bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of acoustic radiation force impulse elastography, aminotransferase to platelet ratio index and fibrotest for the assessment of significant fibrosis and cirrhosis in chronic liver disease
Authors: Rijhwani Anurag , Mohanani Laxmi , Chouhan Ankit Ranjitsinh , Khatri Nikunj M.
Published: June 2020

Background: Accurate grading of hepatic fibrosis is important for the application of appropriate intervening strategy. Liver biopsy is the golden standard of fibrotic grading, however wide clinical application is hindered by its inherent drawbacks. Biomechanical-based ultrasonic elastography has received mass attention. However, several clinical studies found that the sole application of ultrasonic elastography may bring evident errors in diagnosing hepatic fibrosis. It is suggested that a combination of ultrasonic elastography and serum liver functions tests holds the potential to overcome those disadvantages. Aims and objectives was to study the diagnostic accuracy of ultrasonography elastography, APRI, fibrotest for significant fibrosis and cirrhosis in patients with chronic liver disease and established the correlation between ARFI elastography, APRI, Fibrotest in grading of liver fibrosisMethods: Sixty three patients with chronic liver disease were studied.  Liver stiffness was evaluated with ARFI elastography. Histologic staging of liver fibrosis served as the reference standard except a very few cirrhotic patients who were graded as cirrhotic on the basis of clinical examination. The required APRI, Fibrotest parameters and relevant clinical history was recorded.  Fibrosis stage was assessed according to the METAVIR classification.Results: ARFI, APRI, and Fibrotest demonstrated a significant correlation with the histological stage. According to ARFI and APRI for evaluating fibrotic stages more than F2, ARFI showed an enhanced diagnostic accuracy than APRI. The combined measurement of ARFI and APRI exhibited better accuracy than ARFI alone when evaluating ≥ F2 fibrotic stage that showed  significant concordance  i.e. 79.3% cases,  out of which 69.8% of total cases were correctly diagnosed on comparison with the gold standard. Fibrotest and ARFI elastography show significant concordance in grading of fibrosis i.e. 82.5%. Cases out of which 68.3% of total cases were correctly diagnosed on comparison with the gold standard.Conclusions: APRI, ARFI, and fibrotest are novel tools among non-invasive modalities to rule out significant fibrosis and cirrhosis in patients with chronic liver disease. ARFI with APRI and ARFI with fibrotest showed enhanced diagnostic accuracy than ARFI or APRI or fibrotest alone for significant liver fibrosis.
Awareness of nursing students towards cancer and their comparison with medical students
Authors: S. Radhika , A. Najma R. , Bharadwaj Ira
Published: June 2020

Background: Cancer is the 2nd leading cause of mortality worldwide. The three leading cancers in India are cervical cancer, breast cancer and upper aerodigestive tract carcinoma. Cervical carcinoma is the 2nd most common cancer in women next to breast carcinoma. This study has been done to assess the knowledge, causation and preventive methods about the common cancers in India amongst Medical and Nursing students in a tertiary care center in rural Kerala. Preventive measures and early diagnosis of cancer can lead to decrease in mortality and morbidity. This can be achieved by creating awareness. A special emphasis has been made regarding cervical cancer and HPV vaccination in this study.Methods: A total of 337 medical and 148 nursing students from 1st year to final year were included in this study and the results were analysed by descriptive statistics.Results: Out of 337 medical and 148 nursing students, there was significant difference in knowledge between pretest/posttest and amongst the medical/nursing students. Medical students were found be more aware about the cancer, their causation and preventive methods as compared to the nursing students. 76.4% of nursing students were aware about the role of HPV (Human Papilloma Virus) in the causation of cervical cancer pretest. 98.6% of nursing students were aware about the role of HPV in causation of cervical cancer posttest following a short lecture. Following a short lecture both medical and nursing students were found to have more awareness.Conclusions: Creating awareness to the medical and nursing students who are intouch with the community and the patients is essential. Targeted health education in very important in creating a great impact about the knowledge of cancer in the community, thereby leading to decrease in mortality and morbidity.
Effects of tobacco chewing habits on male infertility
Authors: Borkhataria Bhavna , Dhameliya Jaydev , Mavani Devisha , Dhameliya Juhi
Published: June 2020

