bluuebunny/crossref_metadata_2025 huggingface dataset:
Plasma homocysteine levels in Indian patients with acute ischemic stroke
Authors: Alloli Deepa , Mahishale G. S. , Hanjagi Siddaraya , Hussaini Sayed Mohammed Meraj , Patil Ganga
Published: October 2018

Background: Homocysteine has primary atherogenic and prothrombotic properties. The present study aimed to assess serum homocysteine levels in patients with ischemic stroke and to find association of serum homocysteine levels with various patient related variables.Methods: This observational study included patients who were admitted with the diagnosis of stroke in Sri Ventateswara Ramnarain Ruia Government General Hospital. Patients were evaluated for risk factors like hypertension, diabetes mellitus and hyperlipidemia. Total homocysteine estimation was done and survival of the patients was assessed at the time of discharge from the hospital.Results: Most common risk factor for stroke in our study population was dyslipidemia (40%), followed by hypertension (36%). Total homocysteine levels were raised in 92% of the patients. Patients with homocysteine levels less than 15mM/L had lacunar infarcts. Homocysteine levels higher than 100mM/L were found in 18% of the patients and they all had large sized lesions. Significantly higher mean homocysteine levels were found among patients with large lesions (70.15±2.65 vs 21.68±8.02, p value <0.05). Among various risk factors, higher mean homocysteine levels were found to be associated with dyslipidemia (p value <0.05). No association between hypertension, diabetes mellitus or smoking history was found with higher homocysteine levels. Patients who survived had significantly lower homocysteine levels as compared to non survivors (39.3±19.84 vs 100±18.82, p value<0.001).Conclusions: Further studies are needed on homocysteine and stroke fur using homocysteine as screening test and for initiation of preventive therapy of stroke based on homocysteine levels.
Emotional and psychological factors in patients prior to cataract surgery
Authors: Manhas Angli , Manhas Rameshwar S. , Manhas Gaurav S. , Gupta Dinesh
Published: October 2018

Background: Cataract constitutes as the leading cause of blindness. Lack of information about the surgical procedure and results of surgery in cataract patients tend to show high levels of anxiety. Preoperative educational intervention planning is necessary to prepare patients for cataract surgery. The aim of present study was to identify emotional factors related to daily difficulties among patients having cataract.Methods: The present cross-sectional study was conducted over a period of 10months by means of a preformed pilot tested questionnaire on patients who had been screened for cataract in various eye camps and admitted for cataract surgery in the upgraded Department of Ophthalmology, Government Medical College, Jammu. All the questions were explained to participants in their local language for better understanding and those who were willing to participate, were requested to fill the semi-structure pilot tested questionnaire form with informed consent.Results: Around 75% of participants reported daily difficulties due to the ocular conditions, of which walking (79.6%) followed by doing housework (77.8%) were the most frequently reported difficulties. About 75% of the participants reported fearing the surgical procedure. Regarding the level of acceptance of cataract surgery 13.9% reported being very much afraid. With respect to the surgical procedure, doubt as to the outcome was reported by 22.2%. When cataract surgery was compared to other kinds of surgery, 31.9% thought it was better to undergo eye surgery whereas 48.6% had not given any opinion on the matter.Conclusions: Preoperative orientation is necessary in order to ease the suffering caused by surgery and render satisfaction with the treatment. Thus, patient should be prepared for the procedure, information regarding common outcomes and risks of surgery reduces anxiety and improves patient satisfaction following cataract surgery.
Effect of home based pulmonary rehabilitation on health related quality of life in COPD patients
Authors: Mathew John , Balakrishnan Jayaprakash , Nair Sanjeev
Published: October 2018

Background: Pulmonary rehabilitation is a proven strategy in the management of COPD, it’s a neglected area in our part of world and there are very few studies on home based pulmonary rehabilitation in COPD in our scenario and hence we evaluated the effectiveness of such a strategy. Aim of the research work was to study the effectiveness of home based pulmonary rehabilitation on health related quality of life, exercise tolerance, depression levels and perceived dyspnea as assessed by SGRQ (St. George Respiratory Questionnaire), 6MWTD (Six-Minute Walk Test distance), PHQ-9 (Patient Health Questionnaire-9), Modified Borg scale respectively.Methods: Patients attending the Department of Pulmonary Medicine, Medical College Trivandrum, diagnosed as COPD based on GOLD guidelines who fulfil the inclusion and exclusion criteria were studied from January 2013 to June 2014. Patients were educated about the disease and need for rehabilitation, advised smoking cessation, nutritional modification. Breathing exercise, upper limb and lower limb exercises given for 6 weeks in a structured manner and followed up in every second week and analyzed using paired t- test. Pre and post rehabilitation assessment included the SGRQ, 6MWTD, PHQ-9, Modified Borg dyspnea scale was done.Results: Around 40 patients had completed 6weeks of rehabilitation. There was a statistically and clinically significant improvement in quality of life, exercise tolerance, perceived dyspnoea was seen along with decrease in level of depression.Conclusions: Home based pulmonary rehabilitation is a feasible alternative to institution based rehabilitation in the management of COPD and is associated with significant benefit.
Lesch-Nyhan syndrome: case brief of a rare disease
Authors: Agarwalla Sunil Kumar , Satapathy Jagatshreya
Published: October 2018

