bluuebunny/crossref_metadata_2025 huggingface dataset:
TRANSCATHETER AORTIC VALVE IMPLANTATION IN 80-YEAR OLD PATIENT WITH CRITICAL AORTIC STENOSIS
Authors: Chupin A V , Puzenko D V , Lebedev D P , Zvezdkina E A , Alekseeva Y M , Safronov S N
Published: March 2018

The present report describes a 80-year old female suffering from shortness of breath, chest pain and weakness by reason of critical aortic stenosis. The patient with high risk open surgical intervention successfully underwent miniinvasive treatment – transcateter aortic valve implantation (TAVI).
MODERN APPROACH TO MANAGEMENT OF DILATED CARDIOMYOPATHY: CASE REPORT
Authors: Alekseeva Yu M , Potievskaya V I , Kononenko M V , Ignatova E G , Vorobieva M V , Neplyueva G A
Published: March 2018

Description of case reports of a patient with diagnosis of dilated cardiomyopathy granting of a historical reference and modern ideas about the etiology, pathogenesis, course, and management of the disease. Performed surgical treatment (orthotopic transplantation of putrid heart), along with medication, allowed to improve the quality of life and prognosis of the disease.
MULTILEVEL VERTEBROPLASTY WITH MULTIPLE METASTATIC LESIONS OF THE SPINE
Authors: Bukharov A V , Karpenko V Yu , Agzamov D S , Rubtsova N A , Derzhavin V A
Published: March 2018

Presented the clinical observation of patients with multiple metastatic and myeloma lesions of the spine with the presence of pathological fractures of vertebral bodies and severe pain. The authors recommend multilevel vertebroplasty, as it allows to reduce pain, to prevent pathological fracture of the spine, and activate patients in a short time.
ACROMEGALY. Case report
Authors: Soyustova E L
Published: March 2018

Acromegaly - a neuroendocrine pathology, caused by chronic overproduction of growth hormone. Chronic overproduction of somatotropin and insulin growth factor (IGF) is clinically expressed in gigantism or acromegaly. Acromegaly is accompanied by various metabolic disorders, lesions of cardiovascular and respiratory systems.
CELL THERAPY OF STROKE AND SPINAL CORD INJURY COMPLICATIONS
Authors: Konoplyannikov M A , Baklaushev V P , Kalsin V A , Tikhonovsky M A , Averyanov A V
Published: March 2018

The review analyzes the current advances of cell therapy for neurological complications of ischemic stroke and spinal cord injury (SCI). We demonstrate the most recent data on the use of different types of stem cells for the treatment of these severe damages, obtained both in experimental studies using animal models and in clinical studies. We particularly discuss the use of mesenchymal stem cells (MSC) and neural stem/progenitor cells (NSC/NPC) for the treatment of stroke and SCI. We also discuss the prospects for a further development of cell therapy of these diseases.
CLINICAL EFFECTS AND RENOPROTECTIVE FACILITIES OF OLMESARTAN AND LERKANIDIPINEAS MONOTHERAPY AND WHEN COMBINED APPLICATION IN PATIENTS WITH ARTERIAL HYPERTENSION
Authors: Evdokimova A G , Ryzhova Yu V , Gukolenko L V
Published: March 2018

The evaluation of the clinical efficacy and renoprotective effects of olmesartan and lercanidipine as monotherapy and when combined application in patients with arterial hypertension (AH) 1-2 degrees and microalbuminuria (MAU).It is established that the degree of blood pressure (BP) reduction and corrective influence on diurnal BP profile were similar in groups of monotherapy with olmesartan and lercanidipine. In the group of combined application of the studied drugs target BP levels were achieved in 88% of cases in the monotherapy group and 78% (1G) and 76% (2 G).Revealed renoprotective effects of olmesartan and lercanidipine as when used in monotherapy and in combination in patients with arterial hypertension of 1-2 degrees, and MAU, revealed reliable decrease in MAU. The greatest reduction in MAU was achieved in the combination therapy group.
EFFECT OF ANTICANCER DRUGS ON PRIMARY CELL CULTURES OF PATIENTS WITH COLORECTAL CANCER
Authors: Golyasnaya N V , Ivanov Yu V , Zhizhin N S
Published: March 2018

The goal of the research is to estimate the effect of 5-Fluorouracil, Cisplatin, Tomudex, Leucovorin and their combinations on colorectal cancer cells in vitro. Cell response to the effect of cytotoxic compounds and immunomodulator was estimated by the change in chromosomal aberrations, cell growth rate, proliferative activity and colonyforming unit. It was detected that antineoplastic drugs affected the mutagenesis and fission rate of cultured cells.
MULTIPARAMETER ULTRASOUND FOR LIVER AND PANCREAS IN MODERN CONDITIONS
Authors: Morozova T G , Borsukov A V , Pleshkov V G
Published: March 2018

