bluuebunny/crossref_metadata_2025 huggingface dataset:
Serological study of toxoplasmosis spread among unmarried female university students using LAT, ELISA and IgG avidity
Authors: AL-Mossawei Muna Turky , Mossawei Hind Majeed AL- , AL-Dujaily Khitam Yahya
Published: December 2016

Toxoplasma gondii has a worldwide distribution and it is one of the most prevalent infectious agents in Iraq. The study was conducted on 200 serum samples of unmarried female university of students age ranged between 18 to 26 years to detect Toxoplasma gondii antibodies. The aim of this study was to detect T. gondii antibodies among unmarried female students in Iraqi universities using different serological tests. Seventy six (38%) serum samples out of 200 subjects were positive for toxoplasma antibodies by Latex agglutination test (LAT). Among 76 LAT sera positive ,only 58 (29%) serum samples were positive with toxoplasma IgG ELISA test , however , the results of IgM ELISA assay were positive only for 3 (1.5%) unmarried female sample .None of negative LAT serum samples gave positive results with neither IgG nor IgM ELISA.
Haematological and Genotoxic effects of cadmium chloride on Mesopotamichthys sharpeyi
Authors: Salman Noor M. , Al-Rudainy AbdAlmotalib J.
Published: December 2016

The present study investigated Haematological changes in Mesopotamichthys sharpeyi, as well as determination genotoxic effects of cadmium chloride on bunni fish by using 120 fingerlings, fish were distributed randomly into four treatments in addition to control group. Fish in first group treated (T1) with cadmium 0.093mg/L with changing water and added cadmium continuously, fish in the second group treated (T2) with cadmium 0.093mg/L with changing water without adding cadmium, third treatment (T3) with cadmium 0.046mg/L with changing water and adding cadmium continuously, and fourth treatment (T4) with cadmium 0.046mg/L with changing water without adding cadmium. Results of blood picture in T1 and T3 showed a significant reduction in red blood cells count, hemoglobin concentration, packed cell volume values, while the number of white blood cells showed a significant increase in its values. Results showed presence of improvement of clinical and microscopical signs and blood picture in T2 and T4, were changed water aquarium continuously and added cadmium only once compared withT1 and T3.
Results of the present study concluded that changing water aquarium in the treatments without adding cadmium led to improvement of health status of fish which increased with the passage of time results of blood picture were almost the same of the control group. It could be concluded from the current study that the adding of cadmium to water aquarium containing bunni fish led to decrease in red blood cells count, hemoglobin and packed cell volume values and increase in micronuclei number.
Biochemical Study on Anti Thyroid Peroxidase in Type 2 Diabetic patients with thyroid disorders
Authors: Al–A'araji Sanad B. , Rasen Taufeek F. , Kadhum Reiam A.
Published: December 2016

Type 2 diabetes mellitus (T2DM) is the most frequent endocrinal disease commonly associated with thyroid disorders .The study is conducted at the Specialized Center for Endocrinology and Diabetes in Baghdad ,during December 2014 up to October 2015.This study was done to investigate the prevalence of anti- thyroid peroxidase (Anti-TPO) antibody in patients suffered from type 2 diabetes with thyroid disorders .The study groups included a total number of 80 subjects consisting of 60 type 2 diabetic patients divided into 20 hyperthyroidism subjects (group 1) ,20 hypothyroidism subjects (group 2), 20 euthyroidism subjects (group 3) and 20 healthy controls (group 4) . The fasting blood samples were analyzed for (T3,T4,TSH) by using Vitek Immuno diagnstic Assay System (VIDAS). Enzyme Linked Immunosorbent Assay (ELISA) is used to detect anti-thyroid peroxidase (Anti-TPO) antibody .The results show that age, gender and BMI (body mass index) have significantly higher levels in the patients groups as compared to the healthy group at (p
Transition Metal Complexes with Tridentate Ligand: Preparation, Spectroscopic Characterization, Thermal Analysis and Structural Studies
Authors: Al-Hamdani Abbas Ali Salih , Hamoodah Rehab Ghalib
Published: December 2016

New series of metal ions complexes have been prepared from the new ligand 1,5- Dimethyl-4- (5-oxohexan-2- ylideneamino) -2-phenyl- 1H-pyrazol-3 (2H)-one derived from 2,5-hexandione and 4-aminophenazone. Then, its V(IV), Ni(II), Cu(II), Pd(II), Re(V) and Pt(IV) complexes prepared. The compounds have been characterized by FT-IR, UV-Vis, mass and 1H and 13C-NMR spectra, TGA curve, magnetic moment, elemental microanalyses (C.H.N.O.), chloride containing, Atomic absorption and molar conductance. Hyper Chem-8 program has been used to predict structural geometries of compounds in gas phase, the heat of formation, (binding, total and electronic energy) and dipole moment at 298 K.
Synthesis of new Polyimides Derived from 4- minoantipyrine
Authors: Al-Bayati Sameaa J. K. , Sadiq Amaal S. , Mahmood Wasan A. R.
Published: December 2016

In the present study, new five polymers of acryloyl chloride have been synthesized by reaction 4-aminoantipyrine with many substituted acid chloride (A-E). Then condensation of polyacryloyl chloride with the product in one step (A-E), in a suitable solvent in the presence amount of (Et3N) to obtain new polyimides(A1-E5). The prepared compounds were characterized by UV. FT-IR, 1H-NMR and 13C-NMR spectroscopy and measuring of other physical properties such as softening point, melting point and solublities.
Synthesis, Characterization, Antimicrobial and Theoretical Studies of V(IV),Fe(III),Co(II),Ni(II), Cu(II), and Zn(II)Complexes with Bidentate (NN) Donar Azo Dye Ligand
Authors: Al-Hassani Rehab A. M.
Published: December 2016