Background: It is the fact that, India consists of world’s largest tobacco chewer population, more prevalent in low income group. The effects of tobacco chewing on semen parameters have been widely studied. The study aim is to analyze the semen analysis parameters (oligozoospermia, asthenozoospermia, teratozoospermia, oligo-astheno-teratozoospermia -OATS and azoospermia) of tobacco chewer and non chewer infertile patients.Methods: A retrospective analysis of 639 patients was done out of which 150 were non-chewers and 489 were tobacco chewers. The percentage of population with particular semen abnormalities were compared between the two groups. The same comparison was performed between tobacco chewing primary infertility and secondary infertility patients in order to specifically assess the effect of tobacco chewing in sub-fertile patients.Results: OATS and azoospermia cases were significantly higher in the tobacco chewing infertile patients as compared to oligozoospermia, asthenozoospermia and teratozoospermia cases. In case of sub-fertile patients also, the percentage of OATS and azoospermia were significantly higher.Conclusions: This finding suggest that tobacco chewing greatly affects every parameter of sperm i.e. concentration, motility and morphology collectively. Moreover, tobacco chewing may be less affecting the male fertility initially but prolonged exposures affects detrimentally resulting in serious semen parameter abnormalities such as OATS and even azoospermia. And such cases are difficult to treat even with higher and advanced infertility treatment options like ICSI, microfludics, etc. This reduces the chances of IVF success as well as increases the financial burden on the patients undergoing infertility treatment. Thus, infertility clinics must employ awareness programs for such patients to explain them the effects of tobacco chewing habit and reducing it can definitely enhance the treatment outcomes.
Cataract and its risk factor among adults residing in South Bihar, India
Authors: Gupta Shiwani , Gupta Animesh , Nehal M. , Pandey Kalyani , Kreesna Ananta , Shakir Tahreem , Chaudhary Jagmohan , Puneet Priyanka , Sangeeta Kumari
Published: June 2020

Background: Cataract is considered as one of the most common causes of visual impairment and the leading cause of blindness in the world. Age related cataract occurs in people above 50 years of age and the its pathogenesis is multifactorial. Therefore, the present study was aimed to assess the prevalence and risk factors for cataract.Methods: Community based cross sectional study was conducted among adults residing at urban areas of South Bihar. The data was collected by interview method, using pre-tested semi-structured questionnaire which contains socio-demographic data, dietary habits, history of diabetes or hypertension, family history of cataract and long-term sun exposure.Results: Among 240 participants, 94 (39.2%) were male and 146 (60.8%) were female. Maximum participants were aged more than 70 years. The prevalence of cataract was 52.1%.Conclusions: The prevalence of cataract was quite high and was significantly associated with age, long term sun exposure and family history of cataract.
Cardiovascular risk factors in chronic renal failure patient at Soavinandriana Hospital Antananarivo
Authors: Randimbinirina Lucas Z. , Randrianandrianina Fanomezantsoa H. , Rajaobelison Tsirimalala , Rakotoarisoa Jean Claude A. , Ravalisoa Agnes M. L.
Published: June 2020

Background: Cardiovascular disease (CVD) is the primary cause of morbidity and premature mortality in chronic kidney disease (CKD). The aim of this study was to assess the frequency of cardiovascular disease and cardiovascular risk in haemodialysis population for chronic kidney disease.Methods: This was a retrospective and descriptive study for a period of 4 years from January 2016 to December 2019, performed at hemodialysis unit in Soavinandriana Hospital Center Antananarivo, including all patients, following regular hemodialysis for chronic renal failure. Demographic data, cardiovascular disease, cardiovascular risk factors, aetiology of nephropathy, haemoglobin <11 g/dl, phosphocalcic metabolism disorders and uricemia were analyzed.Results: Seventy-six patients were recorded, including 46 males (60.52%) and were women (39.47%). The average age was 59.98 years old. The risk factors of cardiovascular disease were smoking (22.36%), diabetes mellitus (46.05%), high blood pressure (71.05%), dyslipidemia (47.36%) and obesity (11.84%). Fifty-eight patients (76.31%) had a high cardiovascular risk factor. Seventy patients (22.36%) had had a history of cardiovascular diseases. Fifty-nine patients had a haemoglobin concentration under 11 g/dl (77.63%). There were 23 cases of hypocalcemia (30.26%), 22 cases of hyperphosphatemia (28.94%) and 37 cases of hyperuricemia (48.68%).Conclusions: There was a high cardiovascular risk factor in this study population. Early detection of cardiovascular diseases should be done in patients who have a high-risk factor of cardiovascular disease to decrease the mortality rate in chronic kidney diseases population. The appropriate management of modifiable risk factors is important to improve the survival of this study patients.
Serum iron level in patients with COVID-19: a case report study
Authors: Alipour Rasoul , Hashemi Seyed Hasan , Mikaeili Fariba
Published: June 2020

Coronavirus disease emerged in Wuhan, China in December 2019 and led to worldwide pandemic in March 2020. Due to early diagnose, treatment and prevent transmission of COVID-19 disease, we need rapid laboratory tests and develop them. This paper focuses on serum Iron level in patients with COVID-19. We assess the serum Iron level due to the following reasons: I. Iron is a key part of hemoglobin structure in which is essential for providing Oxygen to the body organs, particularly for the patients with pulmonary involvement such as COVID-19. II. Iron deficiency can contribute to muscle weakness and reduction of respiratory capacity, at which increases the risk of deterioration of COVID-19 patients. III. Elevation in Hepcidin level (due to the increase in IL-6 level) in COVID-19 patients inhibits Iron absorption from intestinal lumen and blocks the Iron release from macrophages. IV. Iron is an essential element in infectious suppress and inflammatory process. We noticed that most of the patients, especially admitted to hospital due to the respiratory symptoms, have lower serum Iron level.
Type B congenital pyloric atresia: a case report
Authors: Singh Dikshant , Kumar T. Seetam , Sen Jyotsna
Published: June 2020