The Aim. To determine the value of multiparametric ultrasonic methods of research in the frame-work of comprehensive elastography.Materials and methods. The study included 256 people: men - 145 (56,7%), women - 111 (43,3%), aged 47,4 ± 5,7, suffering from diffuse liver diseases and pancreas diseases. To determine the diagnostic and prognostic value of a comprehensive elastography use there were performed: transient edastography, compression elastography, endosonography in elastography compression, shear wave elastography.Results. According to the study it was found: the body mass index (more than 25 kg/cm2) is the restriction to conduct transient elastography, compression elastography; heart disorder - compression elastography and compression elastography at endosonography (AUROC = 0,893, [0,878 - 0,979]). Compression elastography of pancreas at endosonography is the method of choice in the differential diagnosis of benign and malignant processes, to clarify the “zone of interest” for puncture-aspiration biopsy (AUROC = 0,981, [0,891-0,982]).Conclusions. Multiparameter ultrasound elastography study complex increases the diagnostic and prognostic value of the algorithm of patients examination with liver and pancreas diseases: specificity- 97,5%, sensitivity - 95,6%, accuracy - 96,5%.
TECHNICAL DETAILS AND RESULTS OF CRYOABLATION IN PANCREATIC CANCER
Authors: Ionkin D A , Stepanova Yu A , Shurakova A B , Chzhao A V
Published: March 2018

Aim: To improve the results of treatment of terminal stage pancreatic cancer. Materials and methods. Since 2012 cryosurgery was performed in 45 patients - 20 men (44.4%) and 25 women (55.6%) with pancreatic cancer. With mean age of 59 ± 3 years. The head of the pancreas was struck in 20 (44.4%) cases, a head-body - in 13 (28.9%), the body - in 12 (26.7%). The following distribution of patients depending on pacreatic cancer stages were noted: stage IV- 34 patients, stage III- 11. In 8 patients with pancreatic cancer and liver metastases simultaneous cryodestruction of tumorsof the pancreas and liver malformations were performed. Local cryodestruction has been supplemented by bypass in 29 cases (64.4%). In one case, cryosurgery was performed on segment of the portal vein after the pankreatoduoenal resection. All patients subsequently were underwent adjuvant chemotherapy, supplemented by regional chemoembolization in 10 cases.Results. We proposed indications and contraindications for cryoablation. Intraperitoneal bleeding was diagnosed in 2 (4.4%) cases. Acute pancreatitis - in 5 (11.1%) cases. Suppuration manipulation area was noted in 2 (4.4%) cases. Ascites was detected in 9 (20.0%) patients (docked within 5-8 days therapeutically). Wound supporation was observed in 2 (4.4%) cases. Complete pain relief atchieved after cryoablation was reached in 38% of cases or significant reduction of its intensity in 41%. Kaplan-Meier survival in patients with pancreatic cancer for 6 months was 56%, for 12 months - 28%, for 24 months -15% and for 28 months - 4.3%.Conclusion. Сryodestruction for cancer of the pancreas in patients with unrespectable tumors improves the quality of life of cancer patients, primarily due to decrease pain intensity. Application of chemotherapy improves quality of life and can prolong survival rates.
INVESTIGATION OF STRUCTURE OF THE MEMBRANE RAFTS BY MEANS OF COMPUTER MODELING
Authors: Bozdaganyan M E , Shaitan K V
Published: March 2018

Understanding the structure of the biological membrane and its role in the cell has evolved significantly since the introduction of the classical fluid mosaic model by Singer and Nicholson. Later fluid mosaic model has been redesigned, expanded and has become considerably complicated. It has been experimentally proved that the membrane consists of so-called rafts, which are functional “islands” with the specific lipid composition with proteins. Lipid rafts play a central role in many cellular processes, including barrier functions, membrane polarization and the cell signaling. Several groups of pathogens, bacteria, prions, viruses, parasites use lipid rafts for their purposes. Rafts always occur on both sides of the membrane opposite to each other, but the nature of the two-layer rafts are still poorly understood. Previously it was theoretically calculated that the shift of the monolayers in raft occurs, which reduces the mechanical energy of the boundaries, and ultimately leads to a bilayer structure of the raft. In this study with the help of computer modeling we study the energy of interaction between two monolayers of the raft in order to test the hypothesis about their relative shift.
SIDE EFFECTS OF PROLONGED ANTIARRHYTHMIC THERAPY WITH AMIODARONE
Authors: Dorofeeva N P , Ivanchenko D N , Mashtalova O G , Kulikova I E , Chibineva S A , Ter-Akopyan A O , Sklyarov F V , Kiyashko E E
Published: March 2018

Atrial fibrillation is widespread in population. It determines extensive use of antiarrhythmic drugs such as amiodarone. Thyroid lesion is one of common side effects of this therapy. The article describes a clinical case of photosensitivity’s development in the application of amiodarone
A comparative assessment of the impact of computer assisted learning of knowledge and skill based competencies among undergraduate students in a medical college in South India
Authors: Rathinam Jeyalalitha , R. Divakar , S. P. Subahan , A. Preethi , G. Vanitha , R. Punitha
Published: March 2018

Background: Pharmacology has always been one subject ultimatum and a cornerstone in building up competency, based on applied therapeutics among medical graduates in prescribing and practicing skills. A focus on an integrated strategical approach towards teaching pharmacology for better proficiency in achieving clinical skills is mandatory. Thus, this study has been done to assess the impact and retainment of overall knowledge gained on various domains, based on a revised method of teaching in pharmacology.Methods: An observational, questionnaire based comparative study was done in a medical college, in Chennai. The study included two group of students, one who have completed their pharmacology course based on the revised pattern of teaching with a comparative group of students who have not been exposed to the revised pattern of teaching. A feedback survey was also done.Results: The study results indicated that the average scoring based on the questionnaire was 84% with the students who have been exposed to revised pattern of teaching in comparison to the average scoring of 70% with the students who have not been exposed to the new pattern of teaching. The average scoring of the students who were found to agree to several questions on the new method of teaching was 74% and 22% of the students were found to disagree. 4% of students were non responders.Conclusions: The ultimate improvement in the outcome of health care education can be achieved through appropriate skill building through a simple strategical modification of the regular teaching pattern with an integrated approach involving pharmacologists and clinicians. A refresher course in pharmacology in the final year curriculum and CRRI involving pharmacologists is mandatory.
Effect of Vitamin E on oxidative stress and outcome of treatment in patients of anxiety disorder
Authors: Jogdand Sangita Devrao , Shinde Raju Kamlakarrao
Published: March 2018