The new 4-[(7-chloro-2,1,3-benzoxadiazole)azo]-4,5-diphenyl imidazole (L) have been synthesized and characterized by micro elemental and thermal analyses as well as 1H.NMR, FT-IR, and UV-Vis spectroscopic techniques. (L) acts as a ligand coordinating with some metal ionsV(IV), Fe(III), Co(II), Ni(II), Cu(II), and Zn(II). Structures of the new compounds were characterized by elemental and thermal analyses as well as FT-IR and UV-Vis Spectra. The magnetic properties and electrical conductivities of metal complexes were also determined. Study of the nature of the complexes formed in ethanol following the mole ratio method.. The work also include a theoretical treatment of the formed complexes in the gas phase, this was done using the (hyperchem-8) program for the molecular mechanics and semi-empirical calculations. The heat of formation (?Hf?), binding energy (?Eb)and total energy (?ET) for ligand and their metal complexes were calculated by (PM3) method at 298 K.The electrostatic potential of the ligand (L) was calculated to investigate the reactive sites of the molecules. PM3 were used to evaluate the vibrational and electronic spectra for the ligand (L) and their metal complexes then comparing with the experimental values. The antibacterial activity for the (L)and its metal complexes were studied against two types of pathogenic bacteria Pseudonomous aerugionosa as gram negative and Bacillus subtilis as gram positive. Furthermore, the antifungal activity against two fungi Candida albicans, and Aspergillus flavus was studied for (L) and its metal complexes.
Synthesis and Characterization of New 2-Quinolone Sulfonamide Derivatives
Authors: Ahamad Mohammed R. , Al-Bayati Redha I. , Ahamed Luma S.
Published: December 2016

A series of new 2-quinolone derivatives linked to benzene sulphonyl moieties were performed by many steps: the first step involved preparation of different coumarins (A1,A2) by condensation of different substituted phenols with ethyl acetoacetate. The compound A1 was treated with nitric acid to afford two isomers of nitrocoumarin derivatives (A3) and (A4). The prepared compounds (A2, A3) were treated with hydrazine hydrate to synthesize different 2-quinolone compounds (A5,A6) while the coumarin treated with different amines gave compounds (A7,A8). Then the synthesized 2-quinolone compounds (A5-A8) treated with benzene sulphonyl chloride to afford new sulfonamide derivatives (A9-A12). The synthesized compounds were characterized by FT-IR, 1H-NMR, 13C-NMR spectra and by measurement some of their physical properties.
Heavy Metal Pollution and Men Infertility in Al-Falluja City
Authors: Hassani Hayfa H. , Mohamed Wissam M. , Hasan Hathama R. , Majeed Bushra J. , Khalf Zainab S.
Published: December 2016

Infertilityis oneuof the most problemsathatufacingaadvancedunations. In the general, about halfof allacasesaof the infertility are causedby factors thaturelated toathe male partner. Propos educausesvofumalev infertility include evgeneticuand environmental factors. Blood samples from 64 infertileumen allawere living in urban its al-Fallujah city (30 azospermeiauand 34 oligospermeia) and 32 fertile men (asuthe control group) were collected. Heavy metal concentrations inusera of infertile and fertile groupswereumeasured by using Atomic Absorption Spectrophotometer. Y- chromosomemicrodeletions were detected by using PCR techniques. Significantdifferences (P?0.05)uin the concentration ofucopper (0.0267±0.0147 and 0.0278±0.0273, for infertileuand fertile group respectively), cadmium (0.0477± 0.0038 and 0.0446±0.0059, respectively) and zinc (1.08 ± 0.16) in fertile groupamoreover wereadetected, no deletionsawere recorded in Y Chromosome in peopleuwho exposed to heavy metals in each a azospermiavor severe oligospermia groups. Spermatogenesis disruption in theamale at any phase of cell differentiationamay be increased the abnormaluof sperm count also decrease theutotalspermucount, impair the stability of sperm chromatinuordamageain the sperm DNA.
Mefenamic Acid Selective Membranes Sensor and Its Application to pharmaceutical Analysis
Authors: Al-Bayati Yehya Kamal , Aljabari Fadhel Ibrahem
Published: December 2016

PVC membrane sensor for the selective determination of Mefenamic acid (MFA) was constructed. The sensor is based on ion association of MFA with Dodecaphospho molybdic acid (PMA) and Dodeca–Tungstophosphoric acid(PTA) as ion pairs. Nitro benzene (NB) and di-butyl phthalate (DBPH) were used as plasticizing agents in PVC matrix membranes. The specification of sensor based on PMA showed a linear response of a concentration range 1.0 × 10–2 –1.0 × 10–5 M, Nernstian slopes of 17.1-18.86 mV/ decade, detection limit of 7 × 10-5 -9.5 × 10 -7M, pH range 3 – 8 , with correlation coefficients lying between 0.9992 and 0.9976, respectively. By using the ionphore based on PTA gives a concentration range of 1.0 × 10–4 –1.0 × 10–5 M, Nernstian slope of 17.18-18.4 mV/ decade, limit of detection 8.0 × 10–6-9.3 × 10-5M,pH range 3 – 8 and correlation coefficients range between 0.9984 and 0.9891, respectively. The measurement interferences in the presence of Li+, Na+, Mg2+ Ca2+, Fe3+and Al3+ were studied using separate and match potential methods for selectivity coefficient determination. The method was applied for the determination of Mefenamic Acid in pharmaceutical preparations
The determinants of Italy’s corporate tax rates: an empirical investigation
Authors: Parisi Valentino
Published: December 2016

