bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative study of DIPSI and IADPSG criteria for diagnosis of GDM
Authors: Srinivasan Swathy , Reddi Rani P.
Published: February 2018

GDM is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. The prevalence of GDM varies, widely based on the diagnostic criteria used and the ethnic group studied. It is associated with adverse maternal and perinatal outcome. Incidence of GDM in India is 1-14%. There are several screening and diagnostic tests for GDM. It is important to diagnose early and treat to prevent these complications. The present study was done to compare Diabetes in Pregnancy Study Group India (DIPSI) with International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria for diagnosis of GDM and to assess the validity of these methods.Methods: It was a cross sectional study done in 144 pregnant women who fulfilled the inclusion criteria. They underwent non - fasting OGTT with 75 grams glucose which was given irrespective of the last meal. A venous blood sample was drawn two hours after glucose administration. They were advised to come two to three days later and repeated with 75 grams OGTT after an overnight fast of atleast 8 hours. Venous blood sample was drawn at fasting, one hour and two hours after load with 75 grams of glucose. Plasma glucose was measured by using an autoanalyzer by glucose - oxidase peroxidase (GOD - POD) technique.Results: The epidemiological parameters like Age, BMI, Parity and Gestational age did not have any difference between two groups. 17.4% was diagnosed by DIPSI criteria and 15.3% was diagnosed by IADPSG criteria and 6.9% was diagnosed by both. Sensitivity and specificity of DIPSI was 45% and87% and sensitivity and specificity of IADPSG was 40% and89% respectively. According to kappa statistics, the p-value is 0.000.Conclusions: In present study it was concluded that screening is very essential in all pregnant women due to high prevalence of GDM in India. By comparing these two criteria, sensitivity of DIPSI was found better than IADPSG criteria in diagnosing GDM. Though IADPSG is universally accepted for diagnosis, DIPSI has still got a place in low resource countries as it is easy, cost effective and non fasting test.
Two years follow up study of post placental insertion of IUCD during caesarean sections: safety, efficacy and complications
Authors: Pandher Dilpreet Kaur , Rani Shikha , Goel Poonam
Published: February 2018

Background: The present study evaluates safety, efficacy, expulsion rate and complications of PPIUCD insertion in women undergoing caesarean section in a medical college for 2 years period.Methods: This is a prospective cohort study done over a 2 year period. Total 185 patients undergoing caesarean section and fulfilling medical eligibility criteria for PPIUCD were enrolled in the study. The followup of these patients was done at 6 weeks, 6 months and 1-2 years.Results: Thirteen patients (7%) lost to follow up so final outcome analysis was done in 172 patients. The problems encountered were spontaneous expulsion in 4 patients, removal due to heavy menstrual flow in 13 patients, non-visibility of threads in 4 patients, discharge per-vaginum in 1 patient and pain lower abdomen in 1 patient. Voluntary removal was done in 3 patients by 2 years who wished to conceive. The successful continuation rate came out to be 84.9% by 2 years. There was no failure reported in terms of intra-uterine or extra-uterine pregnancy and no increased risk of infection or perforation over the 2 years follow up.Conclusions: Immediate post-placental IUCD insertion is safe and effective method of contraception with no need to wait for 6 weeks which thereby reduces unwanted pregnancy rates. Mild discomfort and the minor post procedure complaints are taken care of well in puerperium. Higher rate of expulsion can be taken care of by early follow-up with regular visits and offering other safe and effective method of contraception.
HELLP syndrome and its implications on maternal and perinatal outcome
Authors: Kaur Amrit Pal , Kaur Navdeep , Dhillon S. P. S.
Published: February 2018

Background: The HELLP syndrome is characterized by hemolysis (H), elevated liver enzymes (EL) and low platelet count (LP). This syndrome in general complicates 0.2-0.6% of all pregnancies but its incidence increases to 4-12% in severe preeclampsia. In about 15% cases, HELLP syndrome presents without definitive criteria for preeclampsia (atypical preeclampsia). This present study will throw light on incidence, clinical and biochemical profile of patients with HELLP syndrome and maternal and perinatal outcome.Methods: A prospective study was conducted in the department of Obstetrics and Gynecology, Bebe Nanki Mother and Child Care Centre, Amritsar, India from January 2016 to August 2017 after approval from institutional ethics committee.Results: In the present study, total 2949 antenatal admissions were there during the course of study. Out of these patients, 352 patients had preeclampsia-eclampsia (11.93%). Out of these 352 patients, 71 complicated with HELLP syndrome (20.17%). 17.9% had partial HELLP and 2.3% had complete HELLP syndrome. 30.16% had only EL, 31.75% had only LP, 87.3% had elevated LDH (depicted hemolysis). 4.76% had both EL and LP, 30.16% had both EL and elevated LDH, 20.63% had both LP and elevated LDH levels. Majority of the patients presented after 36 weeks of gestation. Only 5 patients had HELLP syndrome in the postpartum period. Among partial HELLP patients, 59.02% delivered vaginally and 40.98% delivered by LSCS and among complete HELLP patients 28.6% delivered vaginally and 71.4% delivered by LSCS. Perinatal mortality rate was 43.7%. Severe maternal complications such as PPH, DIC, abruptio placentae, pulmonary edema and renal failure were seen high among HELLP patients.Conclusions: As the incidence is very high, one must be aware of its clinical and laboratory findings so that early diagnosis and treatment can be initiated. Close surveillance of the mother should be continued even after delivery.
Mifepristone-misoprostol combination in medical termination of early pregnancy
Authors: Pitale Devdatt Laxman
Published: February 2018