Background: The purpose of present study was to assess effect of Vitamin E administration on oxidative stress and outcome of treatment of anxiety disorder.Methods: 80 newly diagnosed patients of anxiety disorder of age 20 to 60 years were included in the study. They were divided in to two groups containing 40 patients in each group. Group-I patients were given treatment with Tablet Clonazepam 0.5mg orally daily at night for six months. Group-II patients were treated with Tablet Clonazepam 0.5mgand Capsule Vitamin E 400 mg twice a day for 6 months. Levels of Mean MDA, SOD and anxiety score were assessed monthly for six months.Results: Group-I (N=38) patients treated with Tablet Clonazepam 0.5mg orally at night show significant increase in Oxidative stress. Mean MDA- 18.80±0.37 increased to 27.97±0.81, SOD- 0.143±0.004 decreased to 0.111±0.004 and decrease in mean anxiety score from first month 12.44±1.24 to last month of treatment 2.55±0.72. In group-II patients(N=37) treated with Clonazepam and Vitamin E there was decrease in mean MDA levels from 18.78±0.45 to 12.56±0.54 and increase in mean SOD levels from 0.141±0.007 to 0.180±0.000. There was reduced anxiety score in group-I from 12.44±1.24 to 2.55±0.72 and in group II from 12.54±1.26 to 1.86±0.58 which was statistically significant. p value <0.05.Conclusions: Treatment of patients treated with Clonazepam showed a significant increase in oxidative stress. In patients treated with Clonazepam and Vitamin E there was more reduction in overall oxidative stress and anxiety.
Evaluation of the role of CRP as an early predictor of chorioamnionitis in PPROM
Authors: Aggarwal Amika , Pahwa Sangeeta
Published: March 2018

Background: Preterm birth is one of the most important cause of perinatal morbidity and mortality. PROM is defined as spontaneous rupture of membranes before the onset of uterine contraction. Objective of present study was to evaluate the role of CRP as an early predictor of Chorioamnionitis in PPROM.Methods: A prospective study was done on 50 cases with PPROM and 50cases of control group without PPROM. All mothers and babies were observed from the time of admission to the time of discharge.Results: C-reactive protein appears to be the most sensitive acute phase protein; rising of less than 24 hours makes it suitable to serve as a marker for diagnosing an infective process in early stage. On comparing C-reactive protein levels with other laboratory tests and indicators of infection (e.g. total leucocyte count DLC, maternal fever, maternal tachycardia, fetal tachycardia) we found CRP level to be more sensitive (100%) but less specific (69.56%) in identifying clinical Chorioamnionitis. The positive predictive value was 22.22% and negative predictive value was 100%.Conclusions: In cases of PPROM, raised CRP is an early predictor of clinical Chorioamnionitis as well as histological Chorioamnionitis.
Study of knowledge, attitude, and practice regarding birth spacing and methods available for spacing in rural Haryana, India
Authors: Yadav Bindoo , Pandey Santvana
Published: March 2018

Background: Birth spacing is defined as the time interval between two births. India has average birth spacing of 22 months, i.e. little less than two years, despite wide knowledge of contraception. Objective of present study was to investigate the knowledge, attitude, and practice regarding birth spacing and methods available for spacing in rural Haryana amongst sexually active married females of reproductive age.Methods: Cross sectional study of 500 sexually active, married females of reproductive age with at least one live issue and not meeting any exclusion criteria was carried at SGT medical college, Gurgaon during 3 months from August 2017.Results: Awareness of need for birth spacing was very high (82.6%) in females interviewed, with 70% of females being aware of birth spacing benefits as well as keen to opt for birth spacing but even higher count of females (92.6%) reporting requiring husband’s consent for birth spacing. Only 40% females were practising birth spacing with 14.6% of females reporting in-law’s opposition as reason for not practising birth spacing.Conclusions: Education is a major factor improving awareness of need as well as benefits of child spacing, with all college studied females being aware of both. Education also leads to improvement in keenness for practising child spacing as well as having lesser opposition to practise of child birthing. Females with only girl child/children were less keen to practise child spacing. Rural geographies still have health personnel as significant source imparting awareness of child spacing.
Clinical analysis of gynecological diseases in postmenopausal women in tertiary care centre
Authors: Parihar Bharti Choudhary , Tiwari Priyanka
Published: March 2018