This paper examines the determinants of the effective corporate tax rates in Italy in the years 1998-2006. While from its inception in the early 1970s, the Italian business income tax regime changed only marginally for over twenty years, in the period between 1998 and 2006, the corporate tax system underwent two major reforms with the declared objective of simplifying the system and reducing the tax burden on firms. Therefore, from a tax policy perspective, the author believes Italy is an interesting case study. The empirical analysis is based on a strongly balanced panel with 5,134 companies that combine company accounts and firm survey data. The author employs a fixed effects panel regression to study the role of size, the debt ratio, the rate of profitability, labor productivity, the assets composition, and internationalization in explaining heterogeneity among firms and, therefore, their effective corporate tax rate. Furthermore, the author employs a quantile regression to analyze the impact of the variation in the effect of independent variables on the effective corporate tax rate at different quantiles of the distribution, thus, providing information on the degree of heterogeneity in firm behavior with the final aim of capturing non-linear effects of the independent variables on the tax rate.
Keywords: effective corporate tax rates, tax heterogeneity, panel regression, Italy. JEL Classification: H25, H32
Capturing the volatility smile: parametric volatility models versus stochastic volatility models
Authors: Blanco Belen
Published: December 2016

Black-Scholes option pricing model (1973) assumes that all option prices on the same underlying asset with the same expiration date, but different exercise prices should have the same implied volatility. However, instead of a flat implied volatility structure, implied volatility (inverting the Black-Scholes formula) shows a smile shape across strikes and time to maturity. This paper compares parametric volatility models with stochastic volatility models in capturing this volatility smile. Results show empirical evidence in favor of parametric volatility models.
Keywords: smile volatility, parametric, stochastic, Black-Scholes. JEL Classification: C14 C68 G12 G13
Espousal of combined assurance model in South Africa’s public sector
Authors: Dzomira Shewangu
Published: December 2016

The study seeks to examine the espousal of the combined assurance model in South Africa’s public sector, since there is not solitary autonomous unit that offers assurance in seclusion but various units add to the assurance progression. The study is grounded on stewardship theory in which various concepts of stewardship imply it to be a function of governments’ accountability for the wellbeing of citizens. This research study followed a qualitative research approach in which data were analyzed qualitatively based on an interpretative philosophy which examined meaningful and symbolic content of qualitative data from general reports on the provincial audit outcomes for the period (2014-2015). It was concluded that the level of appreciation of the combined assurance model and assurance provision in South African public sector is commendable, although there is still a need to improve and fully implement the model so as to attain good governance through stewardship advance. To that end, the governing body in South Africa’s public sector needs to augment its monitoring of harmonized and all inclusive approach in internal control systems, risk management and compliance issues. This serves in the best legitimate interests and expectations of the “inclusive stakeholders” via embracing of stewardship approach.
Keywords: combined assurance, public sector, stewardship, Auditor General. JEL Classification: E61, H20
Influence of income growth on purchasing patterns of luxury cosmetic products among Nigerian customers
Authors: Bechan Kajal , Ehsanul Hoque Muhammad
Published: December 2016

Rapid growth of incomes in Nigeria has resulted in increased consumer spending which allowed the emergence of the new market segments, including luxury cosmetic products. Emergence of middle class along with increasing disposable income, increasing urbanization, more females entering the workplace justifies the demand for luxury cosmetics. It is a dream of any women whatever the age group to look and feel beautiful and this is why the cosmetic industry is so large, as cosmetic consumptions by its customers are growing every day. The purpose of the study is to understand the purchasing patterns of the Nigerian consumer who were luxury cosmetic users who frequented the Estee Lauder companies stores in Nigeria. This was a cross-sectional study conducted among 100 consumers who were selected using systematic sampling techniques. A self-administered anonymous questionnaire was used to gather data from respondents. Results indicated that two thirds (66%) of the luxury cosmetic users were within the 18-35 age group. Most of the respondents in the study had a full time job and 31% of the respondents earned between 132,001 – 379,000 naira, which equates to $660 – $1897. Respondents revealed that their top three luxury cosmetic brands were MAC, Estee Lauder and Bobbie Brown. Consumers are aware of the benefits associated with luxury products, therefore, this market segment must be exploited, as it has untapped potential and opportunity.
Keywords: cosmetics, luxury cosmetic market, purchasing patterns, Nigerian consumer. JEL Classification: D11, D12, L66
Does the “Silver Bullet” Lose its Shine Over the Time? Assessment of Loss of Lithium Response in a Preliminary Sample of Bipolar Disorder Outpatients
Authors: Fornaro M. , Stubbs B. , De Berardis D. , Iasevoli F. , Solmi M. , Veronese N. , Carano A. , Perna G. , De Bartolomeis A.
Published: December 2016

Background:

Though often perceived as a “silver bullet” treatment for bipolar disorder (BD), lithium has seldom reported to lose its efficacy over the time.

Objective:

The aim of the present study was to assess cases of refractoriness toward restarted lithium in BD patients who failed to preserve maintenance.

Method:

Treatment trajectories associated with re-instituted lithium following loss of achieved lithium-based maintenance in BD were retrospectively reviewed for 37 BD-I patients (median age 52 years; F:M=17:20 or 46% of the total) over an 8.1-month period on average.