Lesch-Nyhan Syndrome is a rare X- linked disease due to absence of HPRT enzyme. It leads to hyperuricemia, gout, renal failure, neurological and behavioural disorders, including compulsive self-mutilation. Management includes drugs against hyperuricemia, measures to prevent self-mutilation and behavioural therapy. This case is that of an eight months old child coming for respiratory symptoms and self-mutilation, who was ultimately diagnosed with Lesch- Nyhan syndrome.
Laparoscopic removal of transmigrated intrauterine contraceptive device from abdomen in an asymptomatic patient
Authors: Bhageerathy Pallipuram S. , Singh Scott A. , Dhinakar Manjula , Lukose Jose M.
Published: October 2018

Uterine perforation followed by transmigration of intrauterine contraceptive device to the abdominal cavity is one of the rarest, but most dangerous complication of Copper T. These displaced Copper containing devices can cause chronic inflammatory reaction leading to adhesions, intestinal obstruction and even bowel perforation. Hence removal of these devices once found outside the uterus is recommended. Traditionally, a laparotomy used to be performed owing to the associated inflammation, adhesions and the risks of bowel injury. Laparoscopic removal of these displaced devices is a minimally invasive surgical approach with good results in skilled hands. Authors reported a rare case of misplaced transmigrated intrauterine contraceptive device in a 43-year-old asymptomatic lady. The Copper T had migrated after silent perforation of the uterus and was impacted in the greater omentum. There was evidence of chronic inflammation and small pockets of pus surrounding it. There were flimsy bowel adhesions. The dislodged device was successfully removed laparoscopically along with partial omentectomy without any complications. Regular follow up of patients who have had Copper T insertions and teaching them to feel the thread and report if not felt is essential to diagnose complications early. A transmigrated intrauterine device can be successfully removed laparoscopically.
The management of intra-articular lateral femoral condyle (Hoffa) fracture of the knee using arthroscopy-assisted fixation: a case report
Authors: Aryana I. G. N. Wien , Wibowo Trimanto
Published: October 2018

A Hoffa fracture is a type of supracondylar distal femoral fracture with fracture line located in the coronal plane. It is a rare injury consisting of tangential (coronal shear) fracture of distal femoral condyles. Unicondylar knee fractures are rare and present some diagnostic difficulties due to poor visibility on standard X-ray and are especially harder to identify in non-displaced fracture. A fifty-four-year-old male presented to our emergency room with a chief complaint of pain over his right knee that started 10 months prior. He previously was involved in a motor vehicle accident and underwent open reduction and internal fixation with plate and screws. Physical examination revealed swelling and tenderness over the right knee with limited range of motion. Plain X-ray showed union of tibia plateau fracture with plate and screws and no evidence of distal femoral fracture. A magnetic resonance imaging of the right knee was performed and revealed an intraarticular lateral condyle femur fracture with transverse configuration that was previously missed on plain X-ray. Arthroscopy-assisted reduction and internal fixation using antero-posterior and postero-anterior oriented screws were performed and good reduction was achieved. Diagnosis of this type of fracture is challenging and require some experience. Awareness of such entity and strong clinical suspicion are essential for diagnosis because most of the time the standard X-rays may appear normal. Arthroscopy-assisted fracture fixation using antero-posterior and postero-anterior oriented screws for Hoffa fracture offers many advantages and allows for early mobilization postoperatively without any loss of reduction.
Unplanned surgery increases the morbidity of patients with solitary plasmacytoma of femoral bone: a case report
Authors: Wiratnaya I. Gde Eka , Arimbawa Ida Bagus Gede , Sidharta I. Made Tusan
Published: October 2018

Solitary skeletal plasmacytoma is a malignant plasma cell tumour that accounts for 3-5% of all monoclonal gammopathies. Lytic bone disease is a hallmark, and a substantial percentage of patients develop pathologic fractures. For lesions involving the femur, internal fixation frequently fails; therefore, prosthetic reconstruction may be the optimal choice for treatment. A 52-year-old male patient with pathological fracture of right femoral bone. Patient was undergone surgery with internal fixation. The pain had been continuing for several months and giant masses has developed on affected side. Further test was done and showed solitary plasmacytoma of proximal femur. The patient was treated with cemented modular prosthesis following tumor excision. Treatment of pathological fracture often challenging. Unplanned surgery could be devastating for the patient. Compare to internal fixation, cemented modular prosthesis is designed as a modular system that can be used to replace diseased or deficient bone in the femur following wide excision. Treatment of pathological fractures in solitary plasmacytoma with modular prosthesis appears to be a feasible option. They were able to mobilize early with good pain relief and had a useful functional limb. Further diagnostic test should be done for fracture of proximal femoral bone that considered pathologic. Limb salvage surgery with modular prosthesis can be considered as a viable option for treating painful pathological fractures in solitary plasmacytoma. It provides pain relief, early mobilization, and good functional outcome with improved quality of life.
Psychosis as the sole presenting feature of hyperthyroidism: a case report
Authors: Tuteja Vinay , Nawal C. L. , Singh Aradhana , Chejara R. S. , Singh Rajbeer , Chouhan Siddharth
Published: October 2018

