bluuebunny/crossref_metadata_2025 huggingface dataset:
A comparative study on self medication practices in ACSR Government medical college in Nellore, India
Authors: Penupothu Sree Nagamani , Hanumanthu Lalitha
Published: April 2018

Background: Self medication is rampant in medical undergraduates. There is a need to evaluate the extent and factors that govern self medication. This study was conducted in 7th semester and 5th semester undergraduates to compare the knowledge, attitude and practice regarding self medication.Methods: It is a questionnaire based study in a total of 294 medical students comprising 147 students each belonging to 7th and 5th semesters to assess determinants and practice methods of self medication in the past one year.Results: 100% of 7th semester and 90% of 5th semester students self medicated. Majority followed modern medicine. Awareness of OTC drugs, essential drugs and generic drugs was not optimum. Students self medicated based on old prescriptions and text books for perceived mild illnesses like common cold, fever and headache. Non steroidal anti-inflammatory drugs and antihistamines were most commonly used. Not all students checked package insert prior to use.Conclusions: Self medication practice is more pronounced in 7th semester than in 5th semester students. 7th semester students used diverse drugs compared to 5th semester students who used limited groups of drugs.
A prospective randomised open labelled comparative study of anti inflammatory effects of topical 5% benzoyl peroxide gel vs topical 4% nicotinamide gel for grade I-II acne in a tertiary care hospital
Authors: S. N. Ashok Kumar , N. T. Madan Mohan , H. Shwetha , P. Shanmukananda , D. R. Veena , Dube Upasana
Published: April 2018

Background: Acne vulgaris is a dermatological disorder characterised by formation of comedones and inflammatory lesions. The treatment of acne basically involves reduction of lesions. Benzoyl peroxide, in concentrations of 5%, 10%, and 20%, has been used effectively in the treatment of acne for more than 20 years. Nicotinamide/ Niacinamide is a newly-approved anti-acne drug with a potent anti-inflammatory effect. The present study assessed the efficacy of 5% Benzoyl peroxide gel in comparison to 4% Nicotinamide gel for topical treatment of mild to moderate acne vulgaris.Methods: In this study, the patients with mild to moderate acne vulgaris with inflammation were divided into two groups, group I was treated with topical 5% Benzoyl peroxide gel whereas topical Nicotinamide gel was given to the group II. Assessment of efficacy was done by total lesion counting according acne global severity index, the results were compared at the end of 2 weeks and 4 weeks with the baseline values.Results: At the end of this study, it was found that the reduction of inflammatory and total percentage of decrease in counts of lesions from baseline were highly significant in both the groups (p<0.001), between the groups, differences were statistically significant (p<0.001), therefore 5% Benzoyl peroxide gel has better efficacy than 4% Nicotinamide gel.Conclusions: Benzoyl peroxide is more efficacious than 4 % Nicotinamide gel in mild to moderate acne.
Prescribing trends of anti glaucoma medication usage in treatment naive patients of primary open angle glaucoma in a tertiary care hospital in Eastern India
Authors: Maitra Aditi , Bhattacharyya Shashwat , Mukherjee Shatavisha , Era Nikhil , Ghosh Sambuddha , Tripathi Santanu Kumar
Published: April 2018

Background: Primary open angle glaucoma remains a high magnitude healthcare problem due to its prevalence and chronicity. The real world scenario of anti glaucoma medical therapy needs periodical auditing as far as drug prescriptions are concerned for formulation of treatment guidelines. Few studies from India have taken a longitudinal approach in this respect. This study was undertaken to identify such lacunae.Methods: This was an open label, prospective, observational study. Each treatment naive patient was followed up for a period of 6 months, where their prescriptions were scanned for the type of the anti glaucoma medications, total number of medications, route of administration, their duration of use and their frequency of dosage and change in medications if any, in each visits.Results: A gradual shift from monotherapy towards combination therapy was observed. Overall averages for prescriptions were topped by monotherapy at 44.25 followed by fixed dose combinations at 38.25, and then combination-polytherapy at 36 and the least number of prescriptions were for concurrent polytherapy at 17.5. Amongst all monotherapy agents, beta blockers were the most frequently prescribed drugs at baseline but their share of prescriptions was almost halved at the end of our study. The prostaglandin analogs on the other hand saw an upsurge in prescriptions from their baseline to the end of this study. Prostaglandin analogs andbeta blockers as fixed dose combination was a popular prescription over the entire study duration.Conclusions: Prescribing trends were remarkable for the shift from primary monotherapy towards fixed dose combinations as the study concluded. The decline in the number of beta blocker prescriptions and a rise in prostaglandin analog prescriptions is a testament to their better effectiveness and tolerability. The future of open angle glaucoma pharmacotherapy lies in prescribing more efficacious drugs either in monotherapy or in fixed combinations.
Study of anticonvulsant activity of acetazolamide on albino rats and its influence on anticonvulsant activity of sodium valproate
Authors: K. H. Hemanth Kumar , M. S. Kishore
Published: April 2018