Background: Unplanned and unwanted pregnancies are common worldwide despite of the medical advancements and wider availability of contraceptive methods. The development of safe, effective, inexpensive, nonsurgical methods of abortion is thus highly desirable. Objective of present study was to evaluate the effectiveness of Mifepristone 200 mg orally followed by Misoprostol 800 µg intravaginally 48 hours later in women undergoing medical termination of early pregnancy (up to 63 days of gestational age).Methods: The present study included 100 pregnant women requesting termination of pregnancy in first trimester attending the department of Obstetrics and Gynecology. Women with gestational age up to 63 days from the first day of the last menstrual period with previous regular cycles were studied. Patients without medical or surgical contraindications to Mifepristone and Misoprostol were included.Results: Majority of the pregnant women belonged to the age group between 20-30 years. 30% of these women were nulliparous and 70 % were multiparous. The period of gestation varied from 35-63 days.90% of the patients had complete abortion and 10% had incomplete abortion. All the patients expelled the products of conception within 24 hours of prostaglandin administration. The adverse effects reported were nausea reported by 30%, vomiting by 5 %and diarrhea by 2% of the cases. None of the patients reported excess bleeding at the time of abortion, hospitalization or blood transfusion. This regimen has the effectiveness of complete abortion rate with few side effects.Conclusions: The Mifepristone- Misoprostol combination offers an effective, acceptable, out-patient procedure and an alternative to surgical methods of abortion in medical termination of early pregnancy (up to 63 days of gestation).
Comparative study of efficacy and adverse effects of different doses of vaginal misoprostol for cervical ripening 10-12 hours before diagnostic hysteroscopy
Authors: Gupta Taru , Ahmad Syed Nawaz , Kumari Sonu
Published: February 2018

Background: Hysteroscopy first described by Panteleoni in 1869 has evolved into a standard procedure for the diagnosis and treatment of intrauterine pathologies such as polyps, fibroids, septae, adhesions, evaluation of abnormal uterine bleeding, evaluation and treatment of infertility, removal of an intrauterine device or foreign body. Present study was carried out to compare the efficacy and complications different doses of vaginal misoprostol for cervical ripening10-12 hours before diagnostic hysteroscopy.Methods: It was a prospective and interventional, double-blinded randomized comparative study. Sixty women, fulfilling the inclusion criteria, requiring diagnostic hysteroscopy for evaluation of infertility were enrolled. The study subjects randomly received either 200μg (group 1) or 400μg (group 2) of vaginal misoprostol 10-12 hours before hysteroscopy with equal number of subjects in both the groups. Hysteroscopy was performed with a standard rigid 6 mm and 300 hysteroscope. The largest dilator that could be inserted without resistance was recorded as the baseline cervical dilatation. The ease of dilatation was recorded on a 5 point LIKERT scale. Procedural time was measured as time taken from the beginning of cervical dilatation to the visualisation of the uterine cavity.Results: The mean base line cervical width in group 1 was 6.41±0.29 mm while in group 2 it was 6.43±0.21 mm (p=0.084). In group 1, 26.6% patients had very easy entry, 53.4% had easy entry while in group 2, 30% patients had very easy entry, 43.4% had easy entry. The mean procedural time 35.5±6.9 seconds in group 1 and 33.2±6.8 seconds in group 2 (p=0.212). Adverse effects like abdominal pain, vaginal bleeding, shivering and fever  were observed more often in group 2 compared to group 1(p=0.038).Conclusions: Two hundred microgram of vaginal misoprostol is safer and equally effective as 400 μg for cervical ripening when used 10-12 hours before diagnostic hysteroscopy.
Prevalence of postpartum depression and association with risk factors in a tertiary care hospital
Authors: Guin Gita , Rawat Sarika
Published: February 2018

Background: Postpartum depression also known as postnatal depression is a non-psychotic depressive disorder of variable severity and it can begin as early as after delivery and can persist indefinitely if untreated. The objective of this study was to determine the prevalence of postpartum depression by Edinburgh postnatal depression scale and to evaluate the factors predisposing to postpartum depression.Methods: The present prospective observation study was conducted in the Department of Obstetrics and Gynaecology, Netaji Subhash Chandra Bose Medical College, Jabalpur from 1st March 2015 to 31st August 2016. Participants were screened for postnatal depression using EPDS. A risk factor questionnaire that covered key socio-demographic and obstetrics factors were also completed by all the subjects. Main outcome measure: prevalence of a score of 13 or higher, on the EPDS. The data of the present study was recorded into computer and after proper validation, error checking, coding and decoding, the data was compiled and analysed using the SPSS Window, Appropriate univariate and bivariate analysis were carried out using the fisher exact test or Chi-square test for categorical variables.Results: The present study concludes that the prevalence of postpartum depression is 12.8% (64/500) amongst postnatal women admitted of Obstetrics unit of NSCB Medical College, Jabalpur (Madhya Pradesh) since the prevalence of an EPDS score ≥13 (which is suggestive of PPD) was found in a significant proportion of women, screening for PPD is indicated in all postpartum subjects to identify and promptly treat these women. Identification of a clear association between certain risk factors and PPD will lead to a prompter diagnosis of PPD.
The effect of seasonal variation on the delivery rate: a retrospective study
Authors: Pal Reena , Gandotra Nikita
Published: February 2018

Background: We are living in a second most populated country in the world where many social, cultural and ecological processes and events occur regularly every year. These seasonal processes influence many vital rates including birth rates. The objective of this study was to assess the effect of seasonal variation on the delivery rate in tertiary care centre.Methods: A retrospective descriptive study carried out in Government Doon Medical College Dehradun. We extracted total number of delivery over five years period from hospital records (2012-2016) and analyzed the figures for monthly variation in delivery rates. This was repeated for a standardized 30-day month and the findings compared.Results: The total number of deliveries during the study period were 43,892 with an average of 3,657 deliveries per month. The highest rate of delivery was in the August month and lowest one was in the month of April. The monthly distribution of delivery rate also showed sinusoidal pattern.Conclusions: There is significant seasonal variation in monthly distribution of delivery rate. There are maximum conception rates are in winter season and minimum conception is in summer season. These findings will prove valuable in health system planning and in the interpretation of seasonal variations in other reproductive parameters.
Impact of infertility on marital relationships among infertile couples attending OPD of a tertiary health care centre
Authors: Kushwaha Chhaya , Sinha Parul , Gupta Uma , Srivastava Kumkum
Published: February 2018

Background: There is little empirical literature on the effects of infertility on marital relationships in India. This study was sought to examine the impact of infertility on the marital relationships of the couple at Eras Lucknow Medical College and Hospital.Methods: This is a descriptive cross-sectional design conducted on infertile women presenting in OPD (outpatient department) of Obstetrics and Gynecology Department of Era’s Lucknow Medical College and Hospital. A self-developed questionnaire was used for collecting data for the study. The questionnaire was divided into 5 sections: A to E. Data was presented in the form of descriptive statistics such as proportion and percentage.Results: This study revealed that infertility affected the sexual life of participants as it was reported that even though they still had regular sexual intercourse with their partners after realising they were infertile (64.5%), sex was only for the purpose of reproduction and not for mutual sexual satisfaction (13%). Sexual intercourse was reported to be unfulfilling as well as unenjoyable (16.4%). The psychological well-being of participants (29.60%) and stability within marital unions were also negatively affected by infertility, resulting in quarrels (13 %).Conclusions: Infertility has numerous negative implications for marital relationship. Thus, infertile persons should not be only physically examined and treated for infertility but should also be given counselling to lessen the psychological trauma attached to infertility.
Iniencephaly: a rare birth defect
Authors: Singh Alpana , Gupta Vasudha , . Amrita
Published: February 2018

Iniencephaly is form of neural tube defect which includes occipital bone defect at foramen magnum along with fixed retroflexion of fetal head and absence of fetal neck. Incidence of iniencephaly is 0.1-10 in 10,000 pregnancies. There is a known female predilection for this condition. Iniencephaly has a poor prognosis. It can be diagnosed antenatally by raised maternal serum alpha-fetoprotein and typical ultrasound features. Termination should be advised to patients who present before 20 weeks. Herein we are describing a case of iniencephaly who presented at 27 weeks of gestation with a brief review of literature.
A rare case of early onset severe preeclampsia with PRES
Authors: Singh Sanjay , Maji Debkalyan , Vardhan Shakti
Published: February 2018

Posterior reversible encephalopathy syndrome (PRES) is a cliniconeuroradiological syndrome. Patients usually present with seizures, visual disturbances, headache, and altered mental state. Most accepted pathophysiology is vasogenic edema. Imaging predominantly shows parieto-occipital white matter changes. We report a 22-year-old G2P1L1 lady who presented at 23 weeks 2 days period of gestation (POG) with high blood pressure (160 /104 mm of Hg) and headache and later on developed diminished vision too. There was no sensory motor deficit. After evaluation a plan of termination of pregnancy was made, in consultation with the patient and her husband. She was put on prophylactic dose of Inj. MgSO4 and anti-hypertensives and termination of pregnancy was done with intracervical application of PGE2 gel followed by vaginal PGE1 tablet (Misoprost) application. Her vision and headache however, didn’t improve even though she was put on Inj. MgSO4 and BP was controlled with antihypertensive. She delivered within 10 hours. In view of persistence of her symptoms, a MRI brain was done in consultation with a neurophysician, two hours after the delivery that suggested edema in occipital and temporal lobe suggestive of posterior reversible encephalopathy syndrome. Approximately 6-8 hours after delivery, gradual clinical improvement in visual acuity and headache was noted. Her vision completely recovered in 6 days. This case highlights the importance of keeping this entity in mind for the prompt diagnosis and early management, thus preventing short and long-term neurological deficits in this reversible condition popularly known as PRES.
Are humans encroaching too much? man versus bear
Authors: Sanyal Aparesh , Rawat Kinnari A. V. , Das Sanjoy , Dvivedi Sanjay , Rajan Manu , Zaidi Rihan
Published: February 2018