Results:

In our sample only 4 cases (roughly 11% of the total, of whom F:M=2:2) developed refractoriness towards lithium after its discontinuation. Thirty-three controls (F:M=15:18) maintained lithium response at the time of re-institution. No statistically significant difference between cases and controls was observed with respect to a number of demographic and clinical features but for time spent before first trial ever with lithium in life (8.5vs.3 years; U=24.5, Z=-2.048, p=.041) and length of lithium discontinuation until new therapeutic attempt (5.5vs.2 years; U=8, Z=-2.927, p=.003) between casesvs.controls respectively. Tapering off of lithium was significantly faster among casesvs.controls (1vs.7 days; U=22, Z=-2.187), though both subgroups had worrisome high rates of poor adherence overall.

Conclusion:

Although intrinsic limitations of the present preliminary assessment hamper the validity and generalizability of overall results, stating the clinical relevance of the topic further prospective research is warranted. The eventual occurrence of lithium refractoriness may indeed be associated with peculiar course trajectories and therapeutic outcomes ultimately urging the prescribing clinicians to put efforts in preserving maintenance of BD in the absence of any conclusive research insight on the matter.
Mortality Risk Assessment of Total Knee Arthroplasty and Related Surgery After Percutaneous Coronary Intervention
Authors: Von Keudell Arvind G. , Thornhill Thomas S. , Katz Jeffrey N. , Losina Elena
Published: December 2016

Background:

The optimal antiplatelet therapy (APT) treatment strategy after Coronary Artery Stenting (CAS) in non-cardiac surgery, such as total knee arthroplasty (TKA) or urgent TKA-related surgery remains unknown.

Methods:

We built a decision tree model to examine the mortality outcomes of two alternative strategies for APT after CAS use in the perioperative period namely, continuous use and discontinuation.

Results:

If surgery was performed in the first month after CAS placement, discontinuing APT led to an estimated 30-day post TKA mortality of 10.5%, compared to 1.0% in a strategy with continuous APT use. Mortality with both strategies decreased with longer intervals.

Conclusion:

Our model demonstrated that APT discontinuation in patients undergoing TKA or urgent TKA related surgery after CAS placement might lead to greater 30-day mortality up to one year.
Current Topics in Avian Conservation Genetics with Special Reference to the Southwestern Willow Flycatcher
Authors: Zink Robert M.
Published: December 2016

It is sometimes said that scientists are entitled to their own opinions but not their own set of facts. This suggests that application of the scientific method ought to lead to a single conclusion from a given set of data. However, sometimes scientists have conflicting opinions about which analytical methods are most appropriate or which subsets of existing data are most relevant, resulting in different conclusions. Thus, scientists might actually lay claim to different sets of facts. However, if a contrary conclusion is reached by selecting a subset of data, this conclusion should be carefully scrutinized to determine whether consideration of the full data set leads to different conclusions. This is important because conservation agencies are required to consider all of the best available data and make a decision based on them. Therefore, exploring reasons why different conclusions are reached from the same body of data has relevance for management of species. The purpose of this paper was to explore how two groups of researchers can examine the same data and reach opposite conclusions in the case of the taxonomy of the endangered subspecies Southwestern Willow Flycatcher (Empidonax traillii extimus). It was shown that use of subsets of data and characters rather than reliance on entire data sets can explain conflicting conclusions. It was recommend that agencies tasked with making conservation decisions rely on analyses that include all relevant molecular, ecological, behavioral, and morphological data, which in this case show that the subspecies is not valid, and hence its listing is likely not warranted.
Formulation of an herbal mosquito repellent
Authors: Baruah* Prantik Sharma , K. Borthakur S.
Published: December 2016

The present paper deals with formulation of a mosquito repellent product prepared using four plant materials viz, Homalomena aromatica, Ocimum basilicum, Ageratum conyzoides and Litsea glutinosa based on traditional knowledge in prevalent among the ethnic groups of Assam.
Callus proliferation and in vitro organogenesis of Gloriosa superba : An endangered medicinal plant
Authors: Mahajan* Ritu , Kapoor Nisha , Billowria Pallavi
Published: December 2016

Gloriosa superba L. an important medicinal plant has become endangered due to over exploitation, as the tubers are rich source of an alkaloid, colchicine. Poor seed germination and tuber dormancy restricts it multiplication and thus the germplasm available is very less. So, there is urgent need to develop a protocol for its conservation and commercial propagation. Only 10-15% of seeds germinated after three weeks following cold treatment. Best shoot multiplication in sprouted tubers (88.67%) was observed in MS supplemented with 2.0 mg/l BAP, 0.5mg/l Kn and 1.0 mg/l GA3 with 8.7±0.18 average number of shoots per explant. Long and healthy roots were observed in MS medium supplemented with 2.0 mg/l IBA resulting in 84.50% of root growth and average of 7.47±0.29 roots per explant. Organogenesis was obtained from embryogenic callus in MS medium supplemented with BAP, Kn and IBA. Further subculturing of embryogenic callus in MS medium containing 2,4-D, BAP and Kinetin resulted in globular structures while addition of only BAP resulted in heart shaped somatic embryos on the callus. Studies are on way to further use this protocol to increase the content of various alkaloids, with special emphasis on colchicine.
Study of Renal Profile In Diabetic Patient at Nobel Medical College Teaching Hospital, Biratnagar
Authors: Shah Prashant Kumar , Shreewastav Rupesh Kumar , Singh Arambam Giridhari
Published: December 2016