Background: Epilepsy is a common neurological disorder. 30-40% of patients will continue to have seizures despite the use of antiepileptic drugs either alone or in combination. The present study is undertaken to evaluate the anticonvulsant activity of Acetazolamide (ACZ) in albino rats and its influence on anticonvulsant activity of sodium valproate.Methods: Albino rats (150-200gms) of male sex were randomly selected, from central animal facility, MMCRI, Mysore. They were divided into 6groups (per model) of 6 rats each, control group-normal saline 0.5ml, standard group-sodium valproate (300mg/kg), dose 1-ACZ (8.75mg/kg), dose 2-ACZ (17.5mg/kg) and dose 3-ACZ (35mg/kg), dose 4-ACZ (8.75mg/kg) with sodium valproate (150mg/kg). The anti-convulsant activity was screened using MES model and PTZ model.Results: Results were analysed by ANOVA followed by post hoc Fisher’s LSD test. The ACZ has shown anticonvulsant activity at the dose of 17.5mg/kg and 35mg/kg body weight and combination of ACZ 8.75mg/kg with sodium valproate 150mg/kg both in MES model and PTZ model. The anticonvulsant activity of ACZ was less when compared to Sodium Valproate in both MES model and PTZ model. The anticonvulsant activity of combination, ACZ 8.75mg/kg with Sodium valproate 150mg/kg was comparable and more significant when compared to standard drug alone in MES model and PTZ model.Conclusions: The ACZ has shown anticonvulsant activity in MES model and PTZ induced seizure model of epilepsy. This study has shown that ACZ potentiated the effect of sodium valproate and can be used as add on drug with sodium valproate in epilepsy.
Knowledge, attitude and practice of haemovigilance amongst healthcare professionals in Nashik, Maharashtra, India
Authors: Shivgunde Prashant P. , Besekar Smruti M. , Bhojwani Khushboo M. , Bhojwani Divya G.
Published: April 2018

Background: Haemovigilance Programme of India was launched in 2012 with the purpose to identify, analyse and learn the complications related to transfusion and blood donation, in order to avoid such complications in future. Though it is essential to identify the Adverse Transfusion Reactions (ATR) to reduce the incidence and make transfusion easier; there are rare reports available about knowledge, attitude, and practice (KAP) of Healthcare Professionals (HCP) for haemovigilance.Methods: In this cross-sectional study, pre-validated questionnaire designed for assessing the KAP, the possible ways to improve transfusion reaction reporting and causes of underreporting were distributed among 220 Healthcare Professional (HCP) in Nashik, Maharashtra.Results: The response rate of the study was 93%. Amongst them 58% HCP had poor knowledge while only 9% had good knowledge about haemovigilance. According to respondents, training to the HCP, CME’s, making reporting compulsory and launching of a toll-free helpline number will mark a milestone in improving transfusion reaction reporting. Legal liability issue and lack of time & knowledge were the main factors which discouraged them from reporting.Conclusions: Overall, most of HCP in Nashik have a positive attitude towards transfusion reaction reporting but knowledge regarding the haemovigilance concept is poor and the majority of them never reported ATR. Hence, our study demands increased awareness and continued training to strengthen the haemovigilance system, especially ATR reporting.
A randomized placebo controlled trial of metformin alone and metformin plus fixed dose combination of cyproterone acetate and ethinyl estradiol in hirsute women with polycystic ovarian syndrome
Authors: Jalota Shivani , Singh Jatinder , Saini Ravi
Published: April 2018

Background: Polycystic ovarian syndrome is a common endocrine disorder seen in reproductive age group. Hirsutism, oligomennorhea and infertility being the most common chief complaint. Oral contraceptives have shown their efficacy in hirsute females. Metformin, an insulin sensitizer, have also shown some beneficial effects in improving metabolic abnormalities. Aim of this study is to compare the efficacy of metformin alone and metformin with fixed dose combination of cyproterone acetate and ethinyl estradiol in hirsute women with PCOS.Methods: 60 females of PCOS with chief complaint of hirsutism were enrolled. Patients were randomized to either metformin and Diane -35 (35 microgram ethinyl estradiol plus 2mg cyproterone acetate) or metformin and placebo for 9 months. Ferriman Gallwey score and body mass index was calculated at baseline, 3months, 6months and 9 months. FSH/LH/Prolactin/Testosterone/Fasting glucose and Fasting insulin levels were measured at the baseline and at the end of treatment.Results: Majority of females enrolled in the study were in third decade of life. Metformin and Diane- 35 showed higher reduction in Ferriman Gallwey score but Body mass index was reduced in both the groups. There was no significant difference seen between the groups with respect to biochemical profile.Conclusions: This data show that a combination of metformin and contraceptive pill may be more effective in treating hirsutism than metformin alone. Beneficial effects of therapy were seen in relation to BMI as well. Hence, combination therapy is better therapeutic option for treating hirsutism in PCOS.
Knowledge and perception about generic drugs in patients coming to OPD of tertiary care centre
Authors: Choulera Mehul Y. , V. Dashputra Amruta , Borkar Archana S. , Date Amit P.
Published: April 2018