Thyroid disease is a very common entity with a wide range of presentation, We report a case of twenty six year old female presented to emergency room with frank psychosis over the course of her stay in hospital we investigated thoroughly and finally she turned out to be a case of hyperthyroidism with psychosis as the only presenting symptom and after starting her on carbimazole patient responded to the treatment remarkably.
Seborrahic keratitis: a benign pigmented skin lesion management
Authors: Kumar Satish Chandra , Sinha Avinash Kumar , Singh Saurabh
Published: October 2018

Seborrhoeic keratosis are formed from the basal layer of epidermal cells and contain melanocytes. Many terms such as senile wart, melanoacanthoma, basal cell papilloma, senile keratosis and seborrhoeic wart have been applied, but seborrhoeic keratosis is the most widely accepted term. In our case a 50-year-old female presented to the surgery OPD with a painless pigmented skin lesion 2.5cm lateral to the left lateral canthus and 1cm below the hairline of size of 4 *4cm. Pigmented lesion was from last 8 years and slowly progressive in nature and was not associated with any co morbid conditions. On clinical evaluation the clinical diagnosis of epidermal nevus was given and an excisional biopsy with rhomboid flap placement was performed and the tissue was sent for histopathological examination. Post operative period was uneventful and the histopathology report states the seborrhoeic keratosis. Hence, lesions for which the diagnosis is uncertain, based on the history and gross examination, should be biopsied for histopathologic examination to rule out malignancy.
Approach and management considerations in low phospholipid associated cholelithiasis (LPAC) syndrome
Authors: Suresh Indrajit , E. Lokesh , Nanaiah Amrit , Nanaiah Soumya Ganesh , C. Suhas , D. Chandrababu
Published: October 2018

Low phospholipid associated cholelithiasis (LPAC) syndrome, first described in 2001, could be the causality in a significant number of young patients with cholelithiasis, who have a recurrence of symptoms despite cholecystectomy. A mutation of the ABCB4/MDR3 gene, causes a disruption in the translocation of phosphatidylcholine, resulting in bile acid mediated biliary tract injury. The ABCB4 gene is also implicated in other diseases such as progressive familial intrahepatic cholestasis type 3, which is greater in severity and tools like genotyping can aid the physician in prognostication, as well as determining the response to medical therapy. A few symptomatic patients develop features of biliary obstruction due to intrahepatic calculi, and they require interventions-which may be endoscopic or surgical in nature. Although a majority of patients with LPAC syndrome respond well to ursodeoxycholic acid (UDCA) therapy, close monitoring is warranted to keep a check on disease progression.
Assessment of glycaemic control in patients with type 2 diabetes: a clinic-based study in a slum of Kolkata
Authors: Pan Tania , Dasgupta Aparajita , Suman Sweta , Paul Bobby , Banerjee Rajarshi , Burman Jayeeta
Published: October 2018

Background: Although diabetes is a chronic condition, it can be controlled and managed to prevent complications. Long-standing diabetes with poor glycaemic control leads to many complications. This study aims to assess the glycaemic control status and its associated factors among type 2 diabetes patients attending Urban Health Centre in a slum of Kolkata, West Bengal.Methods: A clinic-based cross-sectional study was conducted among 184 diabetic patients attending clinic at Urban Health Centre, Chetla from October-December 2017. Each respondent was interviewed using a structured schedule to collect data on sociodemographic characteristics, physical activity, disease profile and self-care activities. Height and weight were measured. Individuals with PPBS ≥160 mg/dl were said to have poor glycaemic control. Data entry and analysis was done using SPSS version 16.0.Results: Out of 184 participants, 37.5% had poor glycaemic control. Mean (±SD) age of the participants was 51.64 (9.64) years. Median duration of diabetes was 4 years. 104 (56.5%) had overweight/ obesity. Only 26.6% had satisfactory dietary practice. Test results revealed ≥4 years duration of diabetes, overweight/ obesity, smoking, unsatisfactory diet and non-adherence to medications as significant predictors of poor glycaemic control, explaining 31.6% of the variance of glycaemic control with non-significant Hosmer–Lemeshow statistics.Conclusions: The study has identified factors associated with poor glycaemic control among the study participants. Emphasis on promoting a healthy lifestyle which includes a healthful eating plan, cessation of smoking, maintaining optimum body weight and strictly adhering of prescribed medications would go a long way in maintaining good glycaemic control.
Is caffeine consumption amongst students on the rise? Comparison between medical and engineering students: a pilot study
Authors: Mehta Sameera R. , Pokale Aarati B. , Karmarkar Mandar D.
Published: October 2018