ABSTRACTBackground: Menopause is a natural step in ageing process represents the period end of menstruation after last menstrual period in previous 12 months. Gynaecological disorder in older women differs from those who are younger. Disorders peculiar to ageing are pelvic organ prolapse, urinary incontinence, genital infections and malignancies. Present study is contemplated with a view to assess the magnitude of postmenopausal gynaecological morbidity. The goal of this study was to assess the age of onset of menopause and the spectrum of different gynaecological diseases, their incidence, diagnosis and treatment modality in postmenopausal females.Methods: A Prospective observational study of postmenopausal females attending Gynecology OPD or admitted in Sultania Zanana Hospital, Bhopal was carried out between July 2014 to June 2015. Total 401 postmenopausal females were included. Age of menopause and detail of all gynecological problems were recorded using predesigned proforma.Results: The study population was drawn from both rural (41.4%) and urban (58.8%) areas. Mean age of onset of menopause was 48.01 years in study population. In all, 28.4% had pelvic organ prolapse, 26.6% had genital malignancies, 25.5% had urogenital infections and 17.7% had benign disorder like senile endometritis, fibroid uterus etc.Conclusions: Menopausal health has been one of the neglected area in our country and needs timely vital attention as they are at risk of developing various genital malignancies. This emphasises the need for a screening programme for Indian women in our scenario.
Effectiveness of deep breathing and walking exercise in reducing menopausal symptoms among women at Karadivavi, India
Authors: B. Sreerenjini , . Muthulakshmi
Published: March 2018

Background: Menopause has been defined as the point in time of the last menstrual bleeding in a women’s life. Menopausal symptoms affect about 70% of women. The objectives of the study were assessment of the women for menopausal symptoms, assessment of the effectiveness of exercises in reducing menopausal symptoms and associate the demographic variables with menopausal symptoms.Methods: One group pre test and post test design was adopted for the study. Allowable error method was adopted to select the desired sample. The sample size was 30. Demographic profile and menopausal symptoms information were collected. Menopausal symptoms were assessed by Menopausal rating scale. The data collected were analyzed by using both descriptive and inferential statistics method. Paired ‘t’ test was used to compare the pretest and posttest level of menopausal symptoms.Results: Majority of the women (80%) had moderate menopausal symptoms before practice of deep breathing and walking exercise. After practicing exercises only four women had mild menopausal symptoms and 70% of the women relieved from joint pain. Association was found between age at first conception, number of conception, medical problems with pretest menopausal symptoms score.Conclusions: This study review shows that Deep breathing and walking exercise was helpful in reduction of menopausal symptoms among menopausal women. This result can be potentially employed as one of the complementary therapy in the reduction of menopausal symptoms.
Prognostic role of robinson cytological grading system in breast cancer in correlation with the histological grading of modified bloom richardson in Iraq
Authors: Kareem Noora M. , Rahmatullah Nihad Salih
Published: March 2018

Background: The breast cancer is increasing in developing countries and the management options are widened, therefore providing the surgeon with accurate prognostic information on which the mode of therapy will be chosen became so important. Robinson grading system was found to be useful in grading breast carcinoma in fine needle aspirates. The objectives of the study were to estimate the benefits of using Robinson grading system in fine needle aspiration for breast cancer and to estimate the correlation of Robinson grading system in fine needle aspiration with histological grading.Methods: There were Seventy cases of invasive ductal carcinoma was graded on FNA aspirates by Robinson grading system using six cytological parameters (cell dissociation, cell size, cell uniformity, nucleolus, nuclear margin, and nuclear chromatin).Results: The concordance rate between grade I tumors on cytology and histology was 100%, while for grade II tumors it was 62.5% and for grade III tumors it was 100%. The absolute concordance rate was 87.5%, the Spearman rank correlation coefficient (r) was 0.762, p value was (0.00), the sensitivity of Robinson’s cytological grading system in cytological grade I tumors was 73.33% and specificity was 100%. In cytological grade II tumors the sensitivity was 100% and specificity was 76% and in cytological grade III tumors the sensitivity is 100% and specificity was 100%.Conclusions: Robinson’s cytological grading of breast carcinoma correlates well with Bloom-Richardson’s histological grading system and could be a helpful parameter in selecting a neoadjuvant treatment for the breast cancer patients on fine needle aspiration cytology alone.
Clinical profile of patients with pancytopenia in a tertiary care centre
Authors: . Jyotsana , Afreen Khan , Sharma Vishakha , Kapur Prem , Manjavkar Smita , Jain Vineet , Kohli Sunil , Habib Anwar
Published: March 2018

Background: Pancytopenia is a condition in which all three cell lines i.e. erythroid, myeloid and megakaryocytic are affected resulting in anaemia, leukopenia and thrombocytopenia. It can be a manifestation of a wide variety of disorders which primarily or secondarily affect the bone marrow. Early diagnosis of these conditions will help in implementing the appropriate treatment. The objective of the study was to know the clinical presentation and etiology of patients presenting with pancytopenia.Methods: A one year study from April 2016 to March 2017 was conducted in the department of medicine at a tertiary care centre. Total 32 patients with pancytopenia were studied to determine their clinical features and etiology through relevant investigations.Results: Our study revealed megaloblastic anaemia (46.87%) as the most common cause of pancytopenia, followed by malaria (12.5%). Other causes included hypothyroidism (6.2%), hypersplenism (6.2%), drugs (12.5%) and miscellaneous (9.43%).Conclusions: Megaloblastic anaemia was found to be the major cause of pancytopenia in patients. Other causes of pancytopenia were malaria, drugs, hypersplenism and hypothyroidism. These should be kept in mind while evaluating patients with pancytopenia.
Evaluation of recurrence and postoperative pain in laparoscopic inguinal hernia repair with mesh fixation verses without mesh fixation
Authors: Prasad Dinesh , Khedkar Indira , Modi Mitesh
Published: March 2018