Background: In an era of rapidly rising health care costs generic medicines provide a less expensive alternative to branded medicines. In addition to reducing the overall health care expenditure, it has been shown to improve adherence. Objective was to study knowledge and perception about generic drugs among patients coming to outpatient department of tertiary care centre.Methods: After ethical approval a cross sectional questionnaire based study was conducted. Patients (n=71) were interviewed according to questionnaire in vernacular language by investigator to fill questionnaire.Results: About 28% people think that price of generic drug is less than a branded drug while nearly 61% of people don’t know of it. Only 18.85% participants had taken generic medicine. Trusting efficacy of generic drugs only 30 participants were in favour it. Even they have not seen or heard publicity of generic drugs (61.97%). They (60.56%) opined that generic drugs never prescribe in our country.Conclusions: Limitation in knowledge and perception about generic medicines has been seen among participants.
Hypersensitivity reactions to intravenous ferric carboxymaltose in a patient with iron deficiency anemia: a rare case report
Authors: Quazi Shadma H. , Varma Sushil K. , Khan Sharjeel H. , Kirde Sonali S. , Bhoware Harshada Arun
Published: April 2018

Ferric carboxymaltose (FCM) is a non-dextran iron preparation recently approved in the United States for intravenous treatment of iron deficiency anemia (IDA) in adult patients with intolerance or poor response to oral iron therapy. Acute hypersensitivity reactions (HSRs) during iron infusions are very rare but can be life-threatening. Adverse events, including immune system disorders (0% in FCM) and skin disorders (7.3% in FCM), are less frequently observed with FCM. On treatment with FCM, the change in hemoglobin from baseline to the highest observed level is about 2.8g/dL. Treatment of IDA with FCM resulted in fewer hypersensitivity reactions. Here, authors report a case of a 23 years old female diagnosed for IDA presented with the picture of adverse drug reaction due to injection FCM given by the physician. The patient was managed with Antibiotics, Corticosteroids and Intravenous fluids and recovered well within 12 hours of admission from this adverse drug reaction. Since such cases have been rarely reported, authors are intended to notify about this potentially dangerous drug reaction due to FCM which is used extensively in the treatment of IDA. Hence management of iron infusions requires very careful and precise observation, and, in the event of an adverse reaction, prompt recognition and severity-related interventions by well-trained medical and nursing staff.
Clofarabine: a next-generation deoxyadenosine analogue
Authors: Bhalla Amit
Published: April 2018

Acute lymphoblastic leukaemia (ALL) is the most common of the paediatric leukaemias. It is estimated that the use of modern combination chemotherapy results in long-term remission in nearly 80% of children diagnosed with ALL. Despite therapy advances, approximately 20% of children with ALL, experience leukaemia relapse. Clofarabine (2-chloro-2’-fluoro-2’-deoxy-9-β-D-arabinofuranosyladenine) is a second-generation nucleoside analogue and is structurally related to fludarabine and cladribine which are widely used in the treatment of lymphoproliferative disorders. Clofarabine exhibits greater affinity to deoxycytidine kinase (dCyd kinase) and prolonged retention in leukaemic blasts compared to fludarabine and cladribine. Clofarabine inhibits both DNA polymerases and ribonucleotide reductase (RNR). This results in impaired DNA synthesis through inhibition of DNA elongation as well as depletion of deoxyribonucleotides. Accumulation of clofarabine triphosphate, in the blasts of patients with refractory leukemia has been demonstrated. Prolonged intracellular half-life of 24 hours for clofarabine triphosphate. Clofarabine is indicated for the treatment of pediatric patients 1 to 21 years old with relapsed or refractory acute lymphoblastic leukemia after at least two prior regimens.
Maternal mortality at a tertiary health care: a retrospective study
Authors: Singh Sona , Singh Nagendra , Nagar Jagriti Kiran , Jain Sarvesh
Published: April 2018

Background: Maternal mortality is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of pregnancy from any cause related to or aggravated by the pregnancy, but not from accidental or incidental causes. The aim of this study is to find out the causes of maternal mortality and the complications leading to maternal death.Methods: A retrospective study was conducted by reviewing the hospital records to study the maternal deaths and complication leading to maternal death over the period of one year from July 2016 June 2017 in the Department of Obstetrics and Gynecology, Bundelkhand Medical College, and associated hospital Sagar, Madhya Pradesh. All the maternal deaths were scrutinized for various aspects likely to be related to death such as age, locality of residence, antenatal care, admission death interval and the cause of death.Results: The maternal mortality ratio in the present study is 292.33/100,000 live births. There were 28 maternal deaths out of 9578 live birth during the study period. The majority of deaths occurred in the 20-30 age group. hemorrhage (32.14%) and hypertensive disorders (14.28%) are two most common direct cause of maternal deaths. 42.85% of maternal deaths occurred within the first twenty-four hours of admission. Post-operative and post abortal sepsis, amniotic fluid embolism and pulmonary embolism are other direct causes. Indirect causes of maternal deaths account for 21.42%. Severe anemia was the leading indirect causes of maternal deaths.Conclusions: Hemorrhage, hypertensive disorders, and anaemia remain the major cause of maternal deaths. Delay in decision making, provision of treatment and referral to tertiary centre contributed higher maternal mortality. This requires more efforts to recognize the direct and indirect causes of maternal deaths.
Prevalence of end stage renal disease and associated conditions in hemodialysis Iraqi patients
Authors: Dhaidan Fuad Abdullah
Published: April 2018