Background Diabetes Mellitus (DM) is one of the most common health problem characterizd by hyperglycemia. Type II Diabetes Mellitus is the most common one. Diabetic nephropathy is the most common clinical condition arises with in these patients which progressively leads to impairment in kidney’s function. Measurement of microalbumin in urine is the earliest dectactable stage of diabetic kidney disease.Material and Methods The total of 200 diabetic patients (112 males and 88 females) were enrolled and biochemical estimations including blood glucose level, serum creatinine, blood urea, urine albumin was conducted.Results Prevalance of microalbuminuria was 26 % in type II diabetic patients.Renal functions parameters like blood urea and serum ceratinine were higher in patients with positive microalbuminuria.60 % of diabetic patients are normoalbuminrics and rests 14% are proteinurics.Conclusion Various factors like increasing age, duration of diabetics, blood sugar level,blood urea, serum creatinine are the causes for microalbuminuria and proteinuria. Therefore, to rule out the early screening of diabetic kidney disease, DM patients should get routinely checked up with blood sugar level as well as renal profile test like serum creatinine, blood urea and albumin level in urine.Journal of Nobel Medical College Vol.5(2) 2016; 1-4
Gullain-Barré Syndrome during pregnancy: Fetomaternal outcomes
Authors: Pokhrel Ghimire Sita , Ghimire Ram Hari , Ghimire Ashima , Kafle Dilliram , Chhetry Manisha , Kumar Mahanand
Published: December 2016

Background Gullain-Barré Syndrome (GBS) is not uncommon during pregnancy in our setting. There are no studies regarding the clinical profile and fetomaternal outcomes of GBS during pregnancy in Nepal. Therefore, this study was conducted to analyse clinical profile and fetomaternal outcome of pregnant women with GBS.Material & Methods Prospective descriptive analysis was carried out of all female’s cases of >16 years women of GBS with pregnancy who were admitted in the hospital between 1st August 2015 and 30th July 2016. A structured questionnaire was designed which included demographic, obstetric, clinical, neonatal and neurological parameters.Results During the period of 1 year, 11 cases were analysed with median age of 23.7 years. Disease was common in primi and in 3rd trimester. Three patients (27.2%)needed mechanical ventilation and one of them (9%) died due to ventilator associated pneumonia. There was only one (9%) neonatal death.Conclusion Gullain-Barré Syndrome is not uncommon in our setting. Early diagnosis and proper management of pregnant women with GBS may result in good fetomaternal outcome.Journal of Nobel Medical College Vol.5(2) 2016; 5-9
Exacerbation of Asthma during Pregnancy: Fetomaternal Outcomes
Authors: Ghimire Ram Hari , Pokhrel Ghimire Sita , Ghimire Ashima
Published: December 2016

Background Asthma is a common occurrence during pregnancy. Exacerbation during pregnancy represents a important and challenging medical problem and may result in poor fetomaternal outcomes. Until now, there are no studies comparing the fetomaternal outcomes in pregnant women with case (asthma) exacerbation and with control group (non-asthma) women of similar age and period of gestation. Therefore, we analysed selected fetomaternal outcomes retrospectively in these group of women.Material & Methods This is a retrospective observational comparative study. During the study period, total number of deliveries was 5,568. Women who were admitted with the diagnosis of exacerbation of asthma during pregnancy between 1st Jan 2015 to 31st Dec were included in the study. These cases were compared with random selection of controls who were admitted in the same duration of time for the delivery without asthma after matching maternal age and period of gestation. Ethical clearance was obtained before the study. Fetomaternal outcomes were compared between women with exacerbation of asthma and non-asthma.Results One hundred and eight pregnant women from each asthmatic and non- asthmatic group were analysed for selected fetomaternal outcomes. The mean age of asthmatic and nonasthmatic group was 23.2± 4.3 and 24.9±3.2 years respectively. LSCS, UTI and preeclampsia were more common in asthmatic women. Birth weight and APGAR score was lower in babies with asthmatic women. Inpatient care and mortality rate were more common in babies of asthmatic women.Conclusion Exacerbation of asthma during pregnancy may result in poor fetomaternal outcome. Therefore, a more careful monitoring of women with exacerbation of asthma during pregnancy and delivery is required.Journal of Nobel Medical College Vol.5(2) 2016; 32-36
An open label study on Depression Patient's Disability Outcomes: Comparative Evaluation of Escitalopram and Amisulpride
Authors: Kaul Vijay , Dutta Shaktibala , Beg Mirza Atif , Singh Nand Kishore , Bawa Shalu , Anjoom Mohammed , Dutta Srihari , Rai Prithi
Published: December 2016

Background Depression is an important global public health problem due to its relatively high lifetime prevalence and significant disability caused by it. The present study was conducted to compare improvement in disability outcome by Amisulpride and Escitalopram among depression patients using WHO-Disability Assessment Schedule (WHO-DAS).Materials and Methods The study was conducted in depression patients for 1 year in the Department of Neuropsychiatry, Nepalgunj Medical College & Teaching Hospital. A total of 117 depression patients were divided into 2 groups. Group I (58 patients) received Amisulpride tablet at a dose of 50 mg/day and Group II (59 patients) were given Escitalopram at a dose of 10 mg/day. The patients were required to follow up at 4 weeks, 8 weeks and at 15 weeks. The efficacy of the drugs was calculated by Hamilton depression rating scale (HAM-D). The improvement in functional outcome was compared between the two groups by using WHO-Disability Assessment Schedule (WHO-DAS). Appropriate statistical tools using GraphPadInstat 3.0 were used for analysis. p value < 0.05 was considered significant.Results HAM-D score in group receiving Amisulpride at 0 and 15 weeks was 16.92±0.35 and 7.87±0.29 (p<0.0001). HAM-D score in group receiving Escitalopram at 0 and 15 weeks was 17.09±0.39 and 6.63±0.39 (p<0.0001). WHO-DAS score in group receiving Amisulpride at 0 and 15 weeks was 112.54±0.82 and 43.08±1.41 (p<0.0001) respectively. WHO-DAS in group receiving Escitalopram at 0 and 15 weeks was 113.73±1.92 and 40.69±1.49 (p<0.0001) respectively. Intergroup comparison at 15 weeks was insignificant (p>0.05). Gastrointestinal disturbances, sexual disturbances, amenorrhea, lactation, agitation and insomnia were the commonly encountered adverse drug reactions.Conclusion Both Amisulpride and Escitalopram showed improvement in WHO Disability Assessment Score (WHO-DAS) at the end of study period. But intergroup comparison showed no significant difference in the two groups. Journal of Nobel Medical College Vol.5(2) 2016; 37-42
Appendicular Mass: A Conservative Approach
Authors: Koirala Ashok , Thakur Dipendra , Agrawal Sunit , Pathak Kamal Raj , Bhattarai Manoj , Sharma Abhilasha
Published: December 2016