Background: Uttarakhand is a hilly state inhabited by various wild animals. Human encroachment into the forest areas has increased the encounters between humans and wild animals. Encounters have been on the rise and bear mauling seems to be one of the leading causes of wild animal attacks with grievous results.Methods: The study was conducted in the Department of Plastic and Reconstructive Surgery, Himalayan Institute of Medical Sciences (HIMS), Swami Ram Nagar, Dehradun, Uttarakhand, India from November 2016 to February 2017. After obtaining written informed consent from the patient a data pertaining to history of injury, time of hospital arrival, number of operative procedures, time of hospital stay, complications were recorded.Results: The injury timing of bear mauling was maximum during 12pm-8pm in 3 cases. Mean length of hospital stay was 19 days. Three cases (42.85%) of wound dehiscence were due to margin necrosis. Amongst the permanent damages suffered, were loss of vision in one eye in 1 case (14.28%), facial disfigurement in the form of contour deformities in 2 cases (28.57%), ectropion and facial nerve palsy in 1 case (14.28%) and parotid fistula in 1 case (14.28%).Conclusions: Encroachment and deforestation have led to an increase in injuries caused by the Himalayan black bears. Ominous effects seen in the changing climatic pattern largely due to global warming could be a possibility of causing altered living habitat for the bears in this Garhwal region getting more aggressive day by day.
A prospective study of accuracy of modified Alvarado score in patients with acute appendicitis in tertiary care hospital
Authors: Parihar Suman , Parihar M. S. , Kumawat J. L. , Joshi C. P.
Published: February 2018

Background: Acute appendicitis is the most common acute emergency of the abdomen. Clinical diagnosis of acute appendicitis is challenging in most of situation. The present study was designed to evaluate the role of modified Alvarado scoring system in diagnosis of acute appendicitis.Methods: One hundred consecutive patients presenting in the department of surgery Geetanjali Medical College and Hospital from January 2014 to 2016 were included. Demographic characteristics, symptoms and signs, laboratory results were recorded. Data was collected using a pre-tested questionnaire and analyzed using statistical calculation.Results: In the present study 100 patients were studied in a period of two years. Maximum percentage of patients were in age group 20-30 years and males dominated the series. The sensitivity and specificity of modified Alvarado score was 91.57% and 76.47% respectively with positive predictive value 95% and negative predictive value 65% and diagnostic accuracy of 89%.Conclusions: This study shows that use of modified Alvarado scoring system in patients with acute appendicitis provides a high degree of diagnostic accuracy.
Early versus delayed enteral feeding in acute pancreatitis
Authors: B. D. Manjunath , G. Abhishek
Published: February 2018

Background: Early enteral feeding through a nasoenteric feeding tube is often used in patients with acute pancreatitis, as compared to previous notion of pancreatic rest. This study aims to compare various outcomes of early and late enteral feeding in severe acute pancreatitis.Methods: This study was a randomized trial conducted at Victoria hospital, Bengaluru between July 2016 and June 2017. Patients with severe acute pancreatitis were randomized into early enteral feeding and late enteral feeding groups in the ratio of 1:1. Early enteral feeding group were started on oral feeds within 24 hours of admission. Late enteral feeding group were started on oral feeds after 72 hours of admission. Patient demographics, clinical findings, investigations, length of hospital stay, complications were assessed and compared.Results: In 124 out of 132 patients were included who met inclusion criteria. The mean age of patients was 28.6 years. There were 120 males (96.7%) and 4 females (3.2%). There were no significant differences in age, sex ratio and comorbidities between the two groups. Early enteral feeds group showed lesser number of gastrointestinal adverse effects after initiation of enteral feeds, lesser number of days taken to develop full tolerance to enteral feeds, lesser number of days of admission, lesser complications like necrotizing pancreatitis, single or multiple organs failure, lesser number of ICU admissions, requiring mechanical ventilation, including lesser mortality when compared to delayed enteral feeds group.Conclusions: Patients with severe acute pancreatitis can safely be started on early enteral feeds within 24 hours of admission.
Low pressure pneumoperitoneum and intraperitoneal infusion of normal saline for reducing shoulder tip pain after gynecologic laparoscopy: randomized controlled trial
Authors: Sallam Hany F. , Shady Nahla W. , Aly Huda F. , Abo Elfadl Ghada M. , Abbas Ahmed M.
Published: February 2018

Background: To estimate the effectiveness of combined low-pressure pneumoperitoneum (8mmHg) and intraperitoneal normal saline infusion on reducing the incidence and severity of postoperative shoulder tip and upper abdominal pain.Methods: A prospective randomized controlled study was carried out in Aswan University Hospital, Aswan, Egypt. Author included patients undergoing laparoscopic surgery in the laparoscopy unit either diagnostic or operative. They were randomized into two groups: (intervention group) which compromised of 47 patients who underwent low pressure pneumoperitoneum plus intraperitoneal saline infusion and (control group) which included 47 patients underwent standard pressure pneumoperitoneum. The primary outcome of the study is the difference in the mean shoulder tip and upper abdominal pain score postoperatively between the two groups.Results: There was significant reduction in the shoulder tip pain and upper abdominal pain 1, 4, 8, 12 and 24 hours post-operatively shown by visual analogue scale pain scores in the intervention group compared to control (p=0.000). Additionally, there was a significant reduction in the incidence of nausea and vomiting in the intervention group than control group (p=0.000 and p=0.007 respectively). There was no significant difference regards abdominal distention, time of resumption of intestinal peristalsis, operation duration and post-operative hospital stay between the two groups.Conclusions: This study clearly depicts that combined low pressure pneumoperitoneum and intraperitoneal saline infusion is an easy, safe and inexpensive method that significantly reduces the post laparoscopic shoulder tip pain and upper abdominal pain.
Predictive factors of surgical site infections in abdominal wall hernias
Authors: Keswani Siddharth , Akhtar Murtaza , Saxena Divish , Deshpande Gayatri
Published: February 2018