Background: Inguinal hernia affects both men and women but is much more common in men who comprise over 90% of operated patients.  The purpose of this study was to determine whether elimination of tacking the mesh during endoscopic inguinal hernia repair results in decreased postoperative pain or complications, or both, without increasing the incidence of hernia recurrence.Methods: Patients age between 18 to 70 yrs, willing for laparoscopic surgery, suitable for elective laparoscopic surgery were included in the study. TEP or TAPP endoscopic inguinal hernia repairs would be performed with the patient under general anesthesia. Data collection have done by using a structured pre-prepared case performa. The patient evaluated both by radiological and laboratory investigations both pre-operatively and post-operatively.Results: There is no major significant difference in pain at 1 month after operation in both the group. Recurrence was higher among patient having mesh fixation and it was not statistically significant. Wound infection was occurring more among without fixation group and it was not statistically significant. Urinary retention was reported more among without fixation group and it was not statistically significant.  Conclusions: Thus, it was concluded that there is no significant difference in recurrence rate in the both study group either with fixation or without fixation. There is no significant difference in pain at one month in the both study group either with fixation or without fixation. There is more pain (visual analogue scale more than two) at three months after operation in fixation group as compared to without fixation group. There is also high cost in fixation group as compared to without fixation group.
The effect body mass index on varicocele
Authors: Mohammad Ehab Jasim , Abbas Kanaan Mahdi , Abd Ali Hussein , Abdulrazaq Alaa Abdulqader
Published: March 2018

Background: Varicocele, is the most common abnormal finding among men presenting with infertility, yet controversy exist regarding their etiology. Anecdotal experience suggests that varicoceles are more prevalent in lean men, supporting the “nutcracker” effect of the superior mesenteric artery compressing the left renal vein over the aorta. The aim of this study was to determine the association between Body Mass Index (BMI) and occurrence of varicocele.Methods: A total of 100 males with varicocele attending the urological outpatient clinic were evaluated from their physical screening examinations.  All subjects underwent history taking and physical examinations to evaluate for the presence and severity of varicocele, height, weight, and BMI, those compared with 100 men without varicocele (control group) were selected randomly from general population.Results: The mean BMI of the 100 patients with varicocele was 26.1620 while that of the control group was 29.7330 (P= 0.0001) which is clinically significant. Varicocele grade decreased with increasing BMI category (P= 0.0001).Conclusions: The results of this study indicate that there is a decreasing incidence of varicocele and varicocele grade with increasing BMI, Supporting the possibility that obesity results in a decreased nutcracker effect in which the adipose tissue prevents compression of the renal vein.
Study of laparoscopic cholecystectomy in gallstones induced pancreatitis
Authors: Bisht Abhinav , Rehmani Babar
Published: March 2018

Background: Many general surgeons still harbor a notion that laparoscopic cholecystectomy in patients with acute gallstone induced pancreatitis has a higher morbidity. The timing of cholecystectomy in these patients is a matter of debate. Aim of the study was to assess the degree of difficulty, the timing of laparoscopic cholecystectomy (LC), and the complications of surgery in patients of gall stone pancreatitis subjected to laparoscopic cholecystectomy.Methods: 69 patients were diagnosed with gall stone induced pancreatitis over a period of 12 months and 46 underwent laparoscopic cholecystectomy. After an acute attack of pancreatitis the procedure was performed on index admission or was delayed for an interval of 3 to 4 weeks, thereby dividing the study sample into two on the basis of timing of surgery. The severity of pancreatitis was graded according to the Revised Atlanta criteria.Results: All the patients who underwent laparoscopic cholecystectomy had either mild or moderate severity of pancreatitis. Comparing the two groups with regard to timing of cholecystectomy, no statistically signiﬁcant difference was noted in operating time, difficulty in surgery, conversion rate to open procedure or post-operative stay.Conclusions: Laparoscopic cholecystectomy in patients with gallstone induced pancreatitis does not attribute any additional risk and does not have increased morbidity nor is there any increase risk of conversion.
External genital injuries in childhood: obey the rules and detect the unseen
Authors: Tuncer Ahmet A. , Embleton Didem Baskin , User Nese N. , Cetinkursun Salih
Published: March 2018

Background: This paper evaluates the patients with external genital organ injuries (EGOI) and the suitability of the Onen’s genital injury scoring (GIS) for the management of such patients.Methods: This is a cross-sectional study. Patients with the complaints of EGOI were retrospectively explored regarding to age, sex, trauma type, hospitalization time, classification of injury type, presence of additional pathologies and treatment methods. After the injury types are classified by using the Onen’s GIS, we investigated the sufficiency of this scoring method for our treatment modalities.Results: A total of 57 patients, 19 females and 38 males, were diagnosed as EGOI. These patients were classified with Grades (G) by using the Onen’s GIS (G1: 42, G2: 7, G3: 5, G4: 2, and G5: 1 patient.). The Grade 5 patient had a colostomy. The external anal sphincters of two patients were repaired to avoid incontinence in the future. The other patients received either medical or non-specific surgical treatments for their injuries. A G3 patient with testicular hematoma had testicular atrophy in the following year. There was no mortality in the present series.Conclusions: The EGOI at childhood ranges from minor derma-abrasion to complete tears of anorectum which requires colostomy. Onen’s GIS ensures better management.
Study of clinical spectrum and management of acute intestinal obstruction
Authors: Jaiswal N. K. , Shekhar Sandeep , Ranade Pushkar
Published: March 2018

