bluuebunny/crossref_metadata_2025 huggingface dataset:
Knowledge attitude and practices of pharmacogenomics and its educational needs among doctors at a tertiary care hospital VIMS, Ballari: a questionnaire based study
Authors: D. B. Jyothi
Published: February 2020

Background: Genetic differences account for an outsized amount of patient variation in drug response and disposition. Pharmacogenomics is that the study of genetic factors that underlie variation in drug response. The objective of the study was to assess the knowledge, attitude, and practices of pharmacogenomics and its educational needs among doctors of a tertiary care teaching hospital in Vijayanagar Institute of Medical Sciences, Ballari.Methods: A cross-sectional survey was conducted among 110 doctors forming a structured questionnaire.Results: Nearly 82.8% of the survey participants were of the age group 25 to 34 years. When choosing appropriate drug therapy for patients, medical record and age were the factors most commonly cited by respondents as extremely or vital (98%). When asked to rank their familiarity with pharmacogenomics, 40% reported somewhat familiar with the subject. 98% of respondents found pharmacogenomic information in drug labelling extremely/very/somewhat helpful. 48.4% of participants knew that drug metabolizing enzymes were the foremost commonly recognized mechanism for pharmacogenomic differences in drug response. The foremost common reasons for not ordering weren't knowing what test to order (48%). The most common pharmacogenomic resource consulted by survey participants were internet (80%), scientific literature (50%), and medical association literature (30%). The most common preferred formats for a perfect pharmacogenomic resource were indicated as web-based (60%), mobile application (60%), and print materials (34%).Conclusions: There's a requirement for improved resource material preferably in electronic format to extend the appliance of genomics to clinical care.
Knowledge, attitude and practices of postgraduates, interns and nurses, on adverse drug reaction reporting in a tertiary care hospital: a comparative study
Authors: S. Mohana , S. Narayanasamy , B. R. Asokan , Kar Smita
Published: February 2020

Background: Pharmacovigilance is multidisciplinary field of the detection, assessment, understanding, and prevention of adverse drug reactions (ADRs). The incidences of ADRs about 95% are undocumented worldwide. However, there is a lack of information on ADR burden in developing countries due to lack of resources, infrastructure, and expertise.Methods: A cross-sectional questionnaire-based study was conducted on 90 staff nurses 90interns and 90 postgraduates. The validated questionnaire contained items to check knowledge including 7 questions, 9 questions to analyze attitude and 5 for practices. Comparison between knowledge, attitude and practice data obtained from resident doctors and nurses was performed using Chi square test.Results: A total of 270 healthcare professionals participated in the study. In our study the participants had good knowledge regarding the purpose of monitoring and reporting ADRs etc. The result shows that health care professionals felt reporting of ADRs is a professional obligation and all ADRs should be reported. There was no significant difference in the knowledge and attitude between interns and nurses but few questionnaires show significant variations between post graduate and staff nurse. The practice of ADR reporting was significantly higher in postgraduate compared to nurses.Conclusions: This study concluded that post graduate, intern and staff nurse had good knowledge and positive attitude towards pharmacovigilance and ADR reporting, but unfortunately the actual practice of ADR reporting is still deficient among staff nurse and intern. This can be improved by adequate training and motivation.
Anticonvulsant activity of nicardipine in experimentally induced seizures in wistar albino rats.
Authors: M. K. Kayalvizhi , A. T. Sathiya Vinotha
Published: February 2020

Background: The objective of the study was to evaluate the anticonvulsant activity of nicardipine in wistar albino rats.Methods: Anticonvulsant activity of nicardipine in a dose 10 mg/kg, and its effect with the standard drug lamotrigine (5 mg/kg) was studied in a maximal electroshock seizures (MES) experimental animal model.Results: Nicardipine in dose of 10 mg/kg showed significant anticonvulsant effect (p<0.001) and combination with standard drug lamotrigine (p<0.001) also showed more significant anticonvulsant effect in MES model.Conclusions: Nicardipine is having anticonvulsant activity and it also potentiates the anticonvulsant effect of lamotrigine in MES model.
Study on rationality of different fixed dose drug combinations in tertiary care hospital: an evaluation study
Authors: Rajitha Maddala , Shaik Altaf Hussain , Simpson G. B. , Shanthi A. Vishwa
Published: February 2020

Background: The fixed dose drug combinations (FDCs) of drugs is defined as product of two or more active ingredients in a defined composition. There is a need to study the pattern of prescription from time to time to evaluate their rationality. In this context we undertook this study to know the prescription pattern of FDC in our setting. To study the rationality of different prescribed FDCs.Methods: This is a prospective study which is carried out in NIMRA Institute of medical sciences which is a tertiary care teaching private hospital. For this study we have collected one thousand prescriptions of patients for 3 months that is from 10th March 2017 to 25th of June 2017 including both in-patients as well as outpatients. Selection criteria of patients mainly basing on their willingness to give prescriptions. Institutional ethical committee permission was taken for the study. The prescribed FDCs were compared with the essential drug list of FDCs approved by Drugs Controller General of India, July 2018.  we have used descriptive statistics to analyze data. The percentage of FDCs used in each class and their contribution to overall FDCs were calculated.Results: In a total of 2952 drugs were prescribed, of this 747 were FDCs and 2205 were non FDCs. In the prescribed FDCs 89.2% drugs were rational and 10.8% drugs were irrational.Conclusions: From this study, we can conclude that 10.8% of irrational prescription of fixed dose drug combinations are prescribed in Nimra Institute of Medical Sciences which is a tertiary care teaching private hospital.
Evaluations of antidepressant activity of Punica granatum peel extract in albino mice
Authors: Syeda Shakira Fathima , G. Sam Pavan Kumar , Mohsin Mohammed
Published: February 2020