This is a case of congenital pyloric atresia type B not associated with any other anomaly rare condition, seen as an isolated anomaly with excellent prognosis) of  two days female child presenting with vomiting since birth. X-ray abdomen showed only stomach air bubble, sonography showed distended stomach with echoes and on barium meal no passage of contrast was seen beyond pyloric antrum even after 24 hours. Patient underwent Heineke-Mikulicz pyloroplasty and postoperative recovery was uneventful.
Case report of bullous pemphigoid in a 65 year old woman
Authors: Otikeodibi Bolaji , Amadi Ekechi S. , Altraide Dasetima D. , Abbey Belema O. , Ugwa Okezie
Published: June 2020

The unique thing about this case is that it is the first reported case of bullous pemphigoid in the elderly that has been clinically diagnosed with histologic findings highly suggestive of this blistering disorder although an immunofluorescence could not be done due to unavailability in the centre. Patient was managed successfully and discharged home with improvement on subsequent hospital visits. This case report shows how diagnosis of an immunobullous disease was made and managed in a resource poor setting. A descriptive summary of 65-year old black Nigerian woman with bullous pemphigoid covering history, physical examination and management. The main diagnosis was bullous pemphigoid in a recently diagnosed type 2 diabetic. Patient was placed on corticosteroids as well as immunosuppressive agents and diabetes was managed with subcutaneous insulin and oral hypoglycemics with appropriate wound care. Patient showed remarkable improvement after management and was discharged home with subsequent follow up in the clinics. Bullous Pemphigoid (BP) can be diagnosed clinically with a high index of suspicion with the aid of skin biopsy and histology, and can be managed successfully even in a resource poor centre where immunofluorescence facilities are lacking.
Tuberculous meningitis masquerading as acute ischemic stroke in young adult
Authors: Patil Divya V. , K. Jeyapalan , A. Mohamed Kasim
Published: June 2020

Tubercular meningitis (TBM) constitute 5% of all cases of extra pulmonary tuberculosis but a presentation leading to an ischemic stroke in a young adult is a rare clinical entity. In a case of TB vasculopathy, vasculitis, venous thrombosis and aneurysm may be the underlying events leading to a stroke. Stroke in TBM is seen in the tubercular zone which encompasses internal capsule, thalamus and caudate nucleus. Inflammatory mediators like TNF alpha, Interferon gamma and vascular endothelial growth factor have been implicated in the pathogenesis of arteritis. Imaging modalities like MRI show lesions which are usually bilateral in the territory of the perforating vessels. We report a case of 24 year old Asian male who presented with complaints of headache, projectile vomiting and altered sensorium. On examination his Glasgow Coma Scale (GCS) was 10/15, with left oculomotor and left facial nerve palsy, and hypotonia of all 4 limbs with bilateral plantar reflexes being mute. Contrast MRI of brain showed acute infarct, meningeal enhancement and basal exudates. He was started on Anti-tubercular therapy and steroids, but had a poor clinical outcome, due to his late presentation.
Gorlin Goltz syndrome: a rare case report
Authors: Jain Nitisha A. , Rathod Vasantkumar J. , Gandhi Mily S. , Ghai Anshul P.
Published: June 2020

Gorlin-Goltz syndrome is uncommon multisystemic disease with an autosomal dominant trait, with complete penetrance and variable expressivity, though sporadic cases have been described. We report a case of 18 years old male patient having features of Gorlin Goltz syndrome. Gorlin-Goltz syndrome is characterized by multiple basal cell nevi or carcinomas, odontogenic keratocysts, palmar and/or plantar pits, calcification of the falx cerebri, and is associated with internal malignancies. It is important to know the major and minor criteria for the diagnosis and early preventive treatment of this syndrome.
Profile of total knee replacement patients and short term outcome in the sanglah public hospital 2018: a case reports
Authors: Dusak I. Wayan Suryanto , . Dwiwahyonokusuma , Wijaya Putra I. Gusti Ngurah Paramartha
Published: June 2020

Total knee replacement (TKR) is considered to be among the most successful type of orthopedic surgery, with 15-year-survival-rate of implant exceeding 95%; furthermore, the improvement in quality of life is very significant. This study aims to describe the demographics, length of hospitalization and short-term outcome observed in patients undergoing TKR at Sanglah Hospital in 2018. All patients undergoing TKR at Sanglah Hospital in 2018 have been prospectively entered into our database. A total of 59 patients were recorded on 2018 for this study and 1 revision TKR patient and 2 patients with incomplete data were excluded. At baseline, 78.6% patients were female, 72.3% were Balinese and 84.1% were housewives. The mean age of patients was 63 years old. Authors also record that 44 (78.6%) patients are Overweight patients (BMI 25.00-29.99 kg/m2), 11 (19.6%) patients are at Obese Class I (30.00-34.99 kg/ m2) range, and only 1 (1.8%) patients have normal weight (18.50-24.99 kg/m2). As many as 51.8% patients had right TKR and 49.2% left TKR. The modus of patient’s length of stay is 7 days with 27 (48.2%) patients started to walk on the 4th day. VAS was recorded at level 4/10 on 92.9% patient. Drain was removed after 3 days on 42 (75%) patients. 15 patients (26.8%) had PRC transfusion due to anemia after operation.
Mills hemiparetic or hemiplegic variant of amyotrophic lateral sclerosis
Authors: Barua Amit R. , Borah Nomal C. , Barthakur Mausumi , Choudhury Dhruba J. , Sharma Jai P. , Kemprai Pari
Published: June 2020