Background: Caffeine consumption has significantly increased over the last decade and is largely attributed to the lifestyle changes. Adverse effects of excess caffeine consumption vary from sleep disorders to dependence and withdrawal symptoms. Only a few studies are available in India regarding caffeine intake and its effects.Methods: This was a cross sectional study conducted on students of medical and engineering college students of a private university during the period from 1st October 2016 – 30th April 2017 (Seven months). Semi open ended questionnaire was administered using an online tool. The data was entered into IBM SPSS 20 USA. Percentages were calculated and chi square test was applied to find out association between Medical and Engineering student’s caffeine consumption frequency and reasons. P value <0.05 was considered significant.Results: Of 200 participants, 90 (45%) were medical students. Mean age of the participants was 20.25±1.65 years. Twelve (13.3%) medical and 17 (15.5%) engineering students consumed coffee two-three times/day. Nineteen (21.1%) medical and 19 (17.3%) and engineering students respectively consume soft drinks two-three times a week. Thirty two (35.5%) medical and 35 (29.09%) engineering students drink coffee to remain alert. Nine (10%) medical and 11 (13.8%) engineering students have unsuccessfully tried to quit coffee. Fourteen (12.7%) engineering students showed withdrawal symptoms like anxiety, restlessness and nervousness.Conclusions: Engineering students were found to be consuming more caffeine stating reason as social pastime or to increase concentration. Withdrawal symptoms like caffeine cravings, nervousness and anxiety were observed more in engineering students.
A study of human rabies cases admitted in infectious disease hospital KGMU, Lucknow, North India
Authors: Mohammad Khalid , Gupta Pratibha
Published: October 2018

Background: Rabies is only communicable disease of man that is always fatal but easily preventable disease, if animal bites are appropriately and timely managed. It is estimated that India continues to report every year 25,000 to 30,000 human rabies deaths. The objective of this study was to describe the clinic epidemiological characteristics of human rabies.Methods: Analysis of the records of probable rabies cases admitted into the Infectious Diseases Hospital, KGMU, Lucknow during 2010-2014.Results: Total 490 human rabies cases were admitted during study period. Majority (63.26%) of the victims were between 12-60 years of age. Males constituted 83.47% of cases and victims from rural areas were 92.65%. Principal biting animal was dog (94.29%). Majority of the cases (77.96%) were not vaccinated. Most of the cases (93.47%) left against medical advice within 24 hours after admission.Conclusions: Rabies is a major health problem in this part of India. The data indicates that there is still much to do for mitigation of this menace and the crux of the problem is the epidemiological trend has not changed much. Hence, there is an immediate and urgent need to educate the community and health workers about the importance of immediate and adequate post-exposure treatment. Prevention strategies are critical to better manage rabies in these endemic areas.
Impact of health education on attitude regarding oral anti-diabetic drug adherence in type 2 diabetes mellitus, Bengaluru
Authors: Hulugappa Lakshmi , Ramegowda Chethana
Published: October 2018

Background: Diabetes mellitus, especially type 2 diabetes is an emerging global epidemic and public health problem and associated with high morbidity and mortality among patients. Positive attitude is important for the management of drug adherence in diabetes, hence the present study was taken to assess the effectiveness of health education on oral anti-diabetic drug adherence.Methods: A descriptive and interventional study was conducted at urban health training centre of a medical college, Bengaluru from November 2015 to March 2016. A total of 70 type 2 diabetes mellitus patients only on oral anti-diabetic drugs willing to give informed consent were included in the study. A pre-tested semi-structured proforma was administered and information about socio-demographic profile, and impact of health education intervention on attitude was obtained.Results: Most of the subjects were female (80%), in the age group of 35-45 yrs (34%), illiterate (40%), unemployed (67%) with Class IV (78%) socio-economic status according to modified Kuppuswamy Classification 2014. The mean ±SD age was 52.47±11.06 years. Significant improvement in attitude regarding adherence to oral anti-diabetic medication was found in study subjects following health education intervention.Conclusions: The study revealed that health education regarding the importance of drug adherence is needed to build positive attitude in study subjects.
HIV/AIDS knowledge and attitude among adolescents of Kamrup Metro district, Assam
Authors: Pegu Bhabani , Gaur Bhanu Pratap Singh
Published: October 2018

Background: AIDS is a pandemic disease which is threatening the world population. Its prevention largely depends on health education and behavioural changes based on AIDS awareness, particularly among young adults who are prone to risky behaviour. The objectives of the study were to assess the knowledge and attitude about HIV/AIDS among adolescents of Kamrup Metro district, Assam and to study the relevant socio-demographic factors.Methods: A cross sectional, community based study was conducted for a period of three months. A total of 300 study participants from slum & non slum areas of Kamrup Metro district, Assam were included using two stage random sampling. Interview of adolescents in 15-19 years age group was taken using predesigned and pretested schedule.Results: It was found that 95.7% of respondents had heard about AIDS. Virus as a causative agent was known to 51.6% while only 59.6% of the study subjects knew regarding asymptomatic nature of the disease. Transmission by infected syringes and needles, from infected mother to her baby & by unscreened blood transfusion was known to 69%, 74.2% and 81.8% of respondents respectively. Some misconceptions about the disease were also present. Knowledge regarding availability of treatment and prevention was found among 54.4% and 86.4% of respondents respectively. 66.5% of respondents felt that a person with HIV/AIDS must be isolated. 44% of study subjects believed that HIV/AIDS is curable.Conclusions: Though majority of respondents were aware about AIDS but complete knowledge about this disease is still lacking. There is a need for intensified activities regarding information, education and communication for these vulnerable groups.
Determination of awareness level of the female population, their attitude and behaviours towards understanding the risk factors associated with breast cancer
Authors: Krishnaveni K. , Vijayalakshmi R. , Shenuka S. , Kameswaran R. , Rajagopal Shanmuga Sundaram
Published: October 2018