Background: Chronic Kidney Disease (CKD) is the third most common non-communicable disease throughout the world. Most of the patients with chronic kidney disease suffer from hypertension, diabetes and with glomerulonephritis. Many of these CKD patients ultimately terminate to End Stage Renal Disease (ESRD) when life is not sustainable unless hemodialysis is initiated. This study was to identify systemic and renal disease leading to ESRD requiring hemodialysis and associated co-morbidities.Methods: Data was collected from three selected three hemodialysis centers in three hospitals during one-year study in Iraq. Patients were selected purposively who were available at the time of interview. Data was collected on working days at three shifts. these data collected from patients and their relatives in these centers after taking informed consent from patients the pre-tested questionnaire was filled up by taking general history, family history, socioeconomic condition, drug history and available records were reviewed for collecting previous biochemical parameters. All entered data were analyzed by using SPSS program.Results: Among total 400 subjects, male was 260 (65%) and female 140 (35%). Majority of patients were middle aged. Glomerulonephritis were found to be the leading cause of End Stage Renal Disease (ESRD) (50.4%), followed by diabetes in 31.1%, Poly Cystic Kidney Disease (PKD) 5.3%, Renal Stone in 3.7% and rest other. Among the study population hypertension was the most common co morbidity disease (63%) followed by ischemic heart disease and Cerebrovascular accidents.Conclusions: The leading cause of End Stage Renal Disease (ESRD) was the glomerulonephritis and diabetic nephropathy was the second common cause. Hypertension was the most common associated co morbid disease.
Risk factors, clinico-epidemiological profile of tuberculosis among children attending a tertiary care hospital: a two year study
Authors: Tenali Ravikumar , Badri Naveen Kumar , Kandati Jithendra , Ponugoti Munilakshmi
Published: April 2018

Background: TB remains as the one among the top 10 causes of death worldwide. In 2016, 10.4 million people fell ill with TB, and 1.7 million died from the disease with 0.4 million with HIV. At least 1 million children become ill with TB each year. Children represent about 10-11% of all TB cases. Having knowledge of the risk factors for tuberculosis infection in children is important to evaluate the level of ongoing transmission of infection and to help adapt activities within national TB control programs. The main objective is to study the risk factors and their association and variable clinical features in cases of pulmonary and extra pulmonary tuberculosis.Methods: The main objective is to study the risk factors and their association and variable clinical features in cases of pulmonary and extra pulmonary tuberculosis.Results: 98 cases of TB were confirmed out of total 628 with a prevalence of 17.07% in the   study with 78 PTB cases and 20 EPTB. Females were more with male to female ratio of 0.7:1.5-9 years was the most common age group in the study. Statistically significant association was found between old history of ATT, HIV positivity, contact with an open case of TB and malnutrition (p value<0.05). TB meningitis was the most common EPTB (10/20 cases) followed by tuberculous lymphadenitis (5/20). 69.39% (68/98 cases) were smear positive, radiologically 59.18% of cases were positive and Tuberculin skin test was positive in 46.94%.Conclusions: Childhood tuberculosis is a neglected entity in developing countries due to underreporting and difficulties in diagnosis due to variable clinical picture in children. Hence epidemiological surveillance studies in children are required to determine the actual prevalence of pulmonary and extra pulmonary cases of tuberculosis. Increased efforts are required to isolate TB bacilli from body fluids to identify early the childhood cases and manage them to prevent disease burden in the community.
Effectiveness of a training workshop on perceptions and practice of interns in management of acute diarrheal diseases in children
Authors: Sindhu T. G. , Geeta M. G. , Geetha P. , Fiji M. D.
Published: April 2018

Background: There is a perceived lack of competency of interns in managing common childhood conditions like acute diarrheal diseases (ADD). In the present system there is no formal training is given to the interns. Additional structured training programs during internship will help to improve their performance. This is of special importance in the context of current shift towards a competency based medical education (CBME). This study was conducted at a government medical College in North Kerala to find out the effect of a workshop on perceptions and practice of interns in management of acute diarrheal diseases in children.Methods: 15 interns posted in Paediatric department during July 2015 were administered a pre-test to assess their perceptions and practice about managing ADD by using short answer questions (SAQ), questionnaire and Objective Structured Clinical Examination (OSCE). After the pre-test a training workshop on management of ADD was conducted. The feedbacks were obtained. A post test was conducted 3 days later. The pre and post workshop scores were compared using student t test.Results: There was an improvement in knowledge, skills and self-perceived level of confidence of the interns in managing ADD in children after the workshop.  Conclusions: A training workshop will improve the knowledge, skills and confidence of interns in managing a child presenting with acute diarrhoea.
Effect of maternal anaemia on birth weight of term babies
Authors: Nair Mohandas , S. Gireesh , Yakoob Rubeena , N. C. Cheriyan
Published: April 2018