Mills hemiplegic variant of Amyotrophic lateral sclerosis (ALS) is a gradually progressive, spastic ascending or descending hemiparesis or hemiplegia without any sensory involvement. Authors presented a 47 years old female with history of gradually progressive left sided wasting of muscles including the tongue, left hemiparesis along with dysarthria and fasciculation’s of tongue and left sided muscles with left sided cortico-spinal tract signs of 2 years duration. There were no sensory as well as bowel bladder involvement. Her cognition was intact. Relevant blood and CSF examinations were within normal limit. MRI Brain and whole spine were unremarkable. Nerve conduction study was essentially normal. Electromyography(EMG) showed chronic denervation potentials which is in accordance to Revised El Escorial criteria, 2015 for the diagnosis of this extremely uncommon entity- Mills hemiplegic variant of ALS. The major challenge in diagnosis of this disease entity is to exclude other diseases/disorders that may mimic its symptomatology.
Effect of COVID-19 crisis on medical students
Authors: T. Sasikala , Sahoo Sibasish , Lakshmanna N.
Published: June 2020

COVID-19 pandemic demands and pressures that medical students face mental, physical and spiritual well being can be compromised. Hence this review highlights the beneficial targets to improve mental health in medical students. Collected recent articles from search engines Pub med, Google Scholar, published recently relevant to the COVID-19 pandemic from all over world. Provide routine schedules as much as possible by online services or provide e-services to create new environment, novel consultation and giving time gap in e-assignments, ask them to do the regular exercises may improve the mental health and decrease the stress of the medical students. Hence Avoiding of constant stream of news reports about an outbreak can cause anyone to feel anxious or distressed.
Diabetes mellitus augments the complications of patients with COVID-19: a review
Authors: Pramanik Parthiba , Pramanik Purushottam
Published: June 2020

Corona virus disease 2019 (COVID-19) is current pandemic infection caused by RNA virus named severe acute respiratory syndrome coronavirus-2 (SARS Cov-2). The lungs are the organs most affected by COVID-19 and people were died due to severe acute respiratory s syndrome, pneumonia and multi-organs failure. Fatality rate was more, those who suffer in chronic diseases including diabetes mellitus (DM). As COVID-19 pandemic is accelerating , it is important to understand the molecular mechanism through which DM increases the severity related to COVID-19 to able to design more appropriate therapy. The aims of this study was to identify mechanisms through re-analysis of publicly available data by which DM increases susceptibility for COVID-19 infection and/or increase complication for SARS-Cov-2 infection. SARS Cov-2 accesses host cells via membrane bound enzyme, angiotensin converting enzyme-2 (ACE2). This leads to imbalance of vasoprotective and vasodeletorious arms of renin angiotensin system (RAS) with over activity of vasodeletorious arms. Such imbalance of RAS induces alveolar damage, flooding the alveoli and difficulty in breathing. DM augmented the chance of pulmonary infection by impairment of innate immunity and down regulation of ACE2. Hence, diabetic patients of COVID-19 die from multi-organ failure, shock, heart failure, arrhythmias and renal failure along with severe acute respiratory syndrome. Thus it is concluded that DM augments the complications from COVID-19 by enhancing development of RAS imbalance. From view point of public health it is suggested to keep the lung healthy, maintain blood glucose level properly, and intake foods rich in antioxidant and anti-inflammatory agents to prevent and ameliorate the acute effect of COVID-19 in diabetic patients.
An overview of corona virus disease 19 - COVID 19
Authors: Sharma Sarita , Rathod Pragati , Ukey Ujwala
Published: June 2020

A remerging infectious disease that has caught the entire world unaware. Coronavirus is an enveloped virus having non- segmented positive-sense RNA genome and belongs to the family Coronaviridae. Important modes of transmission are direct contact and respiratory droplets. Though the virus survives on environmental surfaces for varied period of time, it gets easily inactivated by chemical disinfectants .The major clinical features in uncomplicated cases include fever (88%), dry cough (67%), myalgia (14.9%) or fatigue (38%). In the absence of an effective treatment and vaccine, preventive measures like physical distancing, hand hygiene, following respiratory etiquettes & wearing mask assume great importance. Vigourous surveillance, contact tracing and containment can go a long way in controlling the spread of Covid 19.
Use of stem cells in tissue engineering and reconstruction of the maxillofacial region
Authors: Kukreja Pankaj , Qahtani Modi Fahd Al , Qahtani Majedah Fahd Al , Qahtani Ahad Fahd Al , Kukreja Bhavna Jha
Published: June 2020