Background: Breast cancer is the most prevalent cancer among women all over the world. Due to the variation in cultural differences, diet and socio economic characters Indian women are more prone to the risk associated with breast cancer. Many women still remain ignorant about breast self-examination (BSE) which is the earliest and simplest way to detect breast cancer.Methods: A prospective observational study was done on 100 women during the period of 6 months to find the association between breast cancer and its risk factors and to evaluate the attitude of common women towards BSE using standardised questionnaire.Results: The BSE pattern of the participants showed that 65% had never done BSE and only 11% of the participants have knowledge about BSE and make it as a regular practice. Pain was the most common symptom reported by the women 32 (91.4%). The risk factors were also recorded and 46% of the participants were overweight, majority of the participants (69%) had a lactation period ranging from 1-2 years, 79 participants had undergone hormonal therapy, only 41% had a habit of doing regular physical activity. The literacy rate of the participants was 100%.Conclusions: Only a fewer proportion of the participants is aware about BSE, and other risk factors associated with breast cancer. Even with high literacy level majority of the women follow poor life style habits.
A cross sectional study on socio-demographic and maternal factors associated with low birth weight babies among institutional deliveries in a tertiary care hospital, Hyderabad, Telangana
Authors: Apoorva M. Sheeba , Thomas Vimala , Kiranmai B.
Published: October 2018

Background: Birth weight is an important indicator of new born growth, survival and psychosocial development. Globally, more than 20 million are born with low birth weight (LBW) and the prevalence of low birth weight in India is 20%. The study was conducted to find the proportion of low birth weight and the factors influencing the weight of the baby.Methods: A cross sectional study was conducted at Gandhi hospital, Telangana from September to November, 2015 using a semi structured questionnaire among 204 postnatal mothers.Results: Out of 204 live births, 26% were found to be low birth weight. About 44.4% LBW babies are born to teenage mothers and 70% among the mothers with height less than 140 cms. Of the pre-term babies, nearly half of the babies (49.3%) were low birth weight. Around 30.3% of LBW was found with an inter-pregnancy interval of <2 years. About 41.2% of the mothers having complications had low birth weight babies.Conclusions: Nearly one fourth of the newborns were low birth weight. Gender of the child, socioeconomic status, education, gestational age, inter pregnancy interval, medical complications were found to affect the birth weight.
Study of epidemiological profile and treatment seeking behavior in children attending anti rabies vaccination clinic at a tertiary care center
Authors: Panchal Sanjaykumar Balajirao , Kulkarni Sonali Kashinathrao , Gattani Prakash Laxminarayan
Published: October 2018

Background: Rabies is an acute infectious highly fatal viral disease of the central nervous system leading to encephalomyelitis. It is primarily zoonotic disease of warm blooded animals. It is mainly transmitted by animal bites mainly dogs. In India alone, 20,000 deaths are estimated to occur annually. Rabies is most common in children aged less than 15 years. Till now no study of epidemiological profile and treatment seeking behavior in Children (<15 years) is carried at an anti-rabies vaccination (ARV) clinic, so with this background kept in mind the present study is planned.Methods: The present hospital record based study is carried out at ARV clinic. All animal bite victims in age groups <15 years, coming between 1st January to 31 December 2017 at ARV clinic are recorded in details regarding history, epidemiological profile and ARV management in month of march 2018. The results were analyzed by proportion & percentages.Results: Out of the total patients attending ARV OPD 30.25% of children were of age <15 years. About 93.09% of children were of Cat – III bite and maximum got bite on lower limb. About 86.05% of the children reported late by 24 hour. Out of the total children attending OPD 93.09% patients were advised for ARS of which only 92.88% of patient had taken ARS.Conclusions: Most of children they are in cat-III so there is need to do counselling about taking PEP (ARV and ARS) treatment and treatment seeking behavior are poor in rural children.
Globus pharyngeus in women: observations and opinions
Authors: Subramanya B. T. , Basavannaiah Sphoorthi , Lohith S.
Published: October 2018

Background: India has world’s fastest growing economy with second largest population in the world. But the health aspects of Indians are neglected even with vast health facilities and resources. Health is an important factor that contributes to well-being and economic growth especially women’s health which must be prioritised but is often ignored. Aims and objectives of the study were to identify the root cause for globus sensation in throat, to assess the percentage of factor causing this symptom and to educate women to eliminate this illusion of foreign body like sensation in the throat.

Methods: All the women who consulted outpatient department with this symptom were evaluated clinically and investigated.  

Results: Anemia topped the list among all the probable causes for globus pharyngeus.

Conclusions: Proper and adequate nutrition in women is a life-long process and it is important to eliminate the myth about Globus pharyngeus in women.
Post-operative speech and swallowing in partial glossectomy patients: role of effective rehabilitation
Authors: Jain Shailesh Kumar , Raj Poonam , Singh S. K. , Chugh Rajeev , Gupta D. K. , Goyal Sunil
Published: October 2018

Background: The tongue is a frequent site for oral carcinoma. Quality of life in such patients is often compromised post treatment in terms of speech and swallowing functions. Although swallowing and speech are included in several health-related quality of life scales, postoperative rehabilitation that influences these domains is not very well studied. This study was conducted to assess the speech and swallowing impairment after partial glossectomy for the tongue cancer patients and role of speech therapy and swallowing rehabilitation exercises in effective postoperative rehabilitation.