Background: Depression is the most common disorder of mental illnesses and affects excess of 10-15% of population. According to the WHO reports, more than 350 million persons suffer from depression all over the world. The aim of present study is to evaluate anti-depressant activity of Punica granatum peel extract (PgPE) in albino mice.Methods: Male albino mice (20-30 g) were used. Animals were divided into 5 groups with 6 animals in each which were subjected to forced swim test. Group 1 is control, group 2 received (standard) imipramine 10 mg/kg, p.o, group 3 (T1) PgPE 50 mg/kg, p.o, group 4 (T2) PgPE 100 mg/kg, p.o, group 5 (T3) PgPE 200 mg/kg, at first animals were forced to swim for 15 min (trained), and the study was performed after 24 hrs. All the animals were treated with individual drug 60 min prior to study, animals were forced to swim for 6 min and the duration of immobility was recorded. The mouse was considered immobile when it floats motionlessly or made only those moments necessary to keep its head above the water surface. The total duration of immobility of each mouse was recorded after the test in each group.Results: The duration of immobility is significantly reduced at PgPE 200 mg/kg and results were analysed by one way analysis of variance (ANOVA).Conclusions: PgPE 200 mg/kg significantly (p<0.05) decreases the duration of immobility in mice.
Drug utilization study in schizophrenia patients in outpatient department of psychiatry: an observational prospective study
Authors: Hivale Nitin Sukadev , Kulkarni Madhuri D. , Athawale Siddharth S.
Published: February 2020

Background: A mental disorder or psychiatry disorder is a behavioural or mental pattern that causes significant distress or impairment of personal functioning. Schizophrenia is one of the most common psychiatric disorders. Aim of the study is to study drug utilization pattern in schizophrenia patients in outpatient department of psychiatry.Methods: A prospective and observational study was conducted in psychiatry outpatient department between May 2018 to October 2018 at Government Medical College and Hospital Aurangabad. Approval from ethics committee was taken. Data collected was of age, sex, final diagnosis, drugs prescribed to patients from case report form. The data obtained was then analyzed in Microsoft excel.Results: Total prescriptions of 129 patients were analyzed. Out of 129 patients 99 (76.74%) were male, while 30 (23.26%) were female. The mean age of the patients admitted in Psychiatry OPD was 36.71±11.76 years. Number of drugs prescribed per patient being 3.40±1.12 (mean±SD). The most common drugs used were olanzapine (66.6%), trihexyphenidyl (51.9%), lorazepam (44.9%), risperidone (39.5%), trifluoperazine (27.9%).Conclusions: Our study shows that atypical antipsychotics were the most common drugs prescribed in patients. Olanzapine was the most common medication used followed by risperidone. Our prospective study is carried out to get a more comprehensive data so that we can improve the drug utilization in our hospital.
Comparative effectiveness of S-adenosylmethionine and etoricoxib in newly diagnosed patients of knee osteoarthritis
Authors: Chaudhary Prashant S. , Deshmukh Shweta V. , Jaybhaye Deepali L. , Johar Sukhmeen K. , Pandey Bajrang L. , Sharma Gagan A.
Published: February 2020

Background: Knee osteoarthritis is an important cause for morbidity in elderly people. Therapy is largely symptomatic with nonsteroidal anti-inflammatory drugs which pose risk in the elderly. Methionine is natural body constituent with novel property of blunting S-adenosylmethionine (SAMe) inflammatory process and cartilage degradation. The aim of this study was to compare effectiveness of SAMe, with standard etoricoxib therapy in newly diagnosed knee osteoarthritis cases.Methods: 127 newly diagnosed knee osteoarthritis patients were randomized into two groups. 55 participants received treatment  of etoricoxib 600 mg extended release once daily for 90 days (group 1) and 72 received  etoricoxib 600 mg extended release once daily and SAMe 400 mg twice daily  for initial 15 days followed by SAMe once daily 400 mg as maintenance dose for next 75 days  (group 2). The outcomes were measured by knee injury and osteoarthritis outcome score (KOOS). Pre and post treatment KOOS scores of all cases were separately pooled to define the median for whole as well as components of KOOS parameters. Relative frequencies of cases with values around respective medians were compared by MOODS median test. Patient characteristics, disease characteristics were also examined for bearing on outcomes besides the treatment.Results: SAMe treatment was associated with significantly greater improvement in symptoms, activities of daily life, spontaneous recreational activities and the quality of life compared to etoricoxib therapy. The therapy was well-tolerated.Conclusions: The study confirms SAMe as superior therapeutic option in osteoarthritis. SAMe indeed has been reported to have specific anti-arthritic effects and promotive to general well-being.
The effect of ladder approach on development of preterm low birth weight infants with HIE-2
Authors: Jadhav Tushar R. , Jaywant Shailaja S.
Published: February 2020