Introduction Appendicular mass is one of the most common complications following acute appendicitis and seen in 2-6% of the patients. The treatment of appendicular mass is controversial with three general approaches. The aim of this study is to evaluate outcome of conservative approach.Material & Methods A retrospective analysis of the patients managed with appendicular mass from 1st January to 31st December 2014 was carried out in NMCTH, Biratnagar. A total of 173 patients with diagnosis of appendicular mass admitted in emergency and OPD of our hospital were studied. All age groups and both sex were included.Results Out of 496 patients with appendicitis, 173 patients [34.87%] were diagnosed with appendicular mass. Age range of the patient in the study varied between 4-84 years and maximum patients found in the age group of 21-30 years. Onset of symptoms was between 2-6 days and greater number of patients reporting between 5-6 days. During study period 10(5.7%) patients came with recurrence, 9 [5.2%] developed abscess, 35(20.23%) patients came for interval appendicectomy, whereas 119 [68.78%] failed to come for a follow up.Conclusion Our study concluded that the appendicular mass can be managed successfully by conservative approach, although few complications may arise which can be managed by surgical intervention.Journal of Nobel Medical College Vol.5(2) 2016; 47-50
Conjoined Twin: Late Presentation and Challenges in Management
Authors: Chhetry Manisha , Pokhrel Ghimire Sita , Subedi Shanti , Lamichhane Sabina , Kumar Mahanand , Banerjee Basudev
Published: December 2016

Conjoined twin is a rare occurrence and its management presents with unique challenges. We report a case of a 23 year primigravida with a thoracophagus conjoined twin with complex cardiac fusion who presented to us at 34weeks of gestation. Condition was diagnosed by ultrasound; degree of fusion was assessed by computed tomography. Inspite of poor prognosis of the babies, patient was delivered by lower segment cesarean section to avoid maternal genital tract trauma.Journal of Nobel Medical College Vol.5(2) 2016; 60-63
DFT Study of the Spin-Forbidden Reaction of N2O with CO Catalysed by Y+ Ions
Authors: Tong Yongchun , Wang Qingyun , Xu Xinjian , Wang Yongcheng
Published: December 2016

The mechanism of the cyclic reaction N2O(X1Σ+) + CO(1Σ+) → N2(X1Σg+) + CO2(1Σg+) catalysed by Y+ ions has been investigated on both singlet and triplet potential energy surfaces. The reactions were investigated by means of the relativistic effective core potential together with the Stuttgart basis sets on Y and the UB3LYP/6-311G** level of theory on non-metal atoms. The crossings involved between the singlet and triplet energy surfaces have been investigated by means of the intrinsic reaction coordinate approach used by Yoshizawa et al. Furthermore, both steps of the reaction are exothermic and the overall reaction is exothermic by 361.12 kJ mol−1.
Double-barrel Y-configuration Stenting for Flow Diversion of a Giant Recurrent Basilar Apex Aneurysm with the Pipeline Flex Embolization Device
Authors: Ding Dale , Starke Robert M. , McGuinness Ben , Brew Stefan
Published: December 2016

Giant basilar apex aneurysms are extremely challenging to successfully manage. The Pipeline Flex embolization device (PFED) is a new generation flow-diverting stent with a modified delivery system which allows resheathing of the stent after partial deployment. We describe a case of double-barrel Y-configuration stenting of a giant, recurrent basilar apex aneurysm using the PFED. A 73-year-old male was previously treated for an unruptured 11-mm basilar apex aneurysm with stent-assisted coiling using a Neuroform stent. The aneurysm was retreated twice with repeat coiling. After the third recurrence and persistent aneurysm growth into a giant, symptomatic lesion, we decided to proceed with flow diversion. We performed Y-stenting of the basilar bifurcation using three PFEDs, and was recoiled the aneurysm sac. Due to the low porosity of the flow diverters, a side-by-side double-barrel configuration was necessary in the basilar artery. Without the PFED’s resheathable capability, it would not have been possible to perform Y-stenting with flow diverters.
Association of Cognitive and Noncognitive Symptoms of Delirium: A Study from Consultation-liaison Psychiatry Set-up
Authors: Grover Sandeep , Mehra Aseem , Chakrabarti Subho , Avasthi Ajit
Published: December 2016