Methods: 50 patients of carcinoma of the tongue managed with partial glossectomy as the definitive treatment were included in the study. Postoperative rehabilitation was offered to all patients, however 10 defaulted. Improvement in speech intelligibility, articulation and swallowing at 15 days, 1 month, 3 months and 06 months after surgery were recorded.  

Results: All three parameters of speech intelligibility, articulation and swallowing which were analysed showed improvements during each follow-up visit. Results obtained for both groups, on comparison showed statistically significant earlier improvement in patients who were receiving rehabilitation therapy versus those who were not receiving any rehabilitation.

Conclusions: Postop speech and swallowing rehabilitation can be an effective tool for improving quality of life. It is imperative to develop easy and simple modules for rehabilitation for patients of oral cancers that can be practiced during the postop follow up and at home with the assistance of family members to ensure uncompromised quality of life post treatment.
Impact of temporal bone dissection on the understanding anatomy of the ear among medical students
Authors: Prasad K. C. , K. Prathyusha , Maruvala Shreeharsha , T. R. Harshita , Gopi Indu Varsha , K. R. Sumanth
Published: October 2018

The aim was to study the impact of temporal bone dissection demonstrations on understanding anatomy of the ear among medical students. During a period of six months from October 2017 to March 2018, 10 cadaveric temporal bones dissections were demonstrated using ZEISS microscope and in the presence of medical students headed by a Consultant Otolaryngologist in the department of ENT, Sri Devaraj URS Medical College and Research Centre, Kolar. Anatomy of the middle ear and inner ear and various operative procedures were demonstrated. The students were divided into 2 groups. Group I comprised students who attended the temporal bone dissection and Group II included those who didn’t attend dissection. After the session both the groups were assessed by the consultant. Scores were given to the group individuals based on the ability to answer the questions. 10 Temporal bone dissections were demonstrated in 6 months period to medical students who were divided into 2 groups based on their attendance of the demonstration. The students of both groups were assessed. Scores were given by Likert scale-5point scale question. The results of our study proved that those students who attended the temporal bone dissection (Group-I) had better understanding of the anatomy and operative procedures of the ear as compared to students in group II. Demonstration of temporal bone dissection to the medical students had a good impact on their understanding of the three dimensional anatomy of the ear.
A retrospective study on clinicopathological correlation of cutaneous tuberculosis
Authors: Kannan Rajkumar , Chellappan Lakshmanan , Venu Sridhar , Chandrasekar Muthusubramanian
Published: October 2018

Background: Cutaneous tuberculosis is a curable chronic infectious disease. The clinical presentation and histopathological interpretation of skin biopsy may show variations as various types of the disease exist. The clinical diagnosis should be confirmed by histopathological features before starting treatment for particular type of the disease.

Methods: A retrospective hospital based study was conducted among patients in Chengalpattu medical college for last 3 years (May 2015 – April 2018) who had cutaneous tuberculosis. Skin biopsy taken from active lesion was stained with routine haematoxylin and eosin (H & E) stain.

Results: Out of 20 cases, male to female ratio was 1.5:1. The age of the patients ranged from 11-68 years. Clinically, lupus vulgaris was the most common type of cutaneous tuberculosis with 35% cases followed by tuberculosis verrucosa cutis 20% cases, scrofuloderma 15% and atypical mycobacterial infections 10%, and least common types are lichen scrofulosorum 5% which correlates with the previous study of Aruna et al. Characteristic tuberculoid granulomas were seen in 71.4% cases of lupus vulgaris, all cases of scrofuloderma, lichen scrofulosorum and 80% of tuberculosis verrucosa cutis. The clinical and histopathological correlation was seen in 17 cases (85%).

Conclusions: There can be overlap between different types of cutaneous tuberculosis with various other dermatological diseases, both clinically and morphologically and so correlation of clinical and histopathological features appears to be more useful for accurate diagnosis and typing of cutaneous tuberculosis. High clinical suspicion is necessary in cutaneous tuberculosis and early diagnosis and treatment are essential to prevent its complications.
DESIGN OF MULTI-AGENT BUILDING MANAGEMENT SYSTEM WITH ONTOLOGIES
Authors:   Yaroslavl State Technical University, Maryasin O.
Published: October 2018

This article describes the design of a building management system. One of the problems that arise in the design is the task of organizing the harmonious work of traditional and advanced control systems for engineering equipment. Another problem is the identification of preferences and of people's activities. To solve these problems, the author suggests using a multi-agent approach. Based on the analysis of the architectures of multi-agent building management systems from literary and Internet sources, the classification of agents was conducted, as a result of which a list of agents was created and agent classes and their characteristics were determined. An example of constructing the architecture of a multi-agent building management system is shown, a description of the functions of individual agents is given. The design solutions were tested by computer simulation of the multi-agent system in the AnyLogic environment. For the first time classes of agents are proposed, which are the basis for building the architecture of a multi-agent building management system.
Classification Method of Hand Gestures Based on Support Vector Machine
Authors: Caesarendra Wahyu , Irfan Mohamad
Published: October 2018