The oral and craniofacial defect reconstruction has been a daunting task for several decades. Many clinicians have attempted to switch surgical techniques in flap transfer to enhance the purposeful outcomes. In many cases, however, near total restoration of the native anatomy is not achievable. Also, the normal functional performance is not attainable, regardless of the surgical technique used. This problem is more evident within the oral and craniofacial region considering the importance of functions, such as speech, chewing, and appearance. Stem cells have attracted a growing interest within the scientific community chiefly for their ability to regenerate broken tissues and conjointly for their known potential in modulating inflammatory and immune responses. These skills have caused stem cells to be thought about as a promising strategic tool for a range of clinical maxillofacial applications. In this review, authors briefly summarize the applications of stem cells in maxillofacial surgery.
Diagnostic utility of cytospin, cell block and immunocytochemistry in pleural effusion cytology
Authors: Miachieo Nounechutuo , Kumar Madhu , Sagar Mala , Maurya Malti Kumari , Kumar Santosh , Kushwaha R. A. S. , Goel Madhu Mati
Published: June 2020

Background: With the introduction of cytospin, the sensitivity of diagnosing malignancies has increased mainly due to the increase in cellular yield. Cell block also gives the advantage of ancillary testing and allows for retrospective studies. Immunocytochemical markers are used to differentiate and subtype various malignancies in body effusions.Aim of the study was to compare the morphological features of both technique and to assess the diagnostic utility of cell block methods in the cytodiagnosis of pleural effusions.Methods: This was a Prospective observational comparative study of two cytopreparatory techniques. All samples were examined and processed by cytospin and cell block techniques. Continuous data were expressed as Mean±SD (standard deviation) while categorical data were expressed in number, percentage and compared by chi-square (χ2) test.Results: The final diagnosis of both cytospin (147 cases) and cell block (150 cases) techniques was divided into four broad categories: Inadequate, Benign, Suspicious and Malignant. The significant diagnostic cytospin (AUC=0.857, p<0.001) in discriminating positive and negative malignant cases with 75.00% sensitivity (95% CI=53.3-90.2) and 100.00% specificity (95% CI=86.7-100.0) and with 100.0% positive predictive value and 81.2% negative predictive value. In contrast, cell block also showed significant diagnostic but with higher accuracy (AUC=1.000, p<0.001) and sensitivity 100.00% (95% CI=86.7-100.0) and specificity 100.00% (95% CI=86.7-100.0) and 100.0% positive predictive value and 100.0% negative predictive value than cytospin technique.Conclusions: Cell block as a technique should be used in routine practice as it not only increases the diagnostic yield but ancillary test can also be done.
Socio-demographic and economic factors influencing utilization of youth friendly reproductive health services among youths in selected universities in Nairobi County, Kenya
Authors: Mutua Felix Mwendwa , Karonjo Jane , Nyaberi Jackline Mosinya , Wanyoike Peter Kamau , Kausya John , Mugai Faith
Published: June 2020

Background: The reproductive and sexual health of the youth remains a relatively new and sensitive area mainly due to restrictive norms and policies guiding the services and also the access and utilization of youth friendly reproductive health services (YFRHS) among the college youth are dependent on many factors.Methods: Descriptive cross-sectional design was used to study 421 youths in selected universities in Nairobi County. Systematic sampling technique was used. Data was collected using a researcher-administered structured questionnaire and Key Informant Interview. Quantitative data analysis was conducted using SPSS version 24.0 and involved univariate and bivariate analysis. Chi-square were used to test the significance of the association between the dependent and independent variables (p<0.05). Qualitative data was analyzed by thematic content analysis.Results: The results indicated that 67.9% of youths utilized counselling services, 42.0% utilized VCT, 24.7% utilized family planning and 12.6% reported having used antenatal or pregnancy services. Utilization for all the reproductive health services increased with age with gender greatly associated with utilization of ANC services (p=0.0001), FP services (p=0.001) and STDs treatment (p=0.002) while age of an individual was associated with VCT services (p=0.0001), FP services (p=0.008) and counselling (p=0.007).Conclusions: Socio-demographic factors influence utilization of YFRHS and therefore there is a need for the Government through the Ministry of Health and partners in health service provision to increase the number of YFRHS and ensure that the recommendations of Adolescent Health Policy guidelines are implemented fully with good evaluation strategies in place.
Exclusive breastfeeding knowledge, practices and determinants among mothers in rural areas, Egypt
Authors: Senosy Shaimaa A. , Saleh Lamiaa Hamdy , Alareed Heba Reda
Published: June 2020