Background: Premature infants with Peri-natal asphyxia leading to a hypoxic-ischemic encephalopathy (HIE) are at greater risk for cerebral palsy. HIE grade II infants have long term neurological complications due to maladaptive brain wiring during NICU stay. Ladder approach, with graded stimulation program is administered by Occupational therapist, plays a vital role to minimize the maladaptive responses to environment. Objective of this study was to effect of Ladder Approach on preterm low birth weight Infants with HIE-2 as compared to conventional treatment. Design of this study was to Prospective Block Randomized Convenient Sampling Control Trial, Experimental design study. The study was carried out in the NICU and PU ward of Tertiary care hospital in metropolitan city from April 2015 to October 2016. The study subjects included a convenient sample of 30 preterm Low birth weight HIE-2 infants randomly selected into study or control groups. Neonatal behavioural Assessment scale (NBAS), Infant Neurological International Battery (INFANIB).Methods: The preterm infants from study group who received Ladder Approach and control group who received routine conventional care only. Outcome measures NBAS was at baseline and first follow up. INFANIB was administered at second follow up to assess neurodevelopment.Results: Showed that the premature infants of the study had significant difference in neuro behavioral status with mean for all subcomponents from to post intervention mean 39.6 in experimental group and from baseline mean of 24.3 to post intervention mean score of 33.2 in control group on neurobehavioral scale. Further neurodevelopmental status showed similar results on INFANIB in experimental group.Conclusions: The premature Infants with HIE grade 2, receiving ladder approach have shown more mature responses resulting into well-organized Neurobehavioral status, and resulted in improved brain wiring as evident in INFANIB.
A comparative study of calf muscle circumference with other anthropometry measurement as a measure of low birth weight in neonates
Authors: Kumar Siddharth , Jain Hemant
Published: February 2020

Background: India having 3rd highest incidence of low birth weight (LBW) infants (28%) in the world. Majority of deliveries in our country are conducted at home by untrained traditional birth attendants or relatives, so it is not possible for untrained birth attenders to operate weighing machine in rural areas, therefore to find an alternative method for the estimation of low birth weight we used simple anthropometric indicators like calf circumference which is easily used by rural communities.Methods: It was a Cross-sectional study done at tertiary care center, Udaipur, Rajasthan, India during 1 year period in 2018. 150 neonates without any congenital malformation delivered at hospital irrespective of gestational age were subjected to anthropometric measurements. The different anthropometric measurements like calf circumference, chest circumference were used and data was analyzed by using Receiver Operating Characteristic curve (ROC) to find out the cut-off values with the highest sensitivity and specificity for birth weight <2500gm and <1800gm. For comparison Pearson's Correlation coefficients was used.Results: From different anthropometric measurements, calf circumference of 9.38 cm and 7.90cm had higher sensitivity and specificity in detecting birth weight babies of <2500gm, and <1800gm respectively. The best correlation was observed in calf circumference (r=0.989) and (r=0.990) for identifying babies with birth weight group 1.21-1.80kg and group 1.81-2.50kg.Conclusions: In the absence of a weighing machine, simple measurements like calf circumference is the best indicator in identifying low birth weight babies.
Clinical correlation of cardiac functions and troponin I and CPK-MB in dengue fever in children
Authors: Chaudhary Devanand G. , Srinivasan Shyam , Sutay Nita R.
Published: February 2020

Background: Dengue is the most rapidly spreading mosquito-borne viral disease in the World. The spectrum of manifestations includes mild fever to severe and life-threatening disease, though uncommon complications such as myocarditis have also been reported in many cases. We conducted this study to analyze association between Clinical Profile, Cardiac Functions and Troponin I and CPK-MB (cardiac biochemical markers) in children with Dengue Fever. Aims and objectives of the study was the association between Clinical Profile, Cardiac Functions and Troponin I and CPK-MB (cardiac biochemical markers) in children with Dengue Fever.Methods: This was a prospective observational study in which 80 paediatric patients who were hospitalized anddiagnosed to be having Dengue fever were included. All patients were stratified into either of the 3 groups- Dengue without warning signs, Dengue with warning signs and severe Dengue. A detailed history and thorough clinical examination were done for all patients. A complete blood count, electrolytes, hepatic and renal function tests were done in all children. Cardiac function was assessed by 2D Echo, CPK-MB and Troponin-I, p value less than 0.05 was taken as statistically significant.Results: Of the 80 studied cases there were 53 (66.25%) males and 27 (33.75%) females with a M:F ratio of 1.9:1. Dengue with and without warning signs was seen in 27.5% and 60% cases respectively whereas severe dengue was seen in 12.5% cases. The ejection fraction was comparable across the 3 groups. On 2D echo ejection fraction was 62.95%, 63.21% and 65.1% in cases with warning signs, without warning signs and severe dengue respectively. Additionally, ECG abnormalities were seen in 8.75% patients. All 80 patients had a normal CPK-MB and Troponin-I levels.Conclusions: Cardiac markers (CPK-MB and Troponin-I) remain unaffected during Dengue illness and do not have significant correlation between Dengue without warning signs, Dengue with warning signs and severe Dengue.
Prevalence and factors affecting nocturnal enuresis among primary school children in Baddi, Himachal Pradesh, India
Authors: Bansal Naveen , Goyal Manju Bala
Published: February 2020