This paper presents the EMG signal classification based on PCA and SVM method. The data is acquired from the 5 subjects and each subject perform 7 hand gestures includes the tripod, power, precision closed, finger point, mouse, hand open, and hand close. Each gesture is repeated 10 times (5 data as training data and the 5 remaining data as testing data). Each of training and testing data are processed using 16 features extraction in time–domain and reduced using principal component analysis (PCA) to obtain new set of features. Features classification using support vector machine classify new set of features from each subject result 85% - 89% percentage of training classification. Training data classification is tested using testing data of EMG signals and giving accuracy reach 80% - 86%.
An overview of the tinnitus network activity and its clinical implications
Authors: Mohsen Samer , Pourbakht Akram
Published: October 2018

Background and Aim: Tinnitus, the phantom perception of sound, in which many cortical and subcortical areas are involved has become one of the popular subjects of neuroscience research. Neuroimaging studies have introduced the tinnitus network model to explain the involvement of auditory and non-auditory areas in this perception. In such a model, the cognitive and emotional aspects of tinnitus can be interpreted conveniently. Therefore, this paper aimed to review the neural basis of tinnitus networks, including data from neuroimaging studies, and discuss the clinical implication of this concept, as well.Recent Findings: The data from neuroimaging studies were reviewed and discussed in order to complete the overall image of tinnitus network and its correlates such as the distress network, attentional network and other cognitive mechanisms. In addition to the auditory system, the anterior cingulate cortex (ACC) and dorsolateral prefrontal cortex (DLPFC) were considered to be important hubs in tinnitus distress network, especially for having important connectivity with the other networks like attention and salience networks. Moreover, the top-down control of DLPFC over the other brain areas was regarded as the most important brain area to be targeted using the non-invasive interventions and the results were compelling.Conclusion: Understanding the network model has helped in optimizing the neuromodulation protocols like electrical stimulation techniques. Thus, the clinical implications of this model can be generalized to the other types of treatments and the outcomes might be satisfying.
Etiology of dizziness among patients referring to an Iranian ear, nose and throat clinic
Authors: Saeedi Masoumeh , Ajalloueyan Mohammad , Abdollahi Farzaneh Zamiri , Choobdari Mohammadreza
Published: October 2018

Background and Aim: Dizziness is one the most common complaints of patients in the emergency rooms. It has various etiologies and can lead to falling and other life-threatening injuries, especially in the elderly. Dizziness aff­ects the quality of life and results in negative emotional reactions. This research studied the etiology of dizziness in a three-year study.
Methods: This study was conducted on 650 patients with the complaint of dizziness, whose specialists suspected them of having possible vestibular involvement, referred to a tertiary audiology clinic from 2015 to 2018. Videonys­tagmography, electrocochleography and cervical vestibular evoked myogenic potentials were administered. Other medical tests including neu­rologic examinations, blood analysis, and brain imaging were performed based on patients’ complaints.

* Corresponding author: Department of Audiology, School of Rehabilitation, Tehran University of Medical Sciences, Piche-Shemiran, Enghelab Ave., Tehran, 1148965141, Iran. Tel: 009821-77530636, E-mail: audiology_zamiri@yahoo.com
 

Results: This was a descriptive study of dizzi­ness prevalence with different etiologies. Patie­nts’ age range was 18-85 years with mean (SD) age: 42.34 (13.12), including 377 (58%) females and 273 (42%) males. Patients’ chief complaints included vertigo in 64.8%, dizziness in 20.2% and imbalance in 15.1%. Vestibular disorders were identified in 49.2% of the referred patients. The patients’ final diagnosis in order of preva­lence were as follows: systemic involvement (292 cases), benign paroxysmal positional ver­tigo (187 cases), unilateral vestibular weakness (63 cases), endolymphatic hydrops (51 cases), bilateral vestibular weakness (37 cases), central involvement (20 cases), cervical (10 cases) and migraine-associated vertigo (8 cases).
Conclusion: About 49.2% of the patients refe­rred to the ENT clinic had actual vestibular involvement. Careful history taking, teamwork, and comprehensive evaluations are necessary to differentiate underlying cause and selecting app­ropriate treatment.
The relationship of mental health with resilience among psychiatric nurses
Authors: Dehvan Fazel , Kamangar Peyman , Baiezeedy Shono , Roshani Daem , Gheshlagh Reza Ghanei-
Published: October 2018

Background & Aim: Psychiatric wards are stressful environments. Resilience can help psychiatric nurses cope with their occupational stress. The aim of the study was to examine the relationship of mental health with resilience among psychiatric nurses.
Materials & Methods: This cross-sectional descriptive-correlational study was conducted in 2017 on a sample of sixty nurses purposively recruited from all wards of Qods psychiatric hospital, Sanandaj, Iran. Study data were collected using a demographic questionnaire, the 28-item General Health Questionnaire, and the 25-item Connor-Davidson Resilience Scale. The data were analyzed via the SPSS software v. 16.0 through conducting the independent-sample t test, the one-way analysis of variance, and the multiple linear regression analysis. The level of significance was set at less than 0.05.
Results: In total, sixty psychiatric nurses (34 males and 26 females) with a mean age of 33.23±5.45 participated in this study. The mean scores of their mental health and resilience were 57.35±11.12 and 63.9±14.05, respectively. Resilience had significant relationships with age (0.025), marital status (P = 0.013), and work shift (P = 0.005). Moreover, among the subscales of mental health, only the mean score of the anxiety and insomnia subscale had significant relationship with resilience, so that each one point increase in the mean score of this subscale was associated with a 1.029-point increase in the mean score of resilience (P = 0.036).
Conclusion: Psychiatric nurses’ resilience can be promoted through managing their stress and promoting their mental health.
Potential of e- and m-health tools and gender-tailored approach in modern model of education and prevention of cardiovascular disease in women
Authors: Zembala-John Joanna , Konka Adam
Published: October 2018