Background: Acute intestinal obstruction is one of the major surgical emergencies. Intestinal obstruction is defined as partial or complete interference with forward flow of small or large intestinal contents. Intestinal obstruction of either small or large bowel continues to be a major cause of morbidity and mortality. Study aims to find the aetiology, diagnosis and management of acute intestinal obstruction.Methods: A total of 135 patients of acute intestinal obstruction was studied from November 2013 to October 2015 in government medical college, Nagpur. Study was done in patients in OPD of this tertiary centre. Inclusion criteria being patients coming to the hospital with features suggestive and further confirmed of acute intestinal obstruction. Patients included were in, age group of 18 years to 80 years giving written informed consent. Patient of pseudo obstruction were excluded from the study.Results: A total of 135 patients, presented with acute intestinal obstruction during the period of the study. Mean patient age was 45.87 years with peak incidence in those aged 21-30years. The foremost signs and symptoms were constipation (85.93%) and abdominal pain (91.11%). Adhesions and bands (61.9%) was the leading causes of intestinal obstruction.Conclusions: Present study concluded that small bowel obstruction is more common than large bowel obstruction. Abdominal pain, constipation and distension are the most common symptoms, while increased bowel sounds, tachycardia and tenderness is most common sign. Post-operative adhesion in small bowel and malignancy in large bowel is major cause of acute intestinal obstruction.
Correlation between triglyceride level and carotid intima media thickness in patients with type 2 diabetes mellitus
Authors: Bendwal Kavita , Bendwal Suresh , Dhawale R. G.
Published: March 2018

Background: Type 2 diabetes mellitus (T2DM) is associated with the development of premature atherosclerosis and high cardiovascular morbidity and mortality. Diabetic dyslipidemia is believed to play an important role in the pathogenesis of accelerated atherosclerosis in this condition. The aim of present study was to find out the role of fasting and postprandial triglyceride level and its relation with carotid intima media thickness in patients of T2DM.

Methods: 120 patients of T2DM were included in this study. All patients didn’t have any peripheral vascular disease, IHD or stroke and all were between 30 to 70 years of age. Ultrasonographic evaluation done in all patients to measure CIMT and its correlation seen with fasting and postprandial triglyceride level and other parameters.

Results: All patients are divided into 3 groups according to their triglyceride level NN, NH and HH. The mean CIMT in the NN, NH and HH group was 0.96±0.26, 1.64±0.39 and 1.94±0.57 mm respectively. The CIMT was higher in the NH and HH groups in comparison with that in NN group which is statistically significant (p<0.001).

Conclusions: Fasting and postprandial triglyceride level both correlate significantly with carotid intima media thickness. But the correlation of postprandial triglyceride level with CIMT is better than that of fasting triglyceride level.
Prevalence of picky eating behavior and its impact on growth in preschool children
Authors: Kumar K. Pavan , Srikrishna S. , Pavan Indira , Chary Eshwara
Published: March 2018

Background: Almost two-thirds of parents report one or more problems with their children’s eating. Although knowledge of the health-related outcomes of picky eating is limited due to a lack of longitudinal studies, research suggests that picky eating is associated with nutrient deficiency, underweight, behavioral problems and symptoms of anxiety and depression. Aim of present study was to assess the Parental perception and maternal strategies in solving feeding difficulties in relation with parenting style.Methods: The present cross sectional study conducted on 1652 parents of preschool children of 1-6 yrs age group. A structured parental questionnaire was administered to parents by Pediatricians based on Stanford feeding Questionnaire on Child- parent feeding.Results: About 58.9% of the children were found to be picky eaters. The prevalence is increasing with age and higher at 6 years age. The mean height and weight are seen affected significantly in picky eaters. Infantile Anorexia is the commonest type of Feeding difficulties, followed by Highly selective intake category. Commonest Parenting style is Authoritarian type, followed by Permissive parenting.Conclusions: As the prevalence of picky eating behaviour is increasing with age, causing parental anxiety and conflict in the family, disrupting parent child bonding, Paediatricians should be thoroughly equipped with knowledge of different Feeding difficulties and their specific management and help parents in doing their best by correcting their parenting style.
Psychosocial problems and needs of patients in palliative care center
Authors: Mithrason Arun T. , Parasuraman Gomathy , Iyer Ramesh Harihara , Varadarajan Suresh
Published: March 2018

Background: Number of cancer cases in India is rising every year and also the sufferings caused by the disease. The patients not only require physical control of disease and symptoms, but, also need help to cope up with other elements caused by the disease. Psychosocial aspect of the patient is usually left unmet.Methods: This study was done in ‘Jeevodaya Hospice Care Centre’, Chennai, India. 60 patients were included in this study. Questionnaire on problems and needs in palliative care was used. The questionnaire consists of eleven elements which deal with psychological issues and fourteen elements which deal with social problems and needs.Results: The five most common psychological problems, perceived by palliative care patients in descending order were; depressed mood (96.7%), fear of metastasis (95%), unpredictability of future (93.3%), not experiencing pleasure (91.5%), and, fear of physical suffering (85%). The five most common social problems perceived by the patients were; loneliness (93.3%), experiencing too little support from others (61.7%), difficulty in talking about the disease for not wanting to bother others (56.7%), finding others not receptive while talking about the disease (53.3%) and difficulty in finding someone confidential to talk to (46.7%).Conclusions: These psychological and social problems along with fear of death causes disruption of the sensitive balance between the body and mind. Proper communication, treatment and counselling helps in a great way to tackle such issues.
Assessment of knowledge regarding rabies and its prevention among the medical students of Government Medical College Rajnandgaon, Chhattisgarh, India
Authors: Tiwari Anjana
Published: March 2018