Background: Enuresis is defined as involuntary urination beyond the age of 5 years. The present study was done to determine the prevalence of nocturnal enuresis and its associated risk factors in children in Baddi, Himachal Pradesh.Methods: This was a prospective observational cross-sectional study done in children in the age group of 5-11 years over a period of 18 months. Nocturnal enuresis was defined using the DSM IV criteria. Data analysis was done using chi square test.Results: The total sample size was 2144 and the prevalence of nocturnal enuresis was found to be 22.0% (n=472). There was statistically significant relationships between nocturnal enuresis and history of nocturnal enuresis in siblings (p=0.0018), history of deep sleep (p<0.05), history of perianal itching (p<0.05), history of urinary tract infection (p<0.05), poor academic performance (p<0.05).Conclusions: Nocturnal enuresis is a result of complex interplay of multiple physiological and psychological factors. Parents need to be sensitised and educated regarding these causation factors for better prevention and treatment of nocturnal enuresis.
Socio-demographic characteristics, breast feeding practices and household sanitation as risk factors for diarrhoeal illness in under five children
Authors: Surana Amita U. , Sengupta Dorothy S. , Chauhan Harshal R. , Budh Hetal P. , Gandhi Toral
Published: February 2020

Background: Acute diarrhoeal disease among children under 5 years remains a major cause of morbidity and mortality. In India, diarrhoea attributes to 13% of under-5 mortality. As most diarrhoeal diseases have feco-oral route of transmission, the source of water supply, sanitary measures and personal hygiene are important factors in prevention of same. This study aims to determine various risk factors for diarrhoeal illnesses.Methods: A descriptive cross-sectional observational case-control study done among under-5 children hospitalized during rainy months in paediatric ward of tertiary care centre. Information regarding participant’s age, sex, immunization status and breast feeding practices collected from the mother or caregiver of the child using a structured questionnaire.Results: Out of 55 cases and 55 controls enrolled, there was no significant difference in birth weight, gender, immunization status, socio economic profile, hygiene practices and sanitation facility between two groups. Statistically significant difference (p 0.01717) was seen in wasting associated with cases and controls however no difference in proportion of stunting was noted. The cases showed early age of start of complimentary feeding (5.86± 1.38m) and less duration of total breast feeding (15.94±4.09m) as compared to controls. Bottle feeding was seen in 69% cases as compared to 53% controls.Conclusions: In socio economically and environmentally similar conditions, faulty feeding is a significant risk factor for diarrhoeal illness in under 5 children. Wasting is also a significant risk factor associated with the same.
Resurgence of diphtheria: clinical profile and outcome in a tertiary care hospital of South India
Authors: Shetty Ananya U. , Chavan Vinod , Matti Mahantesh , Kulkarni Vijay
Published: February 2020

Background: Diphtheria is a potentially fatal acute disease caused by Corynebacterium diphtheria. It was one of the leading causes of mortality in the pre vaccination era. This study is an attempt to highlight the clinical profile, outcome and demographic characteristics, immunization status of pediatric diphtheria cases in South India. Objective of the study was to analyze the clinical profile, immunization status and outcome in children with diphtheria admitted to the PICU in a tertiary care hospital.Methods: This retrospective study was conducted in a tertiary care hospital in South India. The case records of all children admitted to the hospital between January 1st, 2014 to December 31st, 2018 with clinically suspected diphtheria were analyzed. The data was analyzed with respect to clinical features, demographic characteristics, immunization status, complications and outcome using appropriate statistical methods.Results: 18 cases were clinically suspected to have diphtheria. The average age of children presenting with diphtheria was 9 years. Out of the 18 cases, 11 were male, 7 were female. 16 out of 18 cases were from rural areas, whereas only 2 cases were from urban areas. Fever, sore throat and dysphagia were the presenting complaints in all cases. Neck swelling, white patch over tonsil and tender cervical lymphadenopathy were the other findings noted. Out of 18 cases, 7 were completely immunized, 8 were incompletely immunized and 3 were not immunized. Antidiphtheritic serum was given in 14 cases. Myocarditis, airway compromise and neurological deficits were the complications noted. Case fatality rate was 50%.Conclusions: Diphtheria still remains a major public health problem in developing countries like India. Mortality and morbidity due to diphtheria continues to be high despite ready availability of vaccines and antitoxin. Childhood immunization program, especially follow up and administration of booster doses must be prioritized.
A study of clinical profile of intractable epilepsy in children
Authors: Sree C. Bhanu , Belavadi Gangadhar B.
Published: February 2020

