present in 57% cases, 6th nerve being the commonest. Papilloedema common than optic atrophy. Motor deficit like hemiplegia (4.5%). Maximum cases were in stage III BMRC. CSF findings were reduced glucose level in 47.7% of cases (mean 54.5 mg/dl), elevated protein (mean 116.9 mg/dl), lymphocytic pleocytosis (mean value 102.46) (>60% lymphocytes). CT scan abnormality in 75% cases. Hydrocephalus being the most common finding.Conclusions: TBM one of most serious illness. Majority patients presented in stage 3 with neurological deficit, as this are tertiary care centre and due to difficult geographic terrain patient presents at late stage. High index of suspicion to diagnose TBM at early stage. CSF analysis continues to be a key in establishing the diagnosis. One should not wait for the microbiological proof to start the therapy. Mantoux and radiological tests can be good supportive investigation. Early diagnosis and treatment can make complete recovery even in comatose patients.
Predictors of meningitis in children presenting with first episode of febrile seizure
Authors: D. Suresh Reddy , S. Habib Khan , Hegde Pavan
Published: December 2016

Background: Febrile seizure is the most common cause of seizures in infants and toddlers presenting to the paediatric emergency department. Two to five percent of children experience at least one or more episodes of febrile seizures. Simple febrile seizures are benign and self-limiting. They have good prognosis and carry very low risk for epilepsy. Probability of acute bacterial meningitis presenting as fever with seizures varies from 0.6% to 6.7%. The American Academy of Paediatrics (AAP) strongly recommends lumbar puncture (for CSF analysis) in the work up of every child under 18 months of age with a first episode of febrile seizure to rule out acute bacterial meningitis. The objective of this study was to determine the occurrence of meningitis in children who presented with first episode of seizure and fever and also the predictors of meningitis among them.Methods: The records of children admitted to Father Muller Medical College and Hospital between 1st January 2014 to 31st December 2015 were reviewed. All children between 6 months to 6 years of age having first episode of convulsions, associated with fever were included in the study and subjected to retrospective analysis of data collected from the case sheets. Results: Our study included 105 children with febrile seizures, 49 children had simple febrile seizures (SFS) and 56 children presented as atypical febrile seizures (AFS). Lumbar puncture was performed in 43 children (15 with SFS and 28 with AFS). The CSF analysis was normal in all the children who presented as simple febrile seizures. There was 25.87% prevalence of meningitis in children with atypical febrile seizures who underwent lumbar puncture. The CSF yield suggestive of bacterial meningitis was as high as 50% in children below 1 year in whom lumbar puncture was done.Conclusions: Children presenting with Atypical/Complex febrile seizures who were treated with antibiotics have more likelihood of having meningitis rather than those presenting with simple febrile seizures.
To study the correlation of high sensitivity C reactive protein levels with asthma control in children
Authors: Ramakrishnan Nithiyanantham , Sivathanu Shobhana , Sampath Sowmya , JH Suresh David , Mohan Thuthi
Published: December 2016

Background: Childhood asthma appears to be increasing in prevalence despite advancements in the care of asthma. In asthma, local as well as systemic inflammation contributes to the pathogenesis. Thus successful management depends on controlling this inflammation by appropriate doses of inhaled corticosteroids. High sensitivity C reactive protein (hsCRP) is an easily measurable marker of inflammation and its level can be used as a diagnostic tool in assessing control of asthma. The objective of this study was study the correlation of serum hsCRP levels with asthma control in childrenMethods: It is an observational study conducted in the Pediatric asthma clinic of a Government Medical College in south India. The study population consisted of 75 asthmatic children aged 5-15 years. Children with persistent asthma were classified into three groups based on GINA guidelines. Serum hsCRP levels were measured in all the three groups.Results: Among the 75 children 33% belonged to controlled group, 35% to uncontrolled group and 33% to partly controlled group. There was a significant difference in hsCRP levels between controlled and uncontrolled groups. The mean value of hsCRP in controlled group was 0.93±1.3 mg/L whereas in the uncontrolled group it was 2.73±2.46 mg/L. Higher levels of hsCRP were found in the uncontrolled asthma group.Conclusions: There is an inverse correlation between hsCRP levels and asthma control in children. High hsCRP levels have a potential to be used as a surrogate marker for poor control of asthma and can thus be used as a guide for adjustment of dosage of inhaled corticosteroids.
Study of risk factors of neonatal thrombocytopenia
Authors: Tirupathi Keerthi , Swarnkar Keerti , Vagha Jayant
Published: December 2016