Background: Low birth weight is the major determinant of mortality, morbidity and disability in infancy and childhood and has a long-term impact on health outcome in adult life. The objectives of this study were to study the relationship between maternal anemia and birth weight of babies and to study anthropometric measures of babies born to anemic and non-anemic mothers and to correlate the timing of anemia with birth weight of babies.Methods: Term babies born in Institute of Maternal and Child Health, Government Medical College, Kozhikode from November 2014 to October 2016 fulfilling the criteria were divided into 2 groups, cases (term babies with birth weight <2500g) and controls (term babies with weight >2500g) and studied and their maternal hemoglobin values were compared.Results: Maternal anaemia in all three trimesters was found to be more in cases compared to controls. Mean 1st trimester hemoglobin of cases was 10.68 g/dl which was significantly lower when compared to controls. Mean 2nd trimester hemoglobin of cases was 10.36 g/dl compared to 11.47 g/dl in controls. Mean 3rd trimester hemoglobin of cases was 10.42 g/dl which was also significantly lower compared to 11.32 g/dl in controls. SGA babies were also found to be more in cases, 89%, compared to 18% in controls. The difference in head circumference between two groups was not statistically significant. Mean length of babies were higher in controls compared to cases. Mothers with anemia at any time during pregnancy was found to have 4.3 times higher risk of giving birth to low birth weight babies compared to non-anemic mothersConclusion: Anemia during pregnancy is a risk factor for low birth weight and SGA, independent of the trimester. Length of babies born to anaemic mothers is also low. But it does not have a significant effect on head circumference of babies.
Clinico-etiological profile of neonates admitted with jaundice in a tertiary care NICU of Central India
Authors: Kalraiya Ashish , Gyanani Pankaj , Dubey Shiv Ram Krishna , Beohar Vijaya , Verma Pramila
Published: April 2018

Background: Hyperbilirubinemia is a common problem and, in most cases, a benign problem in neonates. Jaundice is observed during the 1st week of life in approximately 60% of term infants and 80% of preterm infants.Methods: In present study, total 187 newborns were enrolled prospectively over one and half year of study period from November 2015 to April 2017. Detailed patient information was taken at the time of admission in NICU. In this study all the newborns with age less than 28 days were included who had clinical jaundice, ascertained by Kramer’s criteria and confirmed by biochemical methods. The investigations done were Serum bilirubin (total, direct and indirect) complete blood picture, reticulocyte count, G6-PD estimation (qualitative), Coombs' test, peripheral smear examination, blood group (ABO,Rh) of the mother and baby, CBC,CRP, thyroid function test.Results: Total 187 newborns were enrolled for study. Maximum number of the babies have a pathological jaundice 108 (57.7%) whereas 79 (42.24%) were found to have exaggerated physiological jaundice. The commonest causes of pathological jaundice were found to be septicemia 63 (33.68%) followed by ABO incompatibility 25 (13.36%). Most of the babies had onset of jaundice between 24-72 hours (86.6%).Conclusions: Health care providers working with neonates play a key role in identifying and assessing neonates at risk for pathologic jaundice. Parents counseling is required for bringing their babies early to healthcare centre preventing acute bilirubin encephalopathy and subsequent kernicterus.
Cranial ultrasonography and doppler in neonates: an observational study
Authors: Karamasi Santosh Kumar , Patil Nivedita
Published: April 2018

Background: The CUS and transcranial doppler sonography is an emerging technique used in neonatal intensive care unit. It is noninvasive, ionizing, portable, safe and inexpensive for serial and long-term studies. Objectives of this study were to study intracranial abnormalities in neonates using ultra sonography on 3rd and 7th day of life and to study ACA blood flow velocity and RI (Resistive index) in neonates on 3rd and 7th day of life.Methods: It was a prospective observational study conducted on 229 neonates at NICU, Department of Pediatrics, Dr. D. Y. Patil Hospital and Research Institute, Kolhapur. During August 2015 to August 2017. After obtaining Informed consent from the parents/guardian details were recorded in a pre-designed pretested, structured proforma. Detailed clinical examination and Cranial ultrasound and doppler evaluation was performed on 3rd and on 7th post-natal day.Results: In the present study, out of 229 study participants, 65.5% were preterm, 34.5% were term. 67.2% had abnormal CUS findings. The PVHE, ICH, PVL, cyst and edema were common cranial abnormalities. These were statistically significant on 3rd day with gestational age, birth weight, low APGAR Score. Out of 229 neonates 58.9% had low, 35.3% normal and 5.8% had high RI index. Statistically significant association was found between gestational age, birth weight and APGAR score. Doppler analysis done on 3rd and 7th day showed rise in systolic and diastolic velocities regardless of the gestational age.Conclusions: Study concludes that CUS and Doppler is an ideal tool to detect various intracranial lesions efficiently in non-invasive manner.
Histopathological pattern of solid malignant pediatric tumors in Kashmir, India
Authors: Wani Lateef Ahmed , Farooq Summyia , Beigh Ambreen , Khuroo Mehnaaz , Abass Farhat
Published: April 2018

Background: Tumors that occurs in children are as diverse as those in adults and present a number of challenges for the pathologist. In general, the features of malignancies in children differ biologically and histologically from those of adults with respect to incidence, type of tumor, underlying familial or genetic aberration and tendency to regress spontaneously or cytodifferentiation. The objective of study was to the study was carried out to document pattern of childhood malignant tumors in Kashmir and compare with other studies from other parts of country.Methods: The records of all the tumors diagnosed histopathologically in children <15 years of age during a period of 3-year (2014 to 2017) in pathology department of Government Medical College Srinagar. The sections 3-5 μ thick, are cut and stained by haematoxylin and eosin in all cases and special stains where ever feasible.Results: A total of 46 tumors were seen in the age range of 2 month to 14 years with 26 (56.52%) in boys and 20 (43.47) in girls. Highest number of cases, 23 (50%) were in the age group of 0-5 years. Lymphomas and retinoblastoma were most common child hood malignancies followed by soft tissue tumors and CNS tumors.Conclusions: Although the exact incidence rate cannot be provided by this hospital-based study, the information is useful in showing patterns of childhood tumors. Documentation of cases, advanced diagnostic methods like IHC, cytogenetic studies and treatment modalities with close follow up is needed to achieve better outcome.
Study of prevalence, etiology, response to treatment and outcome of paediatric shock in a tertiary care hospital
Authors: Gobinathan S. , Kannan K. Suresh
Published: April 2018