Aims: This study aims to evaluate the cognitive functions of patients with delirium using Hindi Mental Status Examination (HMSE), to study the correlation of cognitive functions assessed by HMSE with noncognitive symptoms as assessed using Delirium Rating Scale-Revised 1998 (DRS-R-98) and to study the association of cognitive functions assessed using HMSE and DRS-R98. Methods: A total of 76 consecutive patients fulfilling the diagnosis of delirium were evaluated on DRS-R-98, HMSE, and Short Informant Questionnaire on Cognitive Decline in the Elderly (retrospective IQCODE). Results: The mean DRS-R-98 score 33.9 (standard deviation [SD] - 7.2) and the mean DRS-R-98 severity score was 25.9 (SD - 7.2). The mean score on HMSE was 19.3 (7.98). There were significant correlations of all the domains of HMSE with DRS-R-98 total score, DRS-R-98 severity score, DRS-R-98 cognitive subscale score, DRS-R-98 noncognitive domain subscale score, and DRS severity score without attention score. When the association of each item of DRS-R-98 and HMSE was evaluated, except for the items of delusions, lability of affect and motor retardation, there were significant negative association between all the items of DRS-R-98 and HMSE, indicating that higher severity of cognitive symptoms as assessed on HMSE is associated with higher severity of all the cognitive symptoms and most of the noncognitive symptoms as assessed by DRS-R-98. Conclusion: The present study suggests that attention deficits in patients with delirium influence the severity of cognitive and noncognitive symptoms of delirium. Further, the present study suggests an increase in the severity of cognitive symptoms in other domains is also associated with an increase in the severity of noncognitive symptoms of delirium.
Main Neurosurgical Pathologies in Benin Republic
Authors: Gandaho Hugues Jean Thierry , Soumaila Madougou , Hoinsou-Hans Isaac , Djrolo Gautier M. M. , Zevounou Audrey A. S. , Adeleye Amos O.
Published: December 2016

Background: Benin republic is a very low-income French-speaking country in West Africa The development of Neurosurgery in the Republic of Benin took off with the arrival of the first Beninese neurosurgeons in the year 2003. Aims: This study aims to evaluate patients’ attendance in a public neurosurgical center, and appreciate populations’ affordability to a new specialty. Settings and Design: In the year 2004, the Benin Armed Forces established the first Department of Neurosurgery in the Nation’s Military Teaching Hospital. From the public authorities, that was a proof of motivation to develop this specialty in the Benin Republic. Materials and Methods: A retrospective cross-sectional survey (September 2003 to December 2009) of the total neurosurgical patient population managed in a public pioneer hospital in a developing country. Statistical Analysis Used: Data were captured and analyzed with the SPSS software (SPSS Inc., Chicago, IL, USA) and presented in descriptive statistics such as frequencies and proportions. Results: 2908 new patients, civilians, and militaries were registered. The surgical treatment was offered adult (86%) as well as pediatric (14%) patients. Spinal degenerative diseases (52.1%) were the most common pathology; neurotraumatology emergency cases (8.4%) appeared low in representation. Three-quarters of patients experienced financial difficulties to procure the required radiologic investigations and although 609 (20.94%) benefited from surgery, most patients could not pay for the surgical operations as well as the perioperative care. Conclusions: In spite of the great constraints of this country’s privately-funded health-care delivery system on the affordability of neurosurgical treatment for the average Beninese, this study demonstrates a globally increasing attendance of the department.
An Analytical Study to Correlate Serum Levels of Levetiracetam with Clinical Course in Patients with Epilepsy
Authors: Gupta Varun , Gupta Kanchan , Singh Gagandeep , Kaushal Sandeep
Published: December 2016

Introduction: With the advancement of therapeutics, newer antiepileptic drugs (AEDs) like Levetiracetam (LEV), with good therapeutic efficacy and tolerability are available. But unfortunately, therapeutic drug monitoring is not routinely done in India for these drugs. Objectives: The objective of this study is to determine the range of serum levels of LEV in patients at stabilized doses and correlate them with their clinical course. Materials and Methods: Patients with epilepsy and started on LEV were enrolled from the Neurology Department after the Ethics Committee approval. Serum levels of LEV were estimated using high-performance liquid chromatography and correlated with patient demographics, dosage, dosage forms, concomitant AEDs, compliance of the patient, therapeutic effect, adverse drug reactions (ADRs), and suspected toxicity. Results: Serum levels of LEV ranged from 0.4 to 102.2 μg/ml at different time points and demonstrated a negligible positive correlation with age of the patients (r = 0.12) but negligible negative correlation with bodyweight (r = −0.19). No conclusive relationship could be established for dose, gender, dosage forms, clinical efficacy (seizure frequency), ADRs, and toxicity. Compliance was verified in all the patients. Levels were found to reduce with the use of concomitant enzyme inducer drugs (56.78%) whereas increase with valproic acid (7.8%). Conclusion: These findings emphasize the need for monitoring the serum levels of newer AEDs like LEV considering the various parameters studied here, so as to maintain the therapeutic efficacy by preventing under or over dosage and to generate a broader database of serum levels of LEV in the Indian population to help appropriate prescribing with more confidence.
Frontal Bone Hemangioma in an 8-year-old Female: A Common Tumor in a Rare Location
Authors: Sharma Abhimanyu , Singh Usha Rani , Sihag Prateek
Published: December 2016

Intraosseous hemangioma is a rare bone tumor accounting for 0.7%–1.0% of all bone tumors. In the skull, frontal bone is the commonly involved bone. An 8-year-old female presented to our outpatient department with complaints of pain and swelling over forehead for 4 months. X-ray revealed a lytic expansile lesion involving frontal bone with sunburst pattern of bony spicules radiating to periphery of the lesion. Magnetic resonance imaging revealed the presence of a well-circumscribed lesion with both intra as well as extracranial components. Histopathology revealed a vascular tumor consisting of both small (capillary) and large (cavernous) sized vessels. A diagnosis of mixed type of hemangioma of the frontal bone was given. Recognition of hemangioma on radiology and confirmation by histopathology is essential for proper management as it might be confused clinically with other locally aggressive/malignant lesions.
Primary Sacral Hydatid Cyst Mimicking a Neurogenic Tumor in Chronic Low Back Pain: Case Report and Review of the Literature
Authors: Segura-Trepichio Manuel , Montoza-Nuñez Jose Manuel , Candela-Zaplana David , Herrero-Santacruz Josefa , Pla-Mingorance Fernando
Published: December 2016