Background: Neonatal thrombocytopenia (platelet count < 1.5 lac/µl) is the commonest haematological abnormality encountered in neonatal intensive care unit (NICU). Thrombocytopenia if not detected can result in devastating complications. Determining the risk factors of thrombocytopenia enables us to prevent the inevitable and irreversible complications. The present study highlights the pattern, severity and risk factors of neonatal thrombocytopenia in our hospital.Methods: Prospective observational study was conducted on 200 neonates with thrombocytopenia admitted in NICU of our hospital. Maternal and neonatal risk factors were recorded. Neonates were grouped based on the severity of thrombocytopenia. The risk factors were compared with severity of thrombocytopenia.Results: 200 neonates with thrombocytopenia were divided into three groups based on severity of thrombocytopenia. 81% of babies had moderate to severe thrombocytopenia. The most common maternal predisposing factors were pregnancy induced hypertension (PIH), premature rupture of membranes (PROM) and anemia.62.5% babies were low birth weight babies and they had severe thrombocytopenia. 56% babies had late onset neonatal thrombocytopenia and 44% had early onset thrombocytopenia. The most common neonatal risk factors were sepsis in 48.5% babies and birth asphyxia in 20% babies.Conclusions: The severity of neonatal thrombocytopenia in our NICU was moderate to severe type. PIH, PROM and anemia were the commonest maternal risk factors. Preterm and low birth weight babies had severe thrombocytopenia. Sepsis and birth asphyxia were the commonest neonatal risk factors. Birth asphyxia was associated with early onset neonatal thrombocytopenia and sepsis was associated with late onset thrombocytopenia. Severe thrombocytopenia can be used as a prognostic indicator in sick neonates.
Clear cell sarcoma of kidney: an uncommon paediatric neoplasm-two case reports and review of literature
Authors: Gurusamy Veeraraghavan , Karnan Indumathi , Sadagopan Pappathi
Published: December 2016

Clear cell sarcoma of kidney is an uncommon neoplasm accounting for approximately 5% of all pediatric renal neoplasms, with a peak incidence between 1-3 years of age. Males are most commonly affected (M:F ratio – 2:1). It is a highly malignant neoplasm with a high propensity than other renal neoplasms to metastasize to bones, hence originally called as bone-metastasizing renal tumour of childhood by Marsden and Lawler. We describe here 2 case reports of clear cell sarcoma of kidney.
Pentalogy of cantrell with single umbilical artery: a rare fetal anomaly
Authors: Meena Raj Kumar , Meena Veena
Published: December 2016

Pentalogy of cantrell (PC) is a rare syndrome having both specific ventral and dorsal midline defect, and rarely found to be associated with other anomalies. Most cases occur randomly for no apparent reason (sporadically). We report a 20 years old primigravida referred at 17 weeks 4 days of gestational age, for a fetal anomaly scan having an anterior abdominal wall defect in fetus. Ultrasound done, showed single live fetus gestational age of 18 weeks, with fetal heart, great vessels, stomach, and intestinal loops were found to be lying outside thoracic cavity. Fetal autopsy following termination of the pregnancy confirmed the presence of the malformations with single umbilical artery. Occurrence of both ventral and dorsal midline defects suggests that the timing of fetus insult would be between 14 to 18 days after conception when the splanchnic mesoderm (myocardium) and somatic mesoderm (sternum, abdominal wall, diaphragm and pericardium) is dividing.
Genetically proven fanconi anemia: a case report
Authors: Kamalammal Rugmini , Kutty Divya Narayanan
Published: December 2016

Fanconi anemia (FA) is a rare autosomal recessive disorder characterized by congenital malformations, haematological problems and predisposition to malignancies. It was first described by Guido Fanconi, a Swiss Paediatrician in 1927. The prevalence of FA is 1 to 5 cases per million.The genes that have been found to be mutated in FA patients are called FANC. 16 different FANC genes have been reported, among which 60-65% account for the mutations seen in FANCA genes which is the most frequently seen in FA patients. The disease is most commonly seen in children between 5-15 years. Diagnosis is based on the congenital physical abnormalities and confirmed by genetic testing. Here we report a rare case of Fanconi Anemia in a 4 year old female child with the characteristic clinical findings and the diagnosis was confirmed by genetic studies.
Knowledge and attitude about sexually transmitted infections among women in reproductive age group residing in the urban slums
Authors: Sharma Prajna , Sherkhane Mayur S.
Published: December 2016

Background: Sexually transmitted diseases (STDs) are group of disease primarily affecting sexually active population and has lead to a major public health problem in the reproductive age group (15-45 years), which are largely acquired through sexual act or close contact with genitals leading to potentially devastating effects. Aims and Objectives: To assess the knowledge and attitude towards STDs among women of reproductive age group residing in urban slums and also to provide an insight to the reproductive and sexual health needs through health education sessions.Methods: It is a community based cross sectional study and was conducted in the urban slums attached to a tertiary care hospital. House to house survey was done and women of reproductive age group residing in urban slums were selected and data was collected using predesigned and pretested proforma.  Results: A total of 180 women were enrolled, of which 87.78% opined blood transfusion as major mode of transmission and 86.11% as unprotected sexual intercourse. 32.78% women told that fever is the commonest symptom, followed by menstrual irregularities (38.89%). 72.78% told that STDs can be diagnosed by blood examination. 32.78% opined that STDs can be prevented by using condoms and 27.22% told by giving sex education. 68.89% were willing to get screened for STDs. Overall literates were more aware about STDs compared to illiterates (p<0.001)Conclusions:Information, Education and Communication (IEC) activities should be promoted, so that it reaches the mass at a negligible cost.
A community based cross-sectional study to assess malnutrition among elderly population residing in urban and rural areas of a district in Karnataka, India
Authors: B. G. Ananthesh , Bathija Geeta V. , Bant Dattatraya D.
Published: December 2016