Background: Rabies is a fatal viral zoonotic disease. In India about 20,000 persons die of rabies annually. The aim of present study was to assess the knowledge regarding rabies and its prevention among the medical students.Methods: A cross-sectional study was conducted among183 medical students of Government Medical College Rajnandgaon, Chhattisgarh during August 2017 to September 2017 using a pre-tested questionnaire. Data was entered and analyzed by using descriptive statistics (frequency and percentage).Results: It was seen that majority (83.1%) of medical students knew about the viral cause of rabies, 93.4% knew the dog as most common reservoir of rabies and 91.8% knew the most common mode of rabies transmission by bites of rabid animal. About three fourth (74.3%) of medical students knew that hydrophobia as the symptom of rabies in human. About danger sites of animal bite and fatality of rabies was known by 81.4% and 68.8% of medical students, respectively. Only 45.9% of medical students knew the correct incubation period of rabies. Majority (72.7%) of students knew about the immediate wash of the wound with soap and water but only 42.1% knew about antiseptic use. Majority (71%) of students knew the correct site and only 43.7% knew the correct schedule of vaccination. Only 29% of medical students knew about indication of rabies immunoglobulin.Conclusions: There is a need to organize re-orientation programs and continuing medical education (CME) sessions on rabies and its prevention for medical students, at regular interval.
Comparison of the outcomes of pull through suturing vs. tension band wiring fixation techniques in the management of patellar fractures
Authors: Kadam Rahul , Pandey Sachin , Challani Abhay , Jain Vicky , Shah Akshay , Agarwal Ankit
Published: March 2018

Background: Operative fixation of displaced patella fractures has now become the standard of care. This study aims to asses functional outcomes, as well as identify complications in a patients treated with non-absorbable braided suture fixation for patellar fractures. These patients were then compared to a group of patients treated with K-wires with tension band wiring.

Methods: This study was conducted on the patients admitted to orthopaedic ward at MGM medical college and hospital, Kamothe, Navi Mumbai. Total number of patients was taken for this study. Patients were followed up for a period of 6 weeks, 3 months, 6 months and at each visit. Patients were assessed by Lysholm knee score.

Results: The mean age was 43.33 years for TB wiring group and 46.26 years for pull through suturing group. Out of 30, 15 were in TB wiring group in which 14 males and 1 female and, 15 in pull through suturing group 4 females and 11 males. The mean Lysholm knee score at 6 weeks for TB wiring group was 68.2 at 3 months was 81.4 at 6 months was 87. The mean Lysholm knee score for 6 weeks for pull through suturing was 69.2, at 3 months was 72.5 and at 6 months was 79.2.

Conclusions: Patella fracture most common fractures, in this study we have discussed two modalities of treatment one is TB wiring and second is pull through suturing showing results that TB wiring have better results.
Single intra-articular steroid injection of the glenohumeral joint in management of adhesive capsulitis: a comparison between approaches
Authors: Kalluraya Surykanth , Varma Anand , P. H. Jayaram
Published: March 2018

Background: Adhesive capsulitis is a common, painful musculoskeletal condition of the shoulder associated with loss of range of motion in the glenohumeral joint resulting from contraction of the glenohumeral joint capsule and adherence to the humeral head. Earlier stages of adhesive capsulitis can be treated by intra-articular steroid injections into the glenohumeral joint. This study was designed to study the role of long acting intra-articular corticosteroid injections in combination with simple therapeutic exercises while comparing the outcome of blinded anterior and posterior injection approaches in the management of adhesive capsulitis.

Methods: The study comprised of 60 subjects aged 18 years and above who were diagnosed with primary adhesive capsulitis. They were randomly divided into 2 groups i.e., Group A who received blind intra-articular steroid injections via standard anterior approach and group B who received blind intra-articular steroid injection via standard posterior approach. Both groups followed up with a simple home based exercise program. Outcome measures assessed were visual analog scale (VAS) score, shoulder pain assessment disability index (SPADI) and passive shoulder range of motion (ROM).

Results: At last follow up, both groups showed statistically significant improvements in all outcome measures i.e., VAS score, SPADI, shoulder ROM. However, comparison between groups did not reveal any statistically significant differences between the two groups.