Background: This study was undertaken to find out the prevalence and clinical features of intractable epilepsy (IE) in a tertiary referral center.Methods: Study was conducted in a tertiary care hospital on 60 children with intractable epilepsy. Cases includes  intractable epilepsy is when seizures continue to occur despite maximally tolerated doses of more than two antiepileptics, occurrence of an average of one seizure per month for 18 months with no more than a 3 month seizure free period during these 18 months. Controls: epileptic children who had good control of seizures for the previous 18 months.Results: The prevalence of intractable seizures was 10% with maximum number of children 25 (41.6%) belonged to the 5-12 years. 15 (50%) children had daily seizures. Myoclonic seizures proved to be an important predictor of intractability. 4 children among the cases had history of family seizures, 6 children in cases had history febrile seizure, whereas, 6 children among the controls had history of family seizures, 8 children in controls had history febrile seizure.  23.3% of children presented with Status epilepticus in the cases and 16.6% of the children in the controls. Remote symptomatic etiology 12(40%) is the commonest cause of seizure. 13 (43.3%) children in cases and 3 (10%) children among the controls had a history suggestive of birth asphyxia. EEG was abnormal in 17 (56.6%) cases when compared to 11 (36.6%) children in the controls. CT scan was abnormal in 14 (46.6%) cases and 10 (33.3%) controls. MRI was abnormal in 16 (53.3%) children of the cases and 8 (26.6%) children of the controls.Conclusions: The commonest cause of intractable epilepsy was perinatal asphyxia. Perinatal asphyxia can be prevented by good nutrition during pregnancy, regular antenatal check ups with detection of high risk pregnancy, promoting hospital deliveries and prompt resuscitation of newborn when required.
Clinicopathological and morbidity profile of childhood polyarteritis nodosa in a tertiary referral center
Authors: Shivappa Sanjay Kantharajpura , Hlawndo Jessica Laltlansangi , Rudramurthy Pradeep , Raghuram Jyothi , Rao Anand Prahlad
Published: February 2020

Background: Polyarteritis nodosa (PAN) is a primary systemic necrotizing vasculitis predominantly targeting medium-sized arteries defined as the main visceral arteries and their branches. The objective of this study was to analyze the epidemiology, clinico-pathological and point outcome of PAN in children at a tertiary care centre in Karnataka.Methods: This prospective observational study was conducted among eighteen children diagnosed with PAN from December 2015 to May 2017.  All the children fulfilling EULAR/PRES/PRINTO classification criteria for childhood PAN were included in this study. Clinico-pathological profile of these patients was studied and documented.Results: This study had shown that there are two peaks of age at onset of symptoms at 5 to 7 years and from 11 to 13 years. No sex predilection was noted. Most children present with nonspecific symptoms like myalgia (94%), fever (84%), weight loss (50%) and joint pain (50%). Skin manifestations were seen in all the children. Neurological involvement (61%) in the form of mononeuritis multiplex (38.8%), hypertensive encephalopathy (11%) and stroke (11%) was observed. Four children (22%) presented with pain abdomen while two boys had testicular pain. Only one child had renal manifestation in the form of glomerulonephritis. Most children had neutrophilic leukocytosis, elevated ESR and thrombocytosis. Skin biopsy was performed in ten children and out of these, 9 reports were suggestive of PAN. Angiography was done in four children revealing multiple aneurysms or stenosis in the systemic arteries. All the children received corticosteroids. Cyclophosphamide was used as an induction agent in about 50% of the patients. Corticosteroid treatment alone was sufficient in only one patient. Steroid sparing agent like azathioprine (38%), mycophenolate mofetil (33%) and hydroxychloroquine (5%) were used with low dose steroids as maintenance therapy. Seven children (39%) achieved remission off drugs while 8 children are still on treatment, one child relapsed and three children were lost to follow up.Conclusions: Childhood vasculitis leads to considerable delay in diagnosis the initiation of treatment. High index of suspicion and early referral is required in all cases of vasculitis to reduce morbidity and mortality.
Drug rash with eosinophilia and systemic symptoms syndrome, a uncommon but fatal illness, paediatricians should be aware of: a case of 13 year old female child
Authors: Behera Jyoti Ranjan , Sahu Sanjay Kumar , Gupta Abhas
Published: February 2020

Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is a fatal illness manifested by fever, morbilliform rash, multi systemic involvement and eosinophilic leucocytosis with about 10% mortality. Authors report DRESS syndrome in an adolescent girl due to anti-depressant and anti-psychotic which improved dramatically after withdrawal of offending drugs and starting of steroids
Study of liver function tests and spontaneous bacterial peritonitis in a patients of liver cirrhosis
Authors: Mangudkar Sangram S. , Shivnitwar Sachin K. , Gokhale Vijayashree S. , Ithape Ameya A.
Published: February 2020

Background: Liver cirrhosis patients are highly susceptible to bacterial infections specially Spontaneous bacterial peritonitis (SBP) which is commonest infection. this study undertaken to understand liver function tests and Spontaneous bacterial peritonitis in patients of liver cirrhosis admitted to tertiary care hospital.Methods: A descriptive cross-sectional study conducted among Liver cirrhosis patients in tertiary care center. Total 100 liver cirrhotic patients were included in present study. All the patients were subjected for biochemical evaluation of Serum albumin and globulin level, Serum bilirubin, SGOT (Serum glutamic oxaloacetic transaminase), SGPT (Serum glutamic pyruvate transaminase) and Ascitic fluid polymorph nuclear neutrophil (PMN) count to diagnose SBP.Results: Spontaneous bacterial peritonitis was present in 12% patients. Relation of Serum bilirubin level and SBP was statistically significant. Relation of serum SGOT, SGPT level and serum globulin between SBP and non-SBP group was statistically non-significant.Conclusions: Liver cirrhosis patients are susceptible for bacterial infections because of defects in various host defense mechanism and hence patients of liver cirrhosis must be screened for spontaneous bacterial peritonitis along with liver function tests.
Study of risk factors and its correlation with constraint induced movement therapy for atherosclerosis in patients of coronary artery disease and their offspring
Authors: Margekar Venugopal , Thakur Shweta , Jatav O. P. , Yadav Pankaj
Published: February 2020