Background: The geriatric age group is the fastest-growing segment of the population in most of the countries. Malnutrition has emerged as an important problem among elderly. Nutritional status of the elderly population is seldom focused upon. This study was conducted to evaluate malnutrition among elderly population and its association with sociodemographic correlates and to compare the nutritional status of elderly living in the urban and rural areas of a district in Karnataka.  Methods:A cross-sectional study was conducted among 102 urban and 102 rural residents of Dharwad district for a period of 4 months using pre-designed and structured questionnaire which include details of sociodemographic data and nutritional status which was assessed using the Mini Nutritional Assessment (MNA) questionnaire.Results: The prevalence of malnutrition was found to be 18.6 %. Among 204 subjects, 42.6% were well nourished and 38.7% were at risk of malnutrition. Elderly living in rural are more malnourished than urban areas. And 12.7% of elderly living in urban area were obese, whereas only 7.8% of rural elderly were obese. A significant association was found between nutritional status with age, literacy and the socioeconomic status of the elderly.Conclusions:High prevalence of under-nutrition (at risk of malnutrition and malnutrition) was found in our study. With higher percentages in elderly living in rural area, among illiterates and with low socioeconomic status. This study emphasizes increased need to give attention to the nutritional needs of elderly and also to screen and support elderly with malnutrition.
An educational intervention on the risk factors of lifestyle diseases among men aged 30-50 years in an urban slum in Coimbatore, Tamil Nadu, India
Authors: S. Hamsaa Nandini , S. Karthikeyan
Published: December 2016

Background: Lifestyle diseases like hypertension, atherosclerosis, coronary heart disease (CAD), type –II diabetes mellitus, ischemic  stroke are  Non -communicable diseases leading to premature  sickness, disability and death. To determine the risk factors of lifestyle diseases like hypertension and diabetes mellitus and to impart health education on the risk factors of lifestyle diseases and to determine the impact of health education.Methods: A educational interventional study was conducted in a randomly selected urban slum in Peelamedu, Coimbatore funded by ICMR STS.100 Men in the age group of 30-50 years were administered questionnaire to determine the risk factors of lifestyle diseases. Health education was given to the respondents regarding risk factors. The same questionnaire was given to the respondents after the health education to determine the impact of health education. Statistical analysis was performed by using SPSS version 20. Prevalence of risk factors was presented in percentage. Paired T test was used to find out the effectiveness of Health Education.Results: Among the study population, the risk factors for life style diseases in our study are smoking (39%), alcohol intake (27%), lack of physical activity (40%), overweight (36%), obesity (14%).  The impact of health education on risk factors of lifestyle disease and it was statistically significant with smoking (p=.000), alcohol (p=.02), physical activity (p=.001) and not significant with BMI (p=.71).Conclusions: Regular health checks can be done to improve the frequency of preventive care and support for behavior change. Effective implementation of lifestyle modifications behavior like healthy diet intake, avoidance of high caloric foods, promoting physical activity help in preventing future complications as a part of   primary preventive strategies at primary care level. The importance of lifestyle modifications should be reinforced.
Patterns and felt needs among college going adolescents regarding communication on sexual and reproductive health: a descriptive study
Authors: Sreekumar Sreenidhi , Ramakrishnan Jayalakshmy
Published: December 2016

Background: Communication between adolescents and their parents regarding sexual and reproductive health (SRH) has been a proven factor in reducing the incidence of SRH illnesses among adolescents. This study tries to explore the patterns of communication regarding SRH between adolescents and their families and their perspectives on communication needs.Methods: Data were collected from 397 college going adolescents between 18-19 years in Pondicherry from February 2014 to March 2014. The students were administered a pre-tested self-reported questionnaire to collect the required information for the study purpose.Results: 39.5% adolescents in the study reported communicating at least once in a year with any one parent and 50.6% adolescents discussed with at least any one member of the family during last 5 years. Statistically significant association was found between female adolescents communicating more compared to their male counterparts regarding SRH with any one member in the family as well as with mothers. 50.6% adolescents felt that it is necessary to discuss regarding SRH issues in the family. Almost 38% adolescents preferred mother for discussing SRH and only 6% adolescent preferred father to discuss SRH. Embarrassment and inappropriateness to discuss such topics were the two main hindering factors to initiate discussions on SRH in the family.Conclusions: Mothers are the most preferred individual in the family to have discussions on SRH for adolescents. Results suggest that encouraging adolescents and creating a need for discussion on SRH may result in more active discussions on such matters in the family.