Choroby sercowo-naczyniowe (ChSN) stanowią najczęstszą przyczynę zgonów na świecie. Tylko w roku 2012 z powodu ChSN zmarło 17,5 miliona osób. Mimo że problem ten dotyczy przedstawicieli obu płci, każdego roku więcej kobiet umiera z powodu chorób układu krążenia. Śmiertelność z powodu ChSN w tej grupie jest wyższa niż z powodu nowotworów, gruźlicy, HIV/AIDS i malarii łącznie. Symptomatyka i przebieg ChSN u mężczyzn i kobiet są często odmienne, w przypadku kobiet objawy są często mniej charakterystyczne i w związku z tym trudniejsze do wczesnego rozpoznania i leczenia. Poziom wiedzy i świadomości na temat specyfiki ChSN u kobiet w Polsce jest wciąż ograniczony i często trudno dostępny – zwłaszcza wśród samych zainteresowanych.
Wprowadzenie nowego modelu edukacji i prewencji, skierowanego wyłącznie do kobiet, skrojonego do ich potrzeb: biologicznych, medycznych, technologicznych, estetycznych, uwzględniającego społeczno-kulturowe uwarunkowania i oczekiwania może stanowić wartościową i bardziej skuteczną strategię prewencji ChSN w tej populacji.
Ponadto wykorzystanie w tym modelu nowych technologii, w tym narzędzi e- oraz m-zdrowia, bardziej dopasowanych do mobilnego stylu i tempa życia współczesnej kobiety, w profilaktyce ChSN mogłoby przyczynić się do zwiększenia wiedzy i świadomości na temat kobiecego profilu ChSN, poprawy sytuacji zdrowotnej kobiet w Polsce, a tym samym do redukcji medyczno-ekonomicznego i społecznego ciężaru ChSN w tej populacji.
The Right to Independent Living and being included in the Community: Lessons from the United Nations
Authors: Gooding Piers
Published: October 2018

This review will consider recent United Nations activity on article 19 of the Convention on the Rights of Persons with Disabilities (CRPD) concerning the right to live independently and be included in the community. The Committee on the Rights of Persons with Disabilities adopted its ‘General Comment’ No. 5 in August 2017, which offers guidance to governments on art 19 implementation. This review critically examines content relevant to mental health and capacity law, policy and practice. It considers the strengths and potential limitations of the General Comment with reference to key issues in the field. Gaps include commentary on the rising marketisation of disability services globally and a focus on low and middle-income countries. Yet overall, the General Comment offers useful guidance on implementing this unusual right, including concepts that may help resolve controversies about the role of coercion in mental health and capacity law.
Psychosocial Disability and Deprivation of Liberty: Reviewing the case of Qatar in the light of the Convention on the Rights of Persons with Disabilities
Authors: Cuenca Gómez Patricia , Barranco Avilés María del Carmen , Rodríguez del Pozo Pablo
Published: October 2018

This paper analyses the main implications of the prohibition of deprivation of liberty on the basis of disability in the field of mental health under the Convention on the Rights of Persons with Disabilities and its impact in Qatar’s legal system. It shows the contradiction between the specific regimes of deprivation of liberty of persons with psychosocial disabilities and Article 14 of the Convention. The paper also proposes some changes in Qatar’s system to ensure that persons with psychosocial disabilities enjoy the right to liberty on equal terms with others.
Análise da qualidade de vida em atletas de basquetebol da cidade de Londrina, Paraná
Authors: Heinemann Guilherme Eduardo Guterres , Greguol Márcia , Oliveira Arli Ramos de
Published: October 2018

O principal objetivo do presente estudo foi analisar a qualidade de vida de atletas de Basquetebol da cidade de Londrina, no Paraná. Participaram do estudo 28 atletas de categorias de base da equipe masculina de Basquetebol do Londrina Esporte Clube/APVE/FEL. Para avaliar a Qualidade de Vida foi utilizado o questionário Kidscreen-52, constituído por 52 questões divididas em 10 dimensões. Para a caracterização da amostra foi empregada estatística descritiva e para análise da variável qualidade de vida foi utilizado o Teste “t” de Student e a Análise de Variância (ANOVA) One-Way. Os valores médios obtidos para o construto qualidade de vida como um todo foram de 79,20±10,75 para categoria Sub-13, e 80,50±7,62 para a categoria Sub-14. Quanto às dimensões que compõem a qualidade de vida, nota-se que ambas as categorias manifestaram os escores mais altos na dimensão “Rejeição Social”, seguida pela dimensão “Bem-estar psicológico”. Não foram encontradas diferenças significativas entre ambas as categorias avaliadas para os valores médios do construto qualidade de vida e suas dimensões. Diante dos resultados apresentados, conclui-se que tanto a categoria Sub-13, quanto a categoria Sub-14, apresentaram valores elevados para a qualidade de vida e suas dimensões.