Hydatid disease is caused by infection of Echinococcus granulosus. Bone hydatid cyst presentation without hepatic affectation is infrequent and occurs in 0,5-2% of cases. This rare condition makes clinicians not always aware of the disease, and as a result, misdiagnosis of spinal echinococcosis is common. We present a case of a 48-year-old female patient with primary sacral hydatidosis. Chronic low back pain radiating to the left buttock was the only symptom. The magnetic resonance imaging (MRI) suggested a neurogenic tumor versus giant cell tumor. Biopsy and pathological study revealed a hydatid cyst. Anthelmintic and surgical treatment was performed. At 12 months after surgery, the patient is free of recurrence. In patients with chronic low back pain and a MR suggestive of neurogenic tumor, spinal hydatid cyst should be considered in the differential diagnosis. It is recommended the assistance of an anesthesiologist during biopsy to avoid an anaphylactic shock.
Successful Endovascular Neurosurgical Practice in Resource-poor Exclusive Rural Neuro-hospital Setup
Authors: Harsha Kamble Jayaprakash
Published: December 2016

Aim: The aim of this study to evaluate the feasibility of establishing endovascular neurosurgery in remote resource-poor neuro-hospital setup and evaluate its outcome. Materials and Methods: Retrospective analysis of diagnostic and therapeutic endovascular neurosurgical procedures performed during September 2013–June 2016. Results: A total of 174 diagnostic cerebral and spinal digital subtraction angiograms and 70 major endovascular neurosurgeries were performed during the period. The endovascular neurosurgical procedures included 54 aneurysms coiled, 4 cerebral arteriovenous malformation embolization, 2 dural arteriovenous fistulas embolization, 2 cerebral tumor embolizations, 2 intracranial stentings, 5 extracranial carotid stentings, 1 transverse sinus stenting. No complications were seen during diagnostic procedures. Operation related morbidity of 1.4% and mortality of 1.4% seen, with a procedural success rate of 97.2%. Conclusion: Endovascular neurosurgery is feasible in resource-poor remote rural exclusive neuro-hospital setup with procedural success rate and outcomes comparable to existing literature.
Relationship between Pelvic Alignment and Weight-bearing Asymmetry in Community-dwelling Chronic Stroke Survivors
Authors: Karthikbabu Suruliraj , Chakrapani Mahabala , Ganesan Sailakshmi , Ellajosyula Ratnavalli
Published: December 2016

Background and Purpose: Altered pelvic alignment and asymmetrical weight bearing on lower extremities are the most common findings observed in standing and walking after stroke. The purpose of this study was to find the relationship between pelvic alignment and weight-bearing asymmetry (WBA) in community-dwelling chronic stroke survivors. Materials and Methods: This cross-sectional study was conducted in tertiary care rehabilitation centers. In standing, the lateral and anterior pelvic tilt angle of chronic stroke survivors was assessed using palpation (PALM™) meter device. The percentage of WBA was measured with two standard weighing scales. Pearson correlation coefficient (r) was used to study the correlation between pelvic tilt and WBA. Results: Of 112 study participants, the mean (standard deviation) age was 54.7 (11.7) years and the poststroke duration was 14 (11) months. The lateral pelvic tilt on the most affected side and bilateral anterior pelvic tilt were 2.47 (1.8) and 4.4 (1.8) degree, respectively. The percentage of WBA was 23.2 (18.94). There was a high correlation of lateral pelvic tilt with WBA (r = 0.631; P < 0.001) than anterior pelvic tilt (r = 0.44; P < 0.001). Conclusion: Excessive lateral pelvic tilt toward the most affected side in standing may influence the weight-bearing ability of the ipsilateral lower extremity in community-dwelling chronic stroke survivors.
Using Multistate Observational Studies to Determine Role of Hypertension and Diabetes as Risk Factors for Dementia
Authors: Singh Mitasha , Raj Des , Raina Sunil Kumar , Gandhi Manoj Kumar , Chander Vishav
Published: December 2016

Background: Evidence suggests that modifiable risk factors which can be targeted by prevention are vascular diseases, such as diabetes, midlife hypertension (HTN), midlife obesity, midlife cholesterol, mid- and late-life depression as well as lifestyle factors such as smoking, physical inactivity, and poor diet. Methods: A comprehensive search of the National Library of Medicine’s PubMed database and Google Scholar was conducted. A combinations of medical subject headings and free text words that included search terms related to the exposure (e.g., prevalence, HTN, raised BP, high BP, diabetes, high blood sugar, DM, India, state), were combined with search terms related to the outcomes (e.g., prevalence, disease burden, estimate, dementia, India). The filters included were English for the language category and humans for the study category. Results: The PubMed search initially identified 269 references, and a total of 204 abstracts were screened by inclusion criteria. Full-text assessment of 136 articles on prevalence of dementia resulted in 20 relevant articles from which the different regions of the country were identified. Based on the search conducted according to the regions; 287abstracts of the prevalence of HTN and 577 on the prevalence of diabetes mellitus were screened. There were 43 full-text articles on the prevalence of HTN and diabetes from the regions where the prevalence of dementia was available. Of these potentially relevant articles were 14 in number. Conclusion: Despite the uncertainty in the role, the data analysis, therefore, points to a role in the prevention of HTN and diabetes to prevent dementia.