Background: A significant percent of cardiovascular event occurs without well-known modifiable risk. A new tool for early identification for atherosclerosis is required for early intervention. Aims and objectives of the study was to study the risk factors for CAD and its correlation with CIMT.Methods: One hundred and forty subjects were studied for the risk factors of CAD in Department of Medicine of G.R. Medical College, Gwalior from 2012 to 2013. Out of 140 subjects, 100 were patients having CAD and 40 age matched subjects were included as control group. Data was also recorded from their offspring. High resolution B mode ultrasonography was performed to assess CIMT of carotid arteries. The maximum CIMT of any one side of carotid artery was taken for study.Results: CAD was more prevalent among males (78%). Majority of the offspring of cases had age between 28-42 years and majority were male (73%). Most common risk factors for CAD was dyslipidemia (48%), hypertension (24%), diabetes (12%) and smoking (21%), whereas in offspring’s of CAD patients, dyslipidemia was seen in 28%, hypertension in 3%, diabetes and tobacco smoking in 12% and 24% respectively. The CIMT of CAD patients was significantly increased with increasing the number of risk factors and the same pattern was also seen in controls.  The CIMT of asymptomatic offspring’s having positive family history was significantly more than the asymptomatic offspring without positive family history of CAD.Conclusions: CIMT measurements can be used as a surrogate marker of atherosclerosis as it has showed a direct link with number of risk factors of CAD.
Is the clinicopathological profile of dengue syndrome changing?: a 6 year study of different epidemics at a tertiary care center in India
Authors: Sud Rahul , Nair Velu
Published: February 2020

Background: As an arthropod-borne viral disease, dengue epidemics has created much public health hazards in tropical countries. In the national capital of India, there has been more than six epidemics. Dengue remains a notifiable disease in India. It is important that we understand the changing clinicopathological profile of this viral infection to prepare ourselves better for any impending future epidemic. This study done at a tertiary care center looks into the recent epidemics to understand the changing trends in the disease profile in two phases of three years each. Further, authors also assessed the utility of the tourniquet test in dengue syndrome.Methods: 260 serologically confirmed patients were recruited in two phases of the study. We evaluated them for clinical, epidemiological and pathological profile of dengue and trends in haematological, biochemical and radiological parameters during the course of the disease and its correlation with the severity of the disease.Results: Fever, headache, body ache, pharyngeal and conjunctival congestion, rhinitis, rash and diarrhea incidences were similar in both epidemics. Lymphadenopathy was seen in 18(18%) patients compared to 40(25%) in the second epidemic. More number of hemorrhagic manifestations with GI and retinal bleed was seen compared to earlier epidemics, which had higher liver involvement.Conclusions: Although the presentation of the disease has not shown a drastic change over the last decades, the severity varies depending on the predominant serotype. Patients with evidence of serositis, increased activated lymphocytes has a longer course in disease with poorer outcome. Early rising haematocrit, ALT/AST ratio, LDH and deranged coagulation parameters are important tools in triaging patients for priority of urgent care and hospitalization in a scenario of a future outbreak.
A prospective study to assess glycemic status as a possible prognostic marker in non diabetic acute organophosphate poisoning patients
Authors: R. Raveendra K. , V. Chandana , Kodur Sanjana
Published: February 2020

Background: Organophosphates (OP) are a diverse group of insecticides used for pest control. Due to easy availability of these compounds over the counter, organophosphate poisoning continues to be a major cause of deliberate self-harm. Although choline esterase inhibition plays a key role in OP poisoning, other metabolic factors like dysglycemia contribute to the severity of poisoning. The present study attempts to assess glycaemic variability as a probable prognostic factor in acute OP poisoning. Aim of the study was to correlate the blood glucose levels with the severity and treatment outcome of acute organophosphate poisoning.Methods: 100 patients of acute organophosphate poisoning admitted in the hospitals affiliated to Bangalore Medical College and Research Institute during the study period from August 2018 to July 2019, were enrolled into the study as per the inclusion criteria and graded into mild, moderate & severe, based on Peradeniya organophosphorus poisoning (POP) scale. Random blood sugar (RBS) was estimated at the time of admission and patients were followed up till recovery/death.Results: The patients in this study were categorized into hypoglycemics (10%), euglycemics (75%) and hyperglycemic (15%). 16% of euglycemics, 30% of hypoglycemics and 60% of hyperglycemics had severe grade of poisoning. The ventilator requirements in hypoglycaemics, euglycemics and hyperglycemics were 40%,48% and 80% respectively. The outcome in terms of mortality was 8% in euglycemics group and 20% in hyperglycemics group. Hence hyperglycemia was found to be a poor prognostic marker in acute organophosphate poisoning.Conclusions: RBS at admission in acute organophosphate poisoning patients is a simple, inexpensive tool that may help to predict the clinical outcome. Early identification of the poor prognostic indicators may help in timely intervention, to reduce morbidity and mortality, especially in a resource limited country like India.
Clinicohematological profile of pancytopenia: a study from a tertiary care hospital
Authors: Yadav Rakesh Kumar , Kumar Sujit
Published: February 2020