Background: Surgical site infections (SSI) are infections presents in any location along the surgical tract after a surgical procedure. Knowledge of predictive factors associated with SSI is important for planning remedial measures. Abdominal wall hernia repair is a common procedure in general surgery practice and knowing the predictors of SSI in these clean surgeries requiring placement of mesh is the aim of the present study.Methods: In a hospital based longitudinal study the subjects were diagnosed cases of anterior abdominal wall hernias undergoing planned or emergency surgeries. Patients of either gender and age group of 18 to 80 years were included in the study. Patients undergoing laparoscopic hernia repair were excluded. The study factors were patient and the surgeon related factors like laboratory parameters, surgeon experience etc. The outcome was SSI assessed with up to 30 days post-operative follow up.Results: Total 198 patients were enrolled with a mean age of 42.49±15.72 years and male preponderance. Overall SSI rate was 9.09% and in planned cases it was 7.07% and 50% in emergency cases. Pre-operative hospital stays of >5 days was the only patient factor associated with increased risk of SSI (p=0.0004) and operating surgeon’s experience was associated with increased risk if SSI i.e. cases operated by junior surgeons had a higher risk of SSI (p=0.013).Conclusions: The only modifiable factor associated with SSI was pre-operative hospital stay of >5 days while high incidence of SSI with junior surgeons cannot be modified in a teaching institute.
Study of burst abdomen: it’s causes and management
Authors: Jaiswal N. K. , Shekhar Sandeep
Published: February 2018

Background: Burst abdomen (abdominal wound dehiscence) is a severe post-operative complication. Burst abdomen is defined  as post-operative separation of abdominal musculo-aponeurotic layers.  The  study aims to find etiological factors of burst abdomen in hospitalised patients ,evaluate current management  methods and to compare conservative and operative approach with respect to complication and outcomes.Methods: All cases presenting with abdominal wound dehiscence after surgery were included. An elaborate clinical history was taken in view of the significant risk factors, the types of surgery performed , type of disease involved and management methods and their outcome. A total of 82 cases were included in this prospective study. Data was analysed using appropriate software.Results: The results concluded that male patients have a higher incidence of laparotomy wound dehiscence and in 5th decade. Patients presenting with peritonitis secondary to gastro-duodenal perforation are more prone to burst abdomen.Conclusions: Burst abdomen is a serious sequel of impaired wound healing. Presence of anaemia,  hypoproteinemia favours high incidence of burst abdomen. Delayed suturing,  of burst abdomen has a lower frequency of complications . Adherence to proper technique and sincere efforts to minimize the impact of the predisposing factors play a much larger role in both treatment and prevention of this condition.
Comparative study of aspiration versus non-aspiration fine needle technique in thyroid nodule and its correlation with post-operative histopathological examination
Authors: C. Harish Kumar , C. Yaam Kumar
Published: February 2018

Background: Thyroid gland is unique of all endocrine glands because it is the largest, superficial and the only one amendable to direct physical examination. A discrete swelling in one lobe and with no palpable abnormality elsewhere is termed as solitary swelling. Fine needle aspiration cytology (FNAC) is the investigation of choice in solitary thyroid swellings. There is another technique fine needle non aspiration cytology (FNNAC) which avoids aspiration but still permits cytologic review of the swellings which can also be done in thyroid swellings. The objective of the study was to compare and analyze the preoperative efficiency of FNAC vs FNNAC in solitary thyroid nodules and its correlation with post-operative histopathological examination findings.Methods: A total of 72 patients presenting with thyroid nodule in this hospital in BMCRI, Bengaluru during period of January2017 to December2017 underwent both FNAC and techniques. 23 G needles was used for both FNAC and FNNAC. FNAC was performed using needle and a syringe using aspiration. In FNNAC technique the needle held between thumb and fore finger of one hand was gently inserted into the nodule and was moved in different directions. Material entering the needle hub by capillary action was then expressed onto clean glass slides after attaching syringe filled with air to it and smears were prepared. Cases which underwent total/hemi thyroidectomy, the specimen was sent to pathology department in 10% formalin solution.Results: FNNAC produced diagnostically superior samples and less diagnostically inadequate samples than FNAC.Conclusions: As thyroid is a vascular and a colloid organ, in FNAC aspiration gives blood/colloid with less cellular architecture in most of the cases. In FNNAC cellular architecture was preserved with less blood/colloid background which aids in easier cytological diagnosis. Hence FNNAC is a better technique than FNAC in cytological diagnosis of solitary thyroid nodule.
A clinico-endoscopic study of upper GI disorders in rural population
Authors: Ainapure Ramesh , Tanga Vishal
Published: February 2018

Background: Upper gastrointestinal disorders are commonly seen in routine clinical practice. The definitive diagnosis of upper gastrointestinal disorders rest on endoscopic evaluation and biopsy if required for planning proper treatment. The objectives of the study were to determine the spectrum of disease in upper gastrointestinal tract and to establish endoscopy as an effective tool in the proper diagnosis of various upper gastrointestinal tract disorders.Methods: A prospective study was conducted among patients who presented with upper gastrointestinal symptoms at Gadag Institute Medical College, from August 2016 to August 2017, Gadag. After history taking and physical examination, patients were subjected to fibre-optic upper GI scopy.Results: The result of present study showed male predominance associated with the upper GI disorders. Gastritis (45.65%) was the most common finding followed by normal exam (17.39%), GERD (6.83%), oesophageal cancer (2.17), Oesophagitis (4.34), gastric ulcer (9.31%), and gastric cancer (3.10%), duodenitis (5.90%) and oesophageal varices at 5.27% Gastritis is the most common upper GI disorder seen the patient population.Conclusions: Upper GI endoscopy is an effective and appropriate approach for initial investigation to assess patients with GI symptoms. Thus, it helps early management gastric disorders.
A rare complication of prosthetic mesh repair of a ventral incisional hernia: erosion and enterocutaneous fistula formation
Authors: M. Sridhar Reddy , M. Naresh , Rath Alok , M. A. Saleem
Published: February 2018