Background: Shock accounts for 2% of children admitted to Paediatric casualty worldwide as per most western literature and in Nelson text book of Paediatrics. About 10 million children die of shock every year in the world. Highest mortality is observed in under 5 children in developing countries. Clinical manifestations are due to decreased perfusion to tissues, the compensatory mechanisms that are triggered by the decreased perfusion and the inadequate removal of metabolic wastes. This study was carried out to assess the prevalence of paediatric shock in children admitted to Paediatric ICU, to identify possible aetiology and the response to treatment and outcome in patients admitted with shock in Paediatrics Department of Government Mohan Kumaramangalam Medical College, Hospital, and Salem.Methods: All sick children admitted to Paediatric intensive care unit of Government Mohankumaramangalam Medical College Hospital, Salem with the suspicion of shock are assessed by using the rapid cardiopulmonary assessment and diagnosed suffering from shock. Possible etiology, type and severity of shock would be arrived at using a targeted history, clinical examination and relevant laboratory investigations.Results: All children who had unstable airway or bradypnea, were having decompensated shock and except one among them all expired despite prompt airway management. Respiratory distress noticed in 23 (40.4%) of children and all of them had either cardiogenic, septic shock or a combination of both. Capillary refill time was prolonged in 52 (91.2%) of children and the remainder 5 (8.8%) had flash refill and managed as warm septic shock. Decompensated shock as evidenced by low blood pressure was seen in 57.9% children. All of them had altered mental status. Urinary output was monitored in 38 children of which 31 (81.6%) had oliguria.Conclusions: Septic shock accounts for majority of decompensated shock and poor outcome to management. Infancy decompensated shock, septic shock and those requiring ventilator support were the factors influencing the outcome of management.
Impact of drug susceptibility on treatment outcome in sputum smear positive pulmonary tuberculosis patients receiving category-II regimen in RNTCP under field conditions in an urban setting
Authors: P. M. Ramesh , M. Saravanan
Published: April 2018

Background: The study was conducted with the aim to evaluate the pre-treatment drug susceptibility profile and to assess the influence of drug resistance on treatment outcome among patients treated with category- II (cat- II) regimen under programme conditions.Methods: This study was conducted on 58 smear positive patients with history of previous anti-tuberculosis treatment for more than one month, comprising cases of ‘Failure’, ‘Treatment after Default’ (TAD) and ‘Relapse’. They received cat- II regimen in Chennai Corporation, RNTCP (revised National tuberculosis control programme) centers from July 2006 to September 2006 and they were monitored upto July 2007 as per RNTCP guidelines to assess the outcome of cat-II treatment by sputum smear status.Results: Male dominance (n=40) was seen in the study participants. Most common age group affected was 35-44 years (n=20). Out of 57 cases, 50.9% cases come under ‘Relapse’, 26.3% arises from ‘TAD’ and 22.8% cases were from ‘Failure’. After completion of treatment with cat-II regimen, out of 57 patients 33 patients were cured and 11 cases were into the category of failure, 10 patients were defaulted during treatment and 3 were died.Conclusions: Besides, the low treatment efficiency in MDR-TB cases, cat- II regimen was effective in sensitive and INH resistant cases.
The magnitude, determinants and barriers for physical activities among diabetic patients in Qassim area of Saudi Arabia
Authors: Aldukhayel Abdulrhman
Published: April 2018

Background: To review the level of physical activity (PA) among adult diabetics and barriers to PA in this population.Methods: This survey was performed in 2017 and enrolled adult diabetics from primary health center of the National Guard in Qassim, Saudi Arabia. International Physical activity questionnaire was used to grade the level of PA. The three intensities of PA (walking, moderate and vigorous exercise), and number of days per week and hours per day were queried for each participant. Metabolic equivalent (MET), a proxy indicator of PA was calculated. Data were analyzed for associations to demographic and diabetes-related factors. Participants were queried on barriers to PA such as time, space, high cost, physical disability, preoccupation with other priorities and languor.  Results: We interviewed 395 diabetic patients. The low and moderate levels of PA were noted for 320 (81%) and 75 (19%) participants respectively. None had a high level of PA. Gender (P=0.4), age (P=0.45), body mass index (P=0.66) were not associated to PA. Joint problems (43%), languor (35.2%) and family time (33.9%) were the main barriers that lowered PA.  Conclusions: There was a low level of PA among diabetics in Qassim. Barriers to PA should be proactively addressed during patient counseling to improve PA in this population. Counseling direct towards increasing PA may mitigate the physically disabling complications of cardiovascular events among diabetics.
Preparing a change laboratory intervention: waste management in a University hospital
Authors: Cassandre Marcio Pascoal , Senger Carine Maria , Querol Marco Antonio Pereira
Published: April 2018