Background: Pancytopenia is common clinical condition which we encounter in our daily clinical practice. Pancytopenia is characterized by decrease in all the three major components of blood like Red Blood Corpuscles, White blood Corpuscle, and platelets. This study was carried out to look for causes of pancytopenia and clinical presentations at tertiary care hospital in north India.Methods: The study was conducted at MLN Medical College, Allahabad in the Department of Medicine between June 2018 to July 2019. Total 125 patients who attended department of medicine were screened for study. After exclusion 94 patients were studied prospectively.Results: Out of 94 patients 59 were males, and 35 females in the study group. Male to female ratio was 1.6:1. Maximum patients were between 20 years to 35years of age group. Pallor and weakness were most common clinical feature in this study group. Out of various etiological causes vitamin B12 deficiency was the commonest in our study. 48(51%) patients had megaloblastic anemia due to vitamin B12 deficiency. Second most common etiological factor was hypo plastic/aplastic anemia. Other etiological abnormalities were hypersplenism, dengue, malaria, sepsis, myelodysplastic syndrome and multiple myeloma.Conclusions: Bone marrow examinations, aspiration cytology or biopsy are important tool for diagnosis of pancytopenia. Underlying cause and severity of disease determine the outcome of pancytopenia. The present study concluded that most of patients with pancytopenia have treatable cause so early diagnosis will be helpful for management of patients.
Comparison of clinical parameters with APACHE-II, Sequential Organ Failure Assessment and Clinical Pulmonary Infection Score scores in predicting treatment outcome of patients with ventilator associated pneumonia
Authors: R. Raveendra K. , N. Devamsh G. , Kodur Nandan , U. Chirag L. , K. Vinay
Published: February 2020

Background: The objective of this study was to study the multiple clinical parameters in patients with VAP and to compare the 3 scores namely, APACHE II, SOFA and CPIS in predicting the treatment outcome of patients with ventilator associated pneumonia.Methods: It was a cross sectional observational study conducted on forty patients admitted in ICU between June 2018 and July 2019, who developed VAP after admission to ICU. Logistic regression analysis was applied to estimate the predictive ability of the APACHE II, SOFA and CPIS scoring systems in assessing VAP-related mortality. A p value of <0.05 was considered significant. All analyses were performed using SPSS software version 10.Results: The sample size in our study was 40 patients. The mean age of patients was 43.4±15.9. The mean duration of mechanical ventilation before VAP onset was 8±2 days. Klebsiella species was the most common organism isolated from ET aspirate. Of the three scores only APACHE II was independent predictor of the mortality in the logistic regression analysis.Conclusions: APACHE II score is better at predicting mortality in patients with VAP as compared to SOFA and CPIS scores. Age, co-morbidities, duration of ICU stay, time of acquiring VAP, multi organ dysfunction, need for ionotropes and multi drug resistant organisms play an important role in predicting the outcome of patients.
A study on efficacy of injection of intratympanic dexamethasone in treatment of sudden sensorineural hearing loss
Authors: K. Srirangaprasad , Kumar V. Vinay , Raj S. Pruthvi
Published: February 2020

Background: Sudden sensorineural hearing loss is a common otologic emergency which occurs due to various etiologies affecting the inner ear. Majority of treatment protocols are focussed on glucocorticoids either systemically or through intratympanic route due to their antioxidant and anti-inflammatory properties.

Methods: This was a pre and post observational clinical study conducted in patients visiting Rajarajeswari medical college between December 2015 to December 2016 with a history of sudden hearing loss (30 patients). 6 of these patients presented with bilateral hearing loss, and we considered each ear as a separate case, giving us a total of 36 cases. A diagnosis of idiopathic sudden sensorineural hearing loss was made based on the patient’s history and audiological evaluation. All the patients were treated with 3 doses of Intratympanic injections of Dexamethasone (4 mg/ml), on alternate days. Pure tone audiometry (PTA) and brain stem evoked response audiometry (BERA) was done pre-treatment, at 1 and 6 months after treatment.  

Results: Mean age of our patients was 44.8. 80% of our patients were male. The average PTA gain, 1 month after treatment was 27.917 and 6 months after treatment was 29.639 with a p value of <0.001, which correlated with BERA. At the end of 6 months after treatment, 15 cases had complete recovery (41.7%), 9 cases showed slight recovery (25%), 6 cases had marked recovery and 6 cases (16.7%) had no recovery.

Conclusions: Intratympanic dexamethasone injections can be used as the first line of treatment with minimal side effects. 
Ewing’s sarcoma of sinonasal tract: a rare case
Authors: Gupta Ankur , Sofia Ancy S. , Sen Kanwar
Published: February 2020

Extra skeletal Ewing’s sarcoma (EES) is a rare, rapidly growing, round cell malignant tumour that can develop in the soft tissue at any location. Involvement of the paranasal sinus is a very rare entity. Nearly 80% of patients are younger than 20 years. Diagnosis is made after histopathological examination, immunohistochemical studies and cytogenetic studies. Treatment includes a multidisciplinary approach with surgery as the first line followed by chemotherapy and radiotherapy.

 
Crocin ameliorated skin tissue inflammation in atopic dermatitis in mice
Authors: Alyoussef Abdullah
Published: February 2020

Background: Atopic dermatitis (AD) is considered a chronic recurrent inflammatory skin disease. In addition, crocin is the major carotenoid compound found in Gardenia jasminoides. It is previously proved to produce anti-inflammatory actions. Therefore, we conducted this research to investigate the therapeutic effects of crocin on a mice model of AD.