Recurrence of hernia has significantly reduced with mesh repair. But mesh is a foreign material which has its own complications like haematoma, infection, sinus formation, mesh migration and erosion. Mesh migration and erosion although rare, is a challenging complication which requires surgical intervention. There are very few such mesh related complications reported in the literature. Authors report a case of mesh erosion resulting in chronic infection and formation of enterocutaneous fistula following incisional hernia repair 5 years after surgery. In this case small bowel segment containing mesh was resected and primary anastomosis was done. Migration of mesh also depends on the nature of mesh (biomaterial) and type of fixation. Although many techniques of hernia repair have been described (open or laparoscopic) care must be taken to fix the mesh to abdominal wall for prevention of delayed complications. Different techniques of repair, types of meshes have been discussed to prevent such complications.
Subhyoid ectopic thyroid with a solitary colloid nodule in a 10-year-old girl: a rare diagnostic entity
Authors: Chawla Meghna , Naik Ajay , Naik Prashant
Published: February 2018

Ectopic thyroid is a rare clinical entity, of which its presence in a subhyoid location is uncommon. It is equally rare to find a solitary thyroid nodule in the paediatric age group. We report a case of subhyoid ectopic thyroid in a 10-year-old girl, and its course over a span of 3 years. It was associated with a solitary colloid nodule, which eventually became symptomatic and did not respond to suppressive levothyroxine therapy. Hence surgical excision was done, and the child was put on replacement doses of levothyroxine.
Cognitive Processes on Tradicional, Pentecostal and Neopentecostal Views on Protestant Religion
Authors: Amorim Jéssica Florinda , Marques Sarah Cassimiro
Published: February 2018

This article produces a relative research accomplished to the gospel population as experimental group, and, as control group, subjects that doesn’t attend any religious institution. Based on neuropsychology and psychology of religion, its purpose to evaluate the flexibility cognition of subjects that are immersed in several protestant contexts. This results pointed significant differences among researched groups.

Processos Cognitivos nas Vertentes Tradicional, Pentecostal e Neopentecostal da Religião Protestante

O presente artigo apresenta uma pesquisa comparativa realizada com a população evangélica como grupo experimental, e como grupo controle indivíduos que não frequentam instituições religiosas. Baseada na neuropsicologia e na psicologia da religião, objetivou-se avaliar a flexibilidade cognitiva de indivíduos inseridos nos diversos contextos protestantes. Os resultados apontaram diferenças significativas entre os grupos estudados.
La creación sinfónica tras el III centenario del Quijote. El compositor Emilio Serrano y su obra de temática cervantina
Authors: Alonso Pérez-Ávila Beatriz
Published: February 2018

Emilio Serrano y Ruiz (1850-1939) es una figura de relevancia fundamental para comprender la música española de finales del siglo XIX y principios del XX. A pesar de que su labor compositiva destaca por presentar obras de envergadura en todos los géneros, Serrano es recordado exclusivamente como autor lírico. Sin embargo, recientes investigaciones muestran un catálogo sinfónico de primera línea en el que destacan dos poemas sinfónicos dedicados a la inmortal obra de Cervantes, compuestos bajo el fervor cervantino de la celebración del III centenario (Alonso, 2015). En este artículo se presentan La primera salida de Don Quijote de la Mancha y Don Quijote de la Mancha, canto segundo. Los molinos de viento, revisándose las interpretaciones en concierto, estableciendo las características del lenguaje compositivo del autor y, finalmente, se sitúan en el contexto de su época.
Análisis de la β-Galactosilceramidasa leucocitaria en pacientes Colombianos con sospecha clínica de enfermedad de Krabbe, un tamizaje de alto riesgo.
Authors: Jay Garcia Lina Manuela , Uribe Ardila Alfredo , Ayala Fajardo Adis
Published: February 2018

La Enfermedad de Krabbe (EK), es un desorden del metabolismo de esfingolípidos de herencia autosómica recesiva causada por la deficiencia de β- galactosilceramidasa (β-Galsil) (E.C. 3.2.1.46), defecto enzimático que causa un cuadro neurodegenerativo, hipertonía muscular y espasticidad, convulsiones, pérdida de la audición y en un 85% de los casos la muerte temprana, entre otros hallazgos.La incidencia de la EK documentada para Estados Unidos y Europa es de 1:100.000 recién nacidos, pero estudios recientes han demostrado valores mayores de 1:22.000 aproximadamente en New York.  En América Latina los informes son escasos, con reportes de tamizaje de alto riesgo en Brasil y casos aislados en México, ofreciendo un panorama de subdiagnóstico importante, situación a la que no es ajena Colombia, donde no hay en la literatura referentes a la enfermedad.Se presenta entonces a la comunidad científica, un estudio de valores de actividad y de referencia para la enzima β-Galactosilceramidasa leucocitaria, a partir de 259 muestras de 110 individuos sanos y 149 pacientes con compromiso neurodegenerativo (CND). La valoración enzimática involucró dos métodos (Colorimétrico y Fluorométrico) de punto final que permitieron establecer un rango de referencia para β-Galsil en técnica Colorimétrica: 2,04 -14,93 nmol/mgprot/h y en técnica fluorométrica: 0,3 – 4,21 nmol/mgprot/h. El estudio de tamizaje permitió identificar un paciente afectado con enfermedad de Krabbe quien presentó valores de actividad expresados en nmol/mgprot/h de 1,85 y 0,034, en forma correspondiente para las técnicas antes descritas. Un hallazgo final que permite validar los dos métodos estandarizados para el diagnóstico de la enfermedad y establecer valores de referencia en población colombiana.
Determinación de la seroprevalencia de cisticercosis porcina e identificación de teniasis humana en personas criadoras de cerdos en el área urbana del municipio de Coyaima Tolima
Authors: Giraldo Forero Julio César , Riaño Rodríguez Milena Marcela , Vásquez Arteaga Luis Reinel
Published: February 2018