Background: Objective of the study was to explore exclusive breastfeeding knowledge and practice of among mothers of children less than 2 years in rural areas in Beni-Suef governorate and factors that determine them.Methods: A community-based cross-sectional study was conducted in rural areas, Beni-Suef governorate over 6 months (February 2019-July 2019) using a designed well-structured questionnaire.Results: The mean breastfeeding knowledge score of enrolled mothers was 7.87±2.2 out of 15. (74.5%) of mothers recruited in this study obtained their knowledge from their mothers, families, and friends. Only 40.4% of the mothers have exclusively breastfed their children. While 57% of participants added food or fluids before 6 months and 37.6% added additional artificial feeding. Mothers’ age, education, occupation, marital status, the order of last-child, mode of delivery, place of delivery and monthly family income were independently associated with exclusive breastfeeding in univariate analysis. While in multi-variate analysis, only mothers’ age, education, occupation, marital status and breastfeeding knowledge score was associated.Conclusions: Rural women had suboptimal knowledge about exclusive breastfeeding, justifying the suboptimal practices of the mothers. Hence, it is recommended to develop interventions emphasizing practical education targeted at addressing factors that influence exclusive breastfeeding. And successful infant-feeding interventions aimed at promoting overall infant health.
Comparative analysis of performance of private and public healthcare systems in Nepal
Authors: Sah Mukesh Kumar , Sangroula Raj Kumar , Arul Kumar S.
Published: June 2020

Background: Though government of every country has their own health delivery system, private sector in the delivery of health service is undeniable and same is true for Nepal. Private healthcare services in Nepal are making better efforts as compared to public health care services. The aim of the study was to compare the performance of private and public healthcare systems in Nepal.Methods: A hospital based cross sectional study was conducted in which five hospitals each from private and public healthcare systems were chosen purposively from five developmental regions of Nepal. The patients visiting the healthcare systems were randomly chosen for the study from the admission registers of the hospitals. This study was approved from the Annamalai University, Tamil Nadu (India). Before data collection, permission was taken from corresponding hospital administration and written consent was taken from respondents of the study. Bivariate analysis was performed to compare the performance of the private and public hospitals.Results: Most of the patients visiting the private hospitals were patients with higher education and income. Public hospitals were more accessible and transparent than the private hospital. Doctors’ punctuality and responsibility were higher in public healthcare systems. Overall patient satisfaction and quality of services provided were significantly higher in the private healthcare systems. Fairness, responsiveness and behavior of the health personnel were almost equally satisfactory in both public and private healthcare systems.Conclusions: The overall services quality and patient satisfaction is higher in private healthcare systems so Government of Nepal should focus on improving services quality, facilities of public healthcare systems so that patient can get easily accessible quality health services with better patient satisfaction.
Social economy and dietary patterns with incidence of stunting in elementary school children at working area of Lapai public health center Padang
Authors: Oktariyani Dasril , Fitri Yuni Resi , Chamy Rahmatiqa
Published: June 2020

Background: The incidence of stunting in the Lapai Public Health Center has increased. The incidence of stunting in primary school-age children 6-12 years is a manifestation of stunting in infants, with 84 cases. Socio-Economic Level and Dietary Patterns are one of the factors that influence stunting. The aim of the study was to determine the socioeconomic and dietary patterns with the incidence of stunting in elementary school children in Lapai Public Health Center, Padang.Methods: This type of research is observational analytic with case-control study program. The study period was June 2019 with a sample of 19 cases and 19 controls. Data collection using questionnaires and univariate analysis using descriptive statistics in the form of frequency and percentage distributions while bivariate with chi-square test α 0.05.Results: From the results of the case group more than half (63.2%) of respondents have high socioeconomic status, more than half (63.2%) of respondents have good dietary patterns, there is no relationship between socioeconomic status with the stunting incidents and there is a meaningful relationship between dietary patterns and stunting incidents. From analysis, the OR value was 14 times the risk of stunting in elementary school children in Lapai Public Health Center.Conclusions: Dietary patterns in school-age children have an important role in improving nutritional status. It is recommended for families to pay attention to children's dietary patterns, adjust their diet according to schedule and accompany children when eating and to the health center to provide counselling to families to play a role in providing care for the child's eating.
Control and prevention of nosocomial infection
Authors: Reddy Palle Lokhnah , Chand Aluka Anand
Published: June 2020

Background: The center for disease control and prevention estimates that 1.5 million people suffer from hospital acquired infection every year and hereby one lack people die. Major nosocomial infections (NIs) are ventilator associated pneumonia (VAP), urinary tract infection (UTI), surgical site infection (SSI) and blood stream infections (BSI).Methods: This was a retrospective multicenter descriptive study involving 2000 consecutive patients in ICU for a period of 2 years. The data was compared with the data available from National Nosocomial infection surveillance. NIs were analyzed by infection site and pathogen distribution.Results: The main factors responsible for NI are both hospital and patients. Almost 40% UTI’s contribute to NI’s, 30% VAP’s, 20% SSI and 10% BSI respectively. Nosocomial infections can be reduced by better surveillance system and infection control. Primary blood stream infections, pneumonia and UTI associated with invasive devises made up the great majority of nosocomial infections.Conclusion: We can reduce NI’s by proper use and care of urine catheters, proper use and care of vascular accesses lines, by proper surveillance of surgical procedure and by proper hand and hygiene standard precautions.
Health and nutritional status of HIV infected children living in the orphanages of Rajamahendravaram, Andhra Pradesh, India
Authors: Palla Jayasree , Mallipudi Aparna , Komaram Ravi Babu , S. K. Mishra
Published: June 2020