Methods: Mice were investigated for the number of scratches and dermatitis score. Skin was isolated and used for measurements of gene and protein expression of β-catenin, NFκB, TNF-α and IL-1β.

Results: Authors found that crocin significantly reduced the number of scratches, ear thickness and dermatitis score. In addition, crocin ameliorated AD-induced elevation in the expression of β-catenin, NFκB, TNF-α and IL-1β.

Conclusions: Crocin ameliorated DNCB-induced AD in mice via blockage of β-catenin with subsequent reduction in inflammatory pathway.

 
Group fairness equilibria
Authors: Moreno-Okuno Alejandro Tatsuo , Mosiño Alejandro
Published: February 2020

In this paper we extend Rabin’s (1993) model of fairness equilibria to groups of individuals and define a new solution concept we name “group-fairness equilibria.” We model two games with two players, where each player in each game belongs to one of two groups. We analyze how the outcome of one game may affect the outcome of the other and how the existence of one individual with a particular grudge or liking towards the player she is playing with can impact the outcome of both games. We analyze some applications of our model.
New approach to treatment of ventral hernias of the medial localization
Authors: Sukovatykh Boris Semyonovich , Nazarenko Pyotr Mikhailovich , Polevoy Yuriy Yurievich , Blinkov Yuriy Yurievich , Netyaga Andrey Alexeevich , Zatolokina Mariya Alexeevna , Dubonos Alexander Anatolievich , Pakhomov Eduard Stanislavovich
Published: February 2020

Importance. Functional results of treatment of the ventral hernias of the medial localization after endoprosthetics of the abdominal wall by the standard polypropylene prosthesis remain unsatisfactory because of the limited flexibility of the abdominal wall.
Purpose. To improve functional results of treatment of patients with ventral hernias of the medial localization by applying a light strengthened endoprosthesis.
Materials and methods. There was done a comparative analysis of the results of treatment of 60 patients with medial hernias of the anterior abdominal wall. Patients were divided into two groups with 30 people in each group. In the first group over-aponeurotic endoprosthetics of the abdominal wall defect was provided with the use of a standard polypropylene prosthesis with the thread diameter 120 micron, while in the second group there was used a light strengthened endoprosthesis with the thread diameter in the basic zones 90 micron and in the strengthened zones 120 and 90 micron. Effectiveness of treatment in the nearest post-operative period was evaluated by the degree of severity of inflammatory implantation response, and in the long-term period evaluation was done on the base of functional state of the abdominal muscles, quality of life of patients and results of treatment by four point scale.
Results and their discussion. Inflammatory exudative response on implantation of the light strengthened endoprosthesis was less and reparative response was 1,1 times higher compare to a standard prosthesis. Endoprosthetics of the abdominal wall with a light strengthened endoprosthesis improved contractility of the abdominal muscles in 1,2 times. Restoration of the functions of the abdominal muscles had a positive influence on quality of life, namely, physical component of health improved by 4,5%, as well as on long-term results of treatment by the increased number of excellent and good results of treatment by 20% and reduction of satisfactory results by 20%.
Conclusions. The use of a light strengthened endoprosthesis enables to improve the functional results of treatment of ventral hernias of the medial localization.
CHANGES IN THE DYNAMICS OF THE FUNCTIONAL ACTIVITY OF BLOOD GRANULOCYTES IN PATIENTS WITH PANCREATIC NECROSIS.
Authors: Baychorov Enver Khuseynovich , Gandzha Nikolay Sergeyevich , Salpagarov Shamil Rashidovich , Guseynov Shakhban Ibragimovich
Published: February 2020

The purpose of research. Predicting risk of infection of acute destructive pancreatitis.
Material and Methods. The dynamics of functional activity of granulocytes in 27 (58,7%) patients with sterile and 19 (41,3%) patients with infected pancreatic necrosis. An objective assessment of the severity of their condition carried out by performed using of the scale of the integrated assessment APPACHE-II. The exclusion criterion from the study was the revealing of accompanying acute and chronic diseases.
Results.Scale APPACHE-II can be used mainly for screening assessment of the degree of polyorgan insufficiency, as well as predicting the development of infected pancreatic necrosis forms, but, unfortunately, only in the later stages of development of pathological process. Dynamics of changes in the functional activity of leukocytes in patients with pancreatic necrosis can be used as an additional test, which characterizes the moment of transition of sterile pancreatic necrosis to infected, and, consequently, in deciding on the timing of terms and nature of performance of operational allowance.
Conclusions. 1. In patients with sterile pancreatic necrosis (SPN) after a moderate decrease in the activity of myeloperoxidase (MPO), the content of the cation proteins (CP) in the first three days in subsequent periods of observation, on the background of complex conservative therapy, noted, compared with the established "Normal" gradual increase or stabilization at close to the indicators of the functional activity of neutrophils. The activity of KF and alkaline phosphatase from patients with SPN, after the increase in performance in the first 11 days, then gradually declines, reaching the normal level. 2. Patients with infected pancreatic necrosis(IPN) sharply, starting with 11 days of the study, by 35-40%, reduce the activity of MPO and the content of CB and Acid Phosphatase activity and Alkaline Phosphatase, on the contrary, it had progressively pronounced growth after 11 days by 35-40%.