Introducción: La cisticercosis porcina causada por la etapa larval de Taenia solium, ocasiona graves pérdidas económicas para sus tenedores y un riesgo para la salud pública en Colombia y en el mundo especialmente en Asia, África y otros países de Latino América. Esta parasitosis se propaga con facilidad en zonas con condiciones higiénicas sanitarias, ambientales y socio económicas precarias. Objetivo: Determinar la seroprevalencia de cisticercosis porcina empleando el ensayo inmunoenzimático (ELISA) y la detección de teniasis humana por examen coproparasitológico en personas criadoras de cerdos en el área urbana.Materiales y Métodos: Se tomó muestra de sangre a 102 porcinos por punción en el pabellón auricular y se impregnaron en discos de papel de filtro para detectar anticuerpos anticisticerco empleando la técnica de ELISA con la fracción antigénica de 53kDa. A los tenedores de porcinos y demás participantes conformado por un grupo de 159 personas, se les solicitó una muestra de heces, que fue conservada en reactivo de Mertiolate Yodo Formol al 5%(MIF). Se preservó a 4°C, para su procesamiento se empleó la técnica de concentración de formol-éter, el diagnóstico se realizó por observación microscópica con objetivo de 40X.Resultados: De los 102 porcinos, el 17% (17/102) presentaron anticuerpos anticisticerco. Con respecto a las variables sociodemográficas del estudio se observó mayor asociación con fuentes de agua, pacientes teniásicos, condiciones ambientales, tipo de alimentación. La prevalencia general de parasitismo intestinal en los criadores fue de 43.3%, y en el 11.1% (3/159) se hallaron huevos de Taenia spp, Se identificó a las fuentes de agua y la tenencia de porcinos como variable estadísticamente significativa (p≤0,005) con la presencia de parasitismo intestinal en la comunidad.Conclusión: El estudio reveló un valor significativo de seroprevalencia de cisticercosis porcina en el área evaluada, ocasionando un serio problema de salud pública en la comunidad coyaimuna.
Prevalencia del riesgo de trastornos de la conducta alimentaria en una población de estudiantes de secundaria, Bogotá - Colombia
Authors: Fajardo Esperanza , Méndez Carolina , Jauregui Alfonso
Published: February 2018

Objetivo: Describir la prevalencia de riesgo de trastornos de la conducta alimentaria, estado nutricional y consumo de alimentos en una población escolar de secundaria de colegios públicos y privados.Materiales y Métodos: Aplicación del cuestionario SCOFF, toma de medidas antropométricas y encuesta de frecuencia de consumo de alimentos a 671 estudiantes de dos colegios públicos y dos privados de la ciudad de Bogotá.Resultados: Se encontró una prevalencia del 30,1% de riesgo de presentar TCA; de ésta, el riesgo en las mujeres es de 41,3%. En cuanto al estado nutricional se observó mayor frecuencia de riesgo en la clasificación normal y en instituciones públicas con un 31,3%. Del total de la población 7,6% presenta talla baja, 16% exceso de peso y 5,1% bajo. Conclusiones: La prevalencia de riesgo de trastornos alimentarios es mayor en las mujeres, con clasificación nutricional normal (73,7%) y en instituciones educacionales públicas.
Globicatella sanguinis: reporte de un caso de meningitis en el Hospital Militar Central
Authors: Díaz Martínez Sergio , Villán Gaona Jorge Luciano , Vega Hurtado Samuel , Pachón Barinas Diana Patricia , Caballero Restrepo Alberto Fabio
Published: February 2018

Globicatella sanguinis es un microorganismo patógeno poco común, coco Gram positivo y catalasa negativo, aunque se aísla en ganado ovino, ha sido descrito como agente infeccioso causante de meningitis en seres humanos. La primera descripción de este patógeno fue realizada por Collins y colaboradores en el año de 1992, se debe resaltar, que antes de este suceso, parte de los casos reportados como meningitis por S. viridans, pudieron ser causados en realidad por G. sanguinis debido a la falta de identificación de este ultimo y a la gran similitud en cuanto a morfología y resultados de pruebas bioquímicas. Al respecto, desde la descripción original hace 20 años, la información disponible de G. sanguinis es escasa. Se ha presentado un caso de meningitis asociada a G. sanguinis posterior a un procedimiento quirúrgico en un paciente de 1 año de edad en el Hospital Militar Central.
Evaluación clínica de meningioma intraventricular: reporte de caso paciente pediátrico y paciente adulto.
Authors: Álvarez Pinzón Andres Mauricio
Published: February 2018