Background: HIV infected orphan children are the most vulnerable and neglected group in the society. They are more susceptible to constant illness, malnutrition and social discrimination. Aim: To assess the health and nutritional status of HIV infected children living in the orphanages of Rajamahendravaram.Methods: This was a community based cross-sectional study, conducted among the HIV infected children aged 1 to 15 years, living at two orphanages in Rajamahendravaram. Study subjects were selected by consecutive sampling method. A semi-structured schedule was used for the collection of data. Health status was assessed by a schedule for morbidity profile; Nutritional status was assessed by anthropometric measurements, clinical examination and by a schedule for dietary intake. Z scores were calculated using the anthropometric measurements of the study participants; WHO reference growth charts were used to assess the nutritional status. Results were presented as percentages, proportions, mean and standard deviation.Results: Total 150 HIV infected children were enrolled in the study. The mean age of children was 9.28±2.88 years. 26% of children were born with birth weight <2.5 kg. Out of 150 children, 46.65% were underweight, 50% were stunted, and 22.6% were thin. The mean energy intake of HIV infected children indicates deficiency in comparison to reference standards of WHO.Conclusions: Unhealthy condition and undernutrition is highly prevalent in HIV infected children living in orphanages. Hence, their needs are to be addressed and all efforts need to be directed at alleviating undernutrition and ill health.
A cross-sectional study on prevalence of hypertension and pre-hypertension among young adults at urban field practice area, Gandhi Medical College, Secunderabad
Authors: Bolisetti Venu , Yale Padmavathi , M. Hima Bindu , Thomas Vimala , . Kavya , Kasam Aishwarya
Published: June 2020

Background: Hypertension is also known as high or raised blood pressure. It is a condition in which the blood vessels have persistently raised pressure. Hypertension is directly responsible for 57% of all stroke deaths and 24% of all coronary heart disease deaths in India. Young adults have been deemed to be at lower risk in their development of hypertension due to resultant gaps in the literature. Hence the present study was aimed to determine the prevalence of hypertension and pre-hypertension among young adults (18-35 years) residing in Urban Field Practice Area of Gandhi Medical College. Objectives of the study was to determine the prevalence of hypertension and pre-hypertension in young adults and to identify the risk factors and sociodemographic factors associated with hypertension and pre-hypertension.Methods: A sample of 233 young adults (18-35 years) was included in the community based cross sectional study by simple random sampling followed by systematic random sampling in Bholakpur. All the participants were assessed for blood pressure and BMI status. Data was analysed in MS Excel version 7.2 Software.Results: The prevalence of hypertension was 9.85% (n=23) and pre–hypertension was 23.65% (n=55). About 13.3% of the study population were smokers and 26.6% of them were alcoholics. Twenty seven percent of the study participants were obese and overweight.Conclusions: Higher proportion of hypertensives and pre-hypertensives were found in the category of males, smoking, alcohol intake and obesity than their counter ones.
Oral hygiene practices and their influence on the oral health of adolescents
Authors: Shenoy Rekha P. , Salam T. A. Abdul , Agrawal Reema , Shenoy K. Prashanth
Published: June 2020

Background: Oral diseases are major public health problems due to their high prevalence and significant social impact. Oral hygiene practices play a critical role in their prevention and control. This study was carried out to evaluate oral hygiene practices and oral status among adolescents in Mangalore taluk, taking into account differences based on location and type of school.Methods: A descriptive cross-sectional study was carried out among 1340 students enrolled in public and private high schools in urban and rural areas of Mangalore taluk. The study sample was equally distributed among urban and rural areas, and among public and private schools. Proforma was prepared to record demographic data, oral hygiene practices, dental caries and periodontal disease. Data were analyzed using Chi-squared test and t-test, with p<0.05 considered statistically significant.Results: Majority of the students used toothbrush and toothpaste to clean their teeth. Horizontal tooth brushing motion and once/twice daily tooth brushing frequency was reported by the highest number of students. Good oral hygiene was found among 55.2% participants. Female participants, urban children and those attending private schools presented with better oral hygiene. Prevalence of dental caries was 59.2%. Prevalence of gingivitis was 83.2%, with higher prevalence among females and rural participants. Poor oral hygiene was found to be associated with gingivitis (r=0.59).Conclusions: Although majority of the participants reported use of requisite oral hygiene aids and regular tooth brushing habits, the high prevalence of oral disease among them can be attributed to poor oral hygiene.
A study on prevalence of dementia among elderly population in rural health training centre field practice area of Nalgonda
Authors: Balaraju Ratna , Vallepalli Chandrasekhar , Chandra Sekhar K. , Prasad Sharma M. M. V. , Sushmita T.
Published: June 2020