Abstract: Researchers, interventionists and managers are challenged to plan an intervention for the development of an activity. To this purpose, it is necessary to understand and negotiate the object of the intervention with the participants. This task can be facilitated through the elaboration of a research scheme used as a planning and learning tool among interventionists and participants. This article presented an outline of such scheme for future application of a Change Laboratory (CL). This lab is considered a method to provide the development of the solid waste management activity in a university hospital in Paraná State, Brazil. The study shows the aspects to be explored to plan a CL in order to develop a new concept of this activity. It is a draft for the planning of these methodology sessions. Its preparation makes use of preliminary ethnographic data collected during the beginning of the investigative procedure foreseen by CL, seeking the current conflict historical understanding.Keywords: Activity Theory. Change Laboratory. Waste Management. University Hospital. Preparando uma intervenção do Laboratório de Mudança:  a gestão dos resíduos de um hospital universitário Resumo: Pesquisadores, intervencionistas e gestores são desafiados a planejar uma intervenção visando ao desenvolvimento de uma atividade. Para tanto, faz-se necessário entender e negociar o objeto da intervenção com os participantes. Tal tarefa pode ser facilitada por meio da elaboração de um esquema usado como instrumento de planejamento e aprendizagem entre intervencionista e participantes. Neste artigo apresentou-se um esboço deste esquema para a aplicação futura de um Laboratório de Mudança (LM). Este laboratório é considerado um método para propiciar o desenvolvimento da atividade de gestão de resíduos sólidos em um hospital universitário do Paraná. O estudo mostra os aspectos a serem explorados para planejar um LM visando desenvolver um novo conceito dessa atividade. Trata-se de um rascunho para o planejamento das sessões dessa metodologia. Sua elaboração faz uso de dados etnográficos preliminares coletados durante o início do processo investigativo previsto pelo LM, buscando a compreensão histórica da atual situação do conflito.Palavras-chave: Teoria da Atividade. Laboratório de Mudança. Gestão de Resíduos. Hospital Universitário.
New Immigrant Health Professional’s Individual, Societal and Economic Impact of Ryerson University’s Internationally Trained Medical Doctors (ITMDs) Bridging Program: Results from a Pilot Bridge Training Program at the Chang School of Continuing Education
Authors: Bhuiyan Shafi U.
Published: April 2018

Although Canada is home to a large number of internationally educated health professionals, their skills and experiences are grossly underutilized in the Canadian healthcare landscape. Barriers to medical practice are pervasive, and as a result the majority of internationally trained medical doctors (ITMDs) work in “survival” jobs significantly below their skill level. The pilot ITMD Bridging Program was developed to provide an alternative path for ITMDs by providing the skills and competencies required for non-licensed health sector employment, ultimately aiming to improve integration of ITMDs into the Canadian workforce. This secondary research evaluates the ITMD Bridging Program by assessing the impact of the program at both individual and societal levels.Qualitative and quantitative data were used to evaluate the individual and societal impact of the program. Secondary data from participants’ entry and exit surveys, as well as key informant interviews conducted with ITMDs upon program completion were used for the analysis.  The economic impact of the program and its overall utility to the economy of Ontario were assessed through literature review and social rate of return analysis.ITMDs program participants reported substantial improvements in skills related each of the core courses including health research methods, health informatics and data management, fundamentals of project management, as well as healthcare professionals communication and leadership skills.  ITMDs also perceived the program to be a viable option to address human potential waste, enhance the economy, develop individual capacity building, and alleviate frustrations associated with labour market exclusion.  The program is also economically viable at the societal level, and represents a rate of return of 6.52%.The ITMD Bridging Program has demonstrated that providing non-licensed health sector employment is a viable option for policymakers to consider in their efforts to address the current brain waste in the Ontario healthcare sector. Bridging programs similar to the ITMD Bridging Program have the capacity to impact individual outcomes of ITMDs, the economic landscape in Ontario, and Canada at large.
An Intercultural Curriculum in a Leadership in Community Engagement Program: Linking Theory and Practice
Authors: Mercer Lorraine , Carter Lorraine
Published: April 2018

AbstractStudent diversity in Canadian universities is rapidly increasing, and faculty and curriculum developers are challenged to transform programs and pedagogies to meet the learning needs of diverse students. While universities across Canada are actively attending to the need for interculturality and diversity in undergraduate education, this same need exists in continuing education units that serve diverse populations of adult learners. This paper explores the intercultural curricular experience in the context of adult education in two ways: (i) literature that reviews key terms and concepts related to culture, interculturality, and learning, and (ii) examples of intercultural learning based on a certificate program called Leadership in Community Engagement offered by the Centre for Continuing Education at McMaster University in Hamilton, Ontario, Canada. Recommendations for those working in adult and continuing education who strive for respectful and meaningful intercultural learning are also offered.
APP PARA RECONHECIMENTO E ATUAÇÃO EM SITUAÇÕES DE URGÊNCIA E EMERGÊNCIA: APOIO AO LEIGO
Authors: Thomazini Vitor Andrade , Silva Silvia Sidnéia da , Caritá Edilson Carlos
Published: April 2018