Los Meningiomas intraventriculares (IVM) representan el 0,5-5% de todos los meningiomas, de los cuales aproximadamente un 80% se localizan en el trígono del ventrículo lateral. Se originan en los ventrículos del tope células aracnoideas contenidos en el plexo coroideo constituyen el grupo tumoral intracraneal frecuente en adultos. En la mayor parte de los casos, se trata de tumores histológicamente benignos, de crecimiento lento. Los meningiomas primarios intraventriculares   suponen   entre   el   0,5   y   el   3% de   los   meningiomas intracraneales. No son comunes en población pediátrica ya que   comprenden menos del 3% de los tumores cerebrales pediátricos y sólo 1.5 a 1.8% de todas las neoplasias intracraneales. Los tumores pediátricos también muestran una asociación con neurofibromatosis tipo 2 y la exposición anterior a radiación.Se presenta el contraste de dos   casos de meningioma intraventriculares en paciente pediátrico y adulto. La edad y el sitio de la lesión en paciente pediátrico es poco común. La escisión de la lesión y tratamiento pronto permitió la cesación de los síntomas en los 2 pacientes
Cadeias de Produtos da Sociobiodiversidade no Sul do Brasil: Valorização de Frutas Nativas da Mata Atlântica no Contexto do Trabalho com Agroecologia
Authors: Ramos Mariana Oliveira , Cruz Fabiana Thomé da , Souza Gabriela Coelho de , Kubo Rumi Regina
Published: February 2018

O presente artigo discute o conceito de cadeias de produtos da sociobiodiversidade, identificando elementos definidores e ameaças presentes na consolidação desses arranjos socioprodutivos. A partir de tais entendimentos, descreve analiticamente experiências em curso no sul do Brasil envolvendo a construção de cadeias de frutas nativas da Mata Atlântica, protagonizadas especialmente por atores identificados com o campo agroecológico e o socioambientalismo. A metodologia usada baseia-se na revisão de literatura e sistematização inicial de dados de campo de pesquisa qualitativa desenvolvida nos Estados de Santa Catarina e Rio Grande do Sul. Como resultado, faz-se uma descrição do atual ambiente organizacional dessas cadeias, bem como uma sistematização de aspectos socioprodutivos, envolvendo produtos, mercados, gargalos e implicações de tais arranjos em alternativas de renda para famílias agricultoras, conservação ambiental e melhorias na alimentação e nutrição de agricultores e consumidores das regiões envolvidas. As cadeias do açaí juçara e de outras frutas nativas (como o butiá, a guabiroba e o araçá) têm comportamentos diferentes e, ainda que de maneira preliminar (uma vez que se trata de pesquisa em andamento), podem-se perceber ameaças e desafios distintos para cada uma destas, incluindo potencial redução do protagonismo de agricultores familiares e extrativistas na cadeia do açaí juçara. Reforça-se a importância da continuidade de ações de fomento, tanto na forma de investimentos diretos nos empreendimentos associativos e familiares, como nas ações de organização social e qualificação das diferentes etapas da cadeia promovidas pela extensão rural comprometida com os princípios da agroecologia, economia solidária e segurança alimentar e nutricional.
“Agora Entrou Água”: Sobre Experiência e Estratégias de Sobrevivência Entre Pescadores Artesanais em uma Vila Amazônica
Authors: Silva Darnisson Viana
Published: February 2018

Este artigo versa sobre o modo de vida contemporâneo de uma família de pescadores artesanais no distrito de Alter do Chão, Santarém/PA. Trata-se de estudo exploratório cujas análises buscam estabelecer a hipótese de que os atores sociais envolvidos na pesquisa mobilizam diferentes manobras e estratégias para escapar das dificuldades encontradas no seu ofício “primordial”, a pesca. Novas configurações sociais do vilarejo e o avanço de forças econômicas externas tensionam a reprodução social e a condição de pescador artesanal local. Os dados coletados em campo a partir de imersão etnográfica apontam para aspectos do modo de vida desses atores sociais que os aproximam da caracterização de pescadores polivalentes nos termos de Furtado (1990, 1993) e os quais sinalizam para a necessidade de uma abordagem que leve em consideração as particularidades histórico-geográficas, trajetórias individuais e situações relacionais. Assim, conclui-se em primeira instância que o entendimento nativo dos pescadores sobre os significados da experiência e da estratégia de sobrevivência é de grande valia tanto nas “artimanhas” para capturar o peixe quanto nas “artimanhas do viver” e que contextos multiculturais em decorrência, sobretudo, da consolidação do turismo na pequena localidade podem gerar novas visões de mundo a partir do contato entre culturas.
Etnoictiologia de Pescadores Artesanais da Comunidade Surucuá (Reserva Extrativista Tapajós-Arapiuns)
Authors: Silva Josele Trindade da , Braga Tony Marcos Porto
Published: February 2018

Este estudo teve por objetivo descrever o conhecimento local dos pescadores artesanais da comunidade de Surucuá (Reserva Extrativista Tapajós-Arapiuns) sobre aspectos das interações tróficas entre os peixes, o uso de hábitats voltados para alimentação ou reprodução e suas relações com atividade pesqueira. Os resultados foram condizentes com a literatura científica e revelaram um saber detalhado sobre as estratégias de sobrevivência das principais espécies no ambiente, permitindo aperfeiçoar a captura dos peixes. Por fim, destaca-se um melhor aproveitamento destes conhecimentos que podem ser utilizados como ferramentas participativas de pesquisa e na elaboração de regras de gestão dos recursos pesqueiros nesta área.