Background: Dementia is one of the major causes of disability and dependency among older people worldwide. Dementia has physical, psychological, social and economic impact. Worldwide prevalence of dementia in elderly population of more than 60 years is 5-8%. Prevalence of mild cognitive impairment in India is 14.89%. Present study aim was to estimate the prevalence of dementia and the risk factors associated with dementia among elderly population in rural field practice area of Nalgonda district.Methods: A descriptive, community based cross-sectional study was conducted among 119 elderly population in the field practice area of Rural Health Training Centre by simple random sampling method, with the help of a pre-designed and pre-tested questionnaire. Data was analyzed using SPSS Version 19. MMSE (mini mental status examination) questionnaire was used to screen for dementia. Barthel index was used to assess the dependency status.Results: Demographic profile of the study population of 119, males 65 (54.62%), females 54 (45.38%). Majority of their source of income were government service pension 30 (25.21%) and old age pension 70 (58.82%). 56 (47.06%) of elderly population living with family and 63 (52.94%) people were living individually. The study revealed the prevalence of cognitive impairment is 35.3%. Risk factors like middle age obesity, smoking, alcohol consumption, social isolation showed significant association with dementia.Conclusions: Dementia can be prevented by early diagnosis and promoting physical health and treating behavioural and psychological symptoms. Risk of dementia can be reduced by following regular exercise, diet, quitting smoking and alcohol.
Intra-family differences in nutritional status between pre-school children and women
Authors: Kumari Honey , Kalaivani K. , Ramachandran Prema
Published: June 2020

Background: National surveys have shown that in India even in families where women were normally nourished or over-nourished prevalence of under-nutrition in preschool children was high. The present study was taken up to assess the magnitude of intra-family differences in nutritional status between preschool children, their mothers and other women in the family and explore factors responsible for these differences.Methods: Nutritional status of pre-school children (height for age, weight for age and BMI for age) their mothers and other women (BMI) in urban low middle income group families were assessed. Intra-family differences in mother child pairs (4102); mother other women pairs (816); other woman and child pairs (981) and child-child pairs (941) were computed.Results: Stunting, underweight and wasting rates were higher in children of undernourished mothers as compared to normally nourished mothers. However even in children of over-nourished mothers stunting and underweight rates were high. If the elder child was stunted, underweight or wasted, the stunting, underweight and wasting rates in the younger children were higher. Prevalence of under-nutrition (BMI<18.5) in mothers was lower and over-nutrition was higher in other women. Over-nutrition rates in other women were higher if the mother was over-nourished.Conclusions: In view of the substantial intra-family differences in nutritional status it is imperative to operationalize universal screening of all pre-school children and women for early detection of wasting and over-nutrition and initiate appropriate interventions.
Effects of industrial air pollution on lung functions of primary school children in Himachal Pradesh
Authors: Barall Deepesh , Mazta Salig R. , Kashyap Rashmi , Goyel Prince
Published: June 2020

Background: Industrial air pollution is one of the most evident environmental problems experienced by all. Air pollution leading to respiratory illnesses is a significant cause of morbidity and mortality with children more susceptible to its effects. Spirometry can be used to estimate their lung function and aid in the diagnosis of certain respiratory disorders in children.Methods: Cross sectional assessment of the lung functions of the primary school children using spirometer was done in the severely polluted industrial area. Forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and peak expiratory flow (PEFR) for each child was measured after their anthropometric measurement.Results: Emission records for the year 2017-18 showed respirable suspended particulate matters (RSPM) level at as high as 286.3 ug/m3. We analyzed 464 spirometry results with equal number from industrial and non-industrial area. We observed that the Industrial areas had the significantly higher number of children with abnormal levels of all observed spirometry parameters except for FVC. Obstructive pattern of spirometry in the industrial area was significantly higher (odds ratio of 4.00, 95%, CI 1.78-8.95, p<0.05) than children in non-industrial area.Conclusions: It was concluded with the estimated overall distribution of 3.01% of probable obstructive illness, 2.58% of restrictive illness and 1.51% of mixed pattern of illness.
Demographic profile of subjects undergoing tympanoplasty in a tertiary care centre of Punjab: analysis of 60 cases
Authors: Munjal Manish , Talwar Gopika , Munjal Shubham , Saggar Tulika
Published: June 2020

Background: Different tympano meatal vascularised flaps were compared in the tympanoplastic surgery in chronic suppurative otitis media.Methods: 60 cases with diagnosis of chronic suppurative otitis media were selected from ENT OPD of Dayanand Medical College and Hospital Ludhiana. 6 types of tympanomeatal flaps were used and 10 cases of each flap were taken. The study was conducted for the period of 1 year from June 2015 to August 2016.Results: Maximum numbers of patients were in the age group of 31-40 years (26.7%), followed by age group of >50 years (23.3%). Minimum age among these patients was 11 years and maximum 65 years. Mean age was 36.67. Graft failure was in 2 patients, 1 lies under age group 31-40 years and other was in more than 50yrs group. Female patients constituted 56.7% and male patients were 43.3% in our study population. Graft uptake was 93% in females and 100% in males. In our study on 60 patients, 41 (68.3%) patients had a rural and 19 (31.7%) an urban background.Conclusions: Age does not affect the results of tympanoplasty, whatever flap maybe utilised. Awareness in rural population regarding reconstructive ear surgery is there nowadays though there is still gender discrimination, with less number of ladies opting for this elective surgery.