Conclusions: Intra-articular steroid injections into the glenohumeral joint in conjunction with simple physiotherapy are effective in improving pain, function and shoulder ROM in adhesive capsulitis. Both the anterior and posterior injection approaches provide good results.
A Data Envelopment Analysis Approach to Performance Efficiency of Intellectual Capital – Case of Titan Company Limited#
Authors: Venugopal Deepa , Nambi S. Thirupparkadal , M. Lakshmanan
Published: March 2018

The purpose of this paper is to value the Performance efficiency of Intellectual Capital (IC) on Financial performance indicators of Titan Company Limited. Data required for analysis were collected from the Annual reports of the company for a period of twenty years. This study uses a DEA – CCR – Output Model which consist of intellectual capital indices as input and financial performance measures as output. Results of the efficiency analysis reveals that of the 20 years studied, only 6 years (2007, 2011, 2012, 2013, 2015, and 2016) were found to be the best performing years in terms of harnessing the goodness of intellectual capital. Some years were very close to perfect efficiency score of one, but the rest of the years showed very poor utilisation of intellectual capital to impact financial performance.
A Simulation Model for Pricing the Spread in a Credit Default Swap: Application and Analysis#
Authors: Sethi Madhvi , Thakkar Parthiv , Jamal Zahid M.
Published: March 2018

This paper explores pricing the contract of a Credit Default Swap (CDS) using a simulation model. It attempts to determine the spread value which is a periodic payment to be made by the protection buyer. It also helps in identifying the factors that should be taken into account to determine the true value of the payment which would hedge the risk in case of a credit event by the issuer of the underlying asset. The paper uses the Hull and White pricing model for creating the simulation model. This model is then applied to analyse CDSs of countries having different credit ratings. The paper using the model analyses the actual and estimated spread of the different countries and discusses the possible reasons for the same. 
Beyond Deal Making Five Steps to Negotiating Profitable Relationships By Melanie Billings – YUN
Authors: H. Gayathri
Published: March 2018

No Abstract.
Editorial
Authors: Sengupta Mousumi
Published: March 2018

No Abstract.
Cloning, expression and characterization of thermostable YdaP from Bacillus licheniformis 9A
Authors: Wani Lako Joseph D , Yengkopiong Jada P , Stafford William HL , Tuffin Marla , Cowan Don A
Published: March 2018

The Bacillus licheniformis ydaP gene encodes for a pyru­vate oxidase that catalyses the oxidative decarboxyla­tion of pyruvate to acetate and CO2. The YdaP form of this enzyme was purified about 48.6-folds to homoge­neity in three steps. The enzyme was recovered in a soluble form and demonstrated significant activity on pyruvate using 2, 6-dichlorophenolindophenol (DCPIP) as an artificial electron acceptor. HPLC analysis of the YdaP-enzyme catalysed conversion of pyruvate showed acetate as the sole product, confirming the putative identity of pyruvate oxidase. Analysis of the substrate specificity showed that the YdaP enzyme demonstrated preference for short chain oxo acids; however, it was activated by 1% Triton X-100. The YdaP substrate-bind­ing pocket from the YdaP protein differed substantially from the equivalent site in all of the so far character­ized pyruvate oxidases, suggesting that the B. licheni­formis YdaP might accept different substrates. This could allow more accessibility of large substrates into the active site of this enzyme. The thermostability and pH activity of the YdaP enzyme were determined, with optimums at 50ºC and pH 5.8, respectively. The amino acid residues forming the catalytic cavity were identi­fied as Gln460 to Ala480.
Lower levels of Caveolin-1 and higher levels of endothelial nitric oxide synthase are observed in abdominal aortic aneurysm patients treated with simvastatin
Authors: Kowalska Karolina , Habrowska-Górczyńska Dominika E , Neumayer Christoph , Bolliger Michael , Domenig Christoph , Piastowska-Ciesielska Agnieszka W , Huk Ihor , Piechota-Polanczyk Aleksandra
Published: March 2018

This study was undertaken to verify if simvastatin modulates Cav-1/eNOS expression and if this modulation is associated with changes in pro- and anti-inflammatory cytokines and Toll-like receptor 4 (TLR4) in abdominal aortic aneurysm (AAA). It was 1:2 case-control study of non-statin (n=12) and simvastatin-treated patients (n=24) who underwent open AAA repair. Simvastatin treatment significantly and dose-dependently decreased Cav-1 and increased eNOS expression in AAA wall (p<0.05 and p<0.01, respectively). The changes in Cav-1 and eNOS were associated with a trend towards decreased concentration of IL-6 and IL-17 (p>0.05) and increased concentration of IL-10 (p=0.055) but not with TLR4 expression suggesting other mechanism of simvastatin influence on Cav-1 and eNOS in AAA wall. Simvastatin may modulate Cav-1 and eNOS expression in aneurysmal wall indicating a new beneficial role of statins in AAA patients.
The mutual cooperation of blood platelets and lymphocytes in the development of autoimmune thyroid diseases
Authors: Tomczyńska Małgorzata , Saluk-Bijak Joanna
Published: March 2018

Autoimmune thyroid diseases include several distinct clinical entities and mainly concern Graves` disease and Hashimoto's thyroiditis. An incompetent immune response directed against the body’s own tissues and the production of antibodies against specific cell antigens, accompanied by chronic inflammation occur in autoimmune thyroid diseases. The autoimmune process is induced by difficult to identify genetic and environmental factors, and generates the development of concomitant diseases of other systems. The inflammatory mediators, high level of thyroid hormones, lymphocyte activation and other immune cells play an important role in the chronic course of these diseases.  Autoimmune thyroid diseases are caused by disruptions of T-cells and other cells functions. The autoantibodies react with target antigens in different kinds of cells, including blood platelets. The autoimmune processes can cause the increased activity different kinds of cells including blood platelets and lymphocytes. The activity of blood platelets and lymphocytes is reciprocally regulated. It is suggested that blood platelets can influence lymphocyte function by direct contact through the receptors and via soluble mediators. The platelet–immune cell interactions represent a hallmark of immunity, as they can potently enhance immune cell functions.