O tempo é um fator determinante para a vida de uma pessoa em situação de urgência e emergência, pois conforme preconizado em diretrizes, nos casos de urgência a assistência à vítima deve acontecer em até duas horas da ocorrência do evento, enquanto os casos emergenciais exigem atendimento imediato. Os referenciais teóricos têm apresentado que o leigo é a pessoa que mais acompanha a ocorrência de situações de urgência e emergência e, portanto, precisa estar capacitado para reconhecer sinais e sintomas que diferenciam a urgência da emergência, podendo, a partir da tomada de atitude, atender a vítima com segurança. O objetivo desse artigo é apresentar o desenvolvimento de um app para orientar o leigo no atendimento às vítimas em situações de urgência e emergência clínica, auxiliando na localização de serviços de pronto atendimento próximos ao local da ocorrência e na orientação quanto à execução da reanimação cardiopulmonar. O app foi desenvolvido com a utilização do ambiente de desenvolvimento Android Studio Integrated Development Environment e pode ser executado em dispositivos móveis que possuem o sistema operacional Android 4.0.3 ou superior. A interface contempla uma tela com o mapa - Open Street Map - das instituições de saúde que realizam pronto atendimento e outra com os procedimentos para realizar a Reanimação Cardiopulmonar (RCP). O app pode ser utilizado off-line, após o mapa da referida região já ter sido baixado anteriormente, conectado à Internet. Os procedimentos relativos à reanimação cardiorrespiratória são descritos conforme preconizado nas Diretrizes para RCP e Atendimento Cardiovascular de Emergência da American Heart Association (2015) para atendimento ao adulto. O app implementado poderá ajudar o leigo a identificar situações de urgência e emergência e atender as vítimas de parada cardiorrespiratória, realizando o suporte básico de vida necessário à estabilização da vítima, acometida por essa emergência clínica, até a chegada do suporte avançado.
Teaching Corporate Social Responsibility In An MBA Program
Authors: Tickell Geoffrey , Paz Veronica , Rahman Monsurur
Published: April 2018

This paper discusses the topic of corporate social responsibility (CSR) and proposes that CSR should be taught in an MBA program and, more specifically, in a Managerial Accounting course of an MBA program. CSR aligns strongly with other managerial accounting topics typically taught in an MBA Program such as the balanced scorecard and triple-bottom line reporting. In putting forward this suggestion, this paper proposes a definition of CSR, reviews recent literature relating to CSR, and provides several strategies for teaching and assessing students’ understanding and appreciation of CSR. In the results section of the paper, a content analysis of student essays provides an insight into how students view CSR. The paper concludes with an overview of what is attainable by teaching CSR in a Managerial Accounting MBA course.
An Inappropriate ADH Syndrome and Lung Cancer Diagnosis in A Patient with Isolated Hyponatremia
Authors: ÖZDEMİR Özlem , SAVRUN Atakan
Published: April 2018

Hyponatremia is generally considered to
have a plasma sodium concentration less than 135 mEq / L.It is the most common
electrolyte abnormality which is important in clinical practice. It can be caused by many etiological
factors. İnappropriate antidiuretic hormone syndrome (SIADH) is the one of the causes of
normovolemic hyponatremia. On the other hand SIADH is responsible for 30% of
hyponatremias due to cancer. It appears as a paraneoplastic syndrome especially
and most offen in the lung carcinoma. The World Health Organization (WHO)
reported that lung cancer is 12.9% of all cancers. It may manifest itself with
specific symptoms, but may also show only the paraneplastic syndrome. Therefore,
it should be kept in mind that the cause of hyponatremia must be determined and
may be a symptom of SIADH and lung cancer.
A Traumatic Asphyxia After A Construction Accident
Authors: ÖZDEMİR Özlem , SAVRUN Atakan
Published: April 2018

The traumatic asphyxia is
defined as cyanosis, petechiae on the face, neck, upper extremities and upper
parts of the thorax and subconjunctival haemorrhage, retinal edema  due to blunt thoracic trauma. Traumatic
asphyxia is a rare syndrome. In cases of traumatic asphyxia,
different neurological symptoms can be seen to be proportional to the severity
of trauma. Treatment is conservative, but depends on the severity of
prognostic-related injuries. In this article, we present a case of traumatic
asphyxia syndrome in a 35 year old male patient who had a traumatic asphyxia
syndrome resulting from a construction accident. And in this context the
literature, diagnosis, treatment and prognosis were discussed.
Análisis categorial y semántico de los derivados en -ari- y en -ario: un estudio a partir del español de México
Authors: Franco Trujillo Erik Daniel
Published: April 2018

En este artículo se traza un primer acercamiento a las características morfológicas y semánticas de los derivados en -ari- y -ario a partir de un corpus de unidades léxicas derivadas presentes en el español mexicano. Tras plantear y justificar la existencia de un sufijo -ari- y un sufijo -ario que conviven en la lengua, se describen los procesos mediante los cuales se generan este tipo de vocablos desde una clasificación minuciosa de sus propiedades morfológicas y semánticas. De esta manera, se atiende a la necesidad de realizar estudios puntuales de los diversos sufijos derivativos de la lengua española apelando a aspectos que competen a distintos niveles gramaticales.