bluuebunny/crossref_metadata_2025 huggingface dataset:
Acidentes de trabalho com exposição a material biológico em fisioterapeutas segundo vínculo formal e informal
Authors: De Souza Janaina Oliveira , Cordeiro de Almeida Milena Maria
Published: November 2020

INTRODUÇÃO: Trabalhadores de saúde, incluindo fisioterapeutas, estão sob maior risco de acidentes de trabalho com exposição à material biológico (At-bio), quando comparados a outros. OBJETIVO: Descrever perfil epidemiológico dos At-bio em fisioterapeutas, segundo vínculo de trabalho. MÉTODOS: Estudo de casuística das notificações de At-bio em fisioterapeutas registradas no Sistema de Informação de Agravos de Notificação, Brasil, 2008 a 2018. RESULTADOS: Foram 2.565 registros At-bio em fisioterapeutas, com crescimento de notificações (169,2%) no período, maioria entre os de vínculo formal (68,3%). Entre formais, a maioria foi do sexo feminino (82,7%), com idade entre 30 a 39 anos (46,8%) e raça/cor branca (69,6%). Entre informais, a maioria também foi feminina (85,3%), mais jovens, de 18 a 29 anos (62,2%) e raça/cor branca (69,8%). Em ambos os grupos, a ocupação específica foi fisioterapeuta geral, com casos evoluindo para alta paciente fonte negativa. Os formais tinham 1 a 6 anos de experiência ocupacional (44,8%) e registro de Comunicação do Acidente de Trabalho (CAT) em 58,1% dos casos. Nos informais, o tempo de experiência era menor que 1 ano (47,7%) e apenas 28,6% tiveram o registro da CAT. O uso dos Equipamentos de Proteção Individual (EPI) teve pequena diferença entre grupos, sendo luva, avental e máscaras os mais utilizados. CONCLUSÃO: Embora os At-bio sejam mais notificados em fisioterapeutas com vínculo formal, entre informais acontecem em mais jovens, com menor tempo de experiência e sem registro da CAT, além de pior registro de informações e abandono de evoluções, indicando maior vulnerabilidade, especialmente em relação às medidas de proteção social.
Rural community awareness levels, challenges and strategies adopted to combat COVID-19: a cross-sectional e-survey
Authors: Srivastav Adarsh Kumar , Sharma Neha , Goyal Manu , Samuel Asir John
Published: November 2020

INTRODUCTION: COVID-19 has a widespread effect on rural economies all over the world. It has affecting household incomes, and businesses in every sector of rural economies. Lockdown due to COVID-19 outbreak limiting the outdoor and regular physical activity, and further can leads to increased risk of chronic health conditions. Physical activity and yoga play a vital role in breaking the boredom due to COVID-19 lockdown and thereby, improves the quality of life. OBJECTIVE: To identifying the level of awareness and challenges faced by the people of rural communities due to the COVID-19 outbreak. MATERIALS AND METHODS:  A total of 36 participants were recruited by convenient sampling method from five different villages in District, Ambala, Haryana, India. E-survey questionnaires were circulated through WhatsApp messaging mobile-based application. The questionnaire was formed incorporating the three-point Likert scale with three domains, 1) Awareness, 2) Challenges and, 3) Strategies and 12 items. The questionnaire validation was carried out by the experts through Delphi survey method until S-CVI/Ave?> 0.8. The central tendency and dispersion of continuous variable age were expressed in mean with a 95% confidence interval (CI). Categorical data were reported in frequencies as a percentage (%) and sample size (n). The levels of significance were set at 0.05 to minimize Type 1 error. RESULTS:  The content validity index of the questionnaire, S-CVI/Ave?=?0.90. By contacting 36 potential participants, a total of 27 survey responses were recorded. Hence, the response rate (RR) was found to be 75%. The mean with 95% CI of age was 30.8 (27.3 to 34.3) years. A total of 94% (n=25) of villagers were aware of COVID-19, 88% (n=24) were facing challenges, and 86% (n=23) of participants are adopting the best strategies which includes, sealing of containment zone, usage of homemade mask made up of clothes, consuming traditional herbal medicine as immunity boosters for prophylaxis and involving in regular physical activity and yoga. CONCLUSION:  The rural populations were aware of COVID-19 and having adequate knowledge about COVID-19. They were facing challenges due to COVID-19 and prepared with the best strategies/methods to combat COVID-19.
Avaliação do impacto das abordagens bottom-up e top-down nas atividades da vida diária em pessoas com neglect – revisão sistemática
Authors: Rosa Marlene Neves , Amorim Andreia , Bartolo Marisa , Martins Ana Rita , Oliveira Catarina , Silva Cândida
Published: November 2020

INTRODUÇÃO: Atualmente não existe um consenso entre quais as caraterísticas das abordagens (bottom-up ou top-down) mais eficazes na reabilitação das Atividades da Vida Diária (AVDs) em pessoas com Síndrome de Neglect (SN). OBJETIVO: Caracterizar as abordagens (bottom-up ou top-down) e o seu impacto nas AVDs em adultos e idosos com SN. MÉTODOS: Esta revisão sistemática foi realizada de acordo com a recomendação PRISMA - Preferred Reporting Items for Systematic Reviews and Meta-Analyses. A pesquisa bibliográfica foi realizada nas bases de dados PubMed, Web of Science, PEDro e Cochrane. Foram considerados estudos experimentais em que pelo menos uma técnica das abordagens bottom-up e top-down fosse utilizada. A ferramenta Joanna Briggs Institute Critical Appraisal Checklist for RCTs foi utilizada para avaliar a qualidade metodológica dos estudos. Foi usada a seguinte combinação de palavras chave: Neglect Syndrome OR Unilateral Syndrome OR Neglect (…) AND Activities of Daily Living OR Daily (…) AND Treatment OR Intervention OR Technique (…). RESULTADOS: Foram incluídos 16 estudos, dos quais 9 incluem técnicas de abordagem bottom-up, 6 incluem técnicas de abordagem top-down e 1 artigo inclui técnicas das duas abordagens. As técnicas da abordagem bottom-up que aumentaram a independência nas AVDs foram Visuomotor Feedback Training, Smooth Pursuit Eye Movement Training e a combinação de Eye Patching com Constraint-induced Therapy. Na abordagem top-down as técnicas com os mesmos resultados foram Visual Scanning, Mental Practice, Continuous Theta Burst Stimulation e Transcranial Direct Current Stimulation. CONCLUSÃO: As abordagens bottom-up e top-down aumentam a independência nas AVDs e cada uma contém técnicas com significativo impacto positivo, como Visuomotor Feedback Training e Continuous Theta Burst Stimulation. O presente trabalho permitiu uma análise crítica à classificação das abordagens em bottom-up e top-down, uma vez que não são sensíveis à distinção dos mecanismos de reabilitação envolvidos.
ENERJİ TÜKETİMİ VE BÜYÜME: ÜST ORTA GELİRLİ ÜLKELER İÇİN PANEL NEDENSELLİK ANALİZİ
Authors: ÇAYIN Mücahit
Published: November 2020

Eskiden olduğu gibi günümüzde de ekonomik büyümenin önemli girdilerinden biri de enerjidir. Bu nedenle enerji ile ilgili etkin politikaların belirlenmesi ülkelerin ekonomileri açısından son derece önemlidir. Enerji tüketimi (ET) ve ekonomik büyüme (EB) arasındaki ilişki özellikle 1970`li yıllarla birlikte ampirik olarak ele alınmış ve giderek artan bir ilgiyle araştırma konusu olmuştur. Ancak çalışmalarda farklı hipotezler altında incelenen bu ilişki için tam bir fikir birliğinin oluşmadığı görülmüştür. Bu araştırmada da ET ve EB arasındaki ilişki, Dünya Bankası tarafından üst orta gelirli ülkeler olarak kategorize edilen ve verisine ulaşılan 27 ülke-nin 1993-2014 dönemine ait verileri ile incelenmiştir. Dumitrescu ve Hurlin (2012) Panel Nedensellik testi kullanılan çalışmanın soncunda ET`den EB`ye doğru nedenselliğin olmadığı fakat EB`de ET`ye doğru %5 an-lam seviyesinde nedenselliğin olduğu tespit edilmiştir.
Morphological evaluation and clinical significance of proximal femoral dimensions among Southern Nigerian population
Authors: Obikili Emmanuel N. , Omotoso Dayo R.
Published: November 2020

Background: Anthropometric studies are vital in evaluation and description of morphological characteristics of body tissues of living individuals or dead remains. This study was done to evaluate proximal femoral dimensions and to describe sexual or bilateral dimorphism among Southern Nigerians.Methods: This study involved 500 pelvic radiographs showing proximal aspects of right and left femurs of Southern Nigerians (including 250 males and 250 females) between ages 25 to 55 years. Measurements taken on radiographs include transverse diameter and vertical diameter of femoral head, neck diameter (ND), neck length (NL) and proximal shaft diameter. Bilateral measurements were recorded and average values evaluated. Data were analyzed using IBM-statistical package for social sciences (SPSS) (version 20) and statistical comparison was done using analysis of variance (ANOVA) with p<0.05 regarded as statistically significant level.Results: Proximal femoral dimensions showed non-significant bilateral differences with right side having higher values in all parameters except NL in males and ND in females. Also, mean values for TD (5.39±0.25 and 4.28±0.21), VD (5.01±0.21 and 4.58±0.19), ND (4.03±0.22 and 3.61±0.18), NL (2.08±0.11 and 1.79±0.10) for male and females subjects respectively showed sexual dimorphism in all parameters with males having significantly (p<0.05) higher values than females.Conclusions: The femur is an important bone in human body that plays crucial morphological and physiological role and offers prominent anthropometric value.
Factors and conditions that influence noncompliance to medical regimen among diabetic patients treated in federal medical centre Owerri
Authors: Chikodi Ezeama Matina , Olivia Iwu A. , Enwereji Ezinna Ezinne
Published: November 2020

Background: Diabetes mellitus poses a major global health threat worldwide. Compliance to prescribed regimen helps to reduce complications and death, but the rate of compliance has been consistently low in developing countries. This study therefore identified factors and conditions that influence compliance to medical regimen among diabetic patients treated in federal medical centre Owerri.Methods: Descriptive survey design was adopted. A convenience sampling technique was used to recruit all the 68 diabetic patients receiving treatment in the out-patients’ male and female wards. Data were collected using administered questionnaire. Data were analyzed and presented with percentages, tables and graphs.Results: The result showed low level of compliance among 37 (54.4%) of the diabetic patients treated in federal medical center Owerri. Factors that influenced compliance as indicated by the respondents include; drugs that are taken for a long time 23 (33.8%), long waiting time before seeing a doctor as well as the distance covered to the facility and diet restriction 22 (32.3%) respectively. Other factors that contributed to poor compliance included: inability to afford monitoring machine 16 (23.5%), and unaffordability of diabetic drugs 15 (23.5%). Majority (73.5%) of the patients suggested good communication as the best measure to promote patient’s compliance.Conclusions: This study identified that several factors contributed to lack of diabetic patients’ compliance to medical regimen and that only good communication can encourage patients’ compliance. Therefore, good communication between the health care givers and diabetic patients should be encouraged.
The effect of pregnancy exercise on the anxiety level of the third trimester of pregnant woman in the Kecamatan Sukawati
Authors: N. N. Ayuk Widiani , W. Noviani N.
Published: November 2020

Background: This study aims to know the effect of pregnancy exercise on the anxiety level of the third trimester of pregnant women.Methods: This type of research is analytic with a one group pre-test post-test design without control, the number of samples is 50 pregnant women who meet the inclusion criteria by using purposive sampling technique. The instrument data collection using depression anxiety and stress scale (DASS) questionnaire. Bivariate analysis using Wilcoxon test.Results: The result of the data shows p value of anxiety level of pregnant women before and after the implementation of pregnancy exercise is 0.000 (<0.05), it can be concluded that there is an effect of the implementation of pregnancy exercise on the anxiety level of pregnant women in the third trimester.Conclusions: From the result of research conducted, the effect of the implementation of pregnancy exercise on the anxiety level of pregnant women before and after of pregnant women in the third trimester.
Evaluation of implementation and satisfaction of distance learning among medical students during COVID-19 pandemic in Indonesia
Authors: Wiranto Rony , Syakurah Rizma Adlia
Published: November 2020

Background: Since it was declared as a pandemic by the world health organization (WHO) on March 11th, 2020, COVID-19 has become a global health problem in the world. The temporary closure of schools and universities was carried out to protect teachers and students from viruses, including in medical schools. Distance learning has been implemented as an alternative to subtitute conventional class. This can affect the satisfaction of medical students toward it. This study aim was to evaluating implementation and analyzing the factors that influence medical student' satisfaction toward distance learning during the COVID-19 pandemic.Methods: An observational analytic study with a cross-sectional study was used. A total of 3331 respondents from all over Indonesia responded through an online questionnaire by Ikatan Senat Mahasiswa Kedokteran Indonesia (ISMKI) distributed from April 9th, 2020 to June 21st, 2020. Data analyzed using chi-square test (alternative: fisher exact test) and logistic regression with significance alpha=0.05.Results: Study showed that most respondents had difficulties in learning and had less satisfaction toward distance learning. Factors that showed statistical significance were university origin grouped by type, region, accreditation, and readiness.Conclusions: Although distance learning is a solution to the problems of medical education during this pandemic, the government and related institutions should be able to continue evaluating so that the learning system remains effective and efficient.
Diagnostic yield of percutaneous computed tomography guided core needle biopsy of lung lesion and its complications in tertiary hospital
Authors: Kayastha Prakash , Adhikari Binaya , Suwal Sundar , Lohani Benu , Paudel Sharma
Published: November 2020

Background: Early diagnosis of lung cancer can reduce its mortality and morbidity. Minimally invasive image guided percutaneous core needle biopsy can obtain tissue sample for diagnosis and staging of lung cancer, which is crucial for correct management of lung lesions. Common complications of lung biopsy include pneumothorax, parenchymal haemorrhage and haemoptysis. The study was aimed to determine diagnostic yield and complications of the percutaneous computed tomography (CT) guided core needle biopsy of lung lesion in tertiary hospital.Methods: Hospital based prospective study was performed in 40 patients in Tribhuvan University Teaching Hospital. CT guided biopsy of lung lesions was performed with 18-gauge semi-automated biopsy instrument. The complications following the biopsy were recorded and correlated with different factors using chi-square test. Histopathology report were obtained to measure the diagnostic yield.Results: Among 40 patients who underwent guided lung biopsy, histopathology showed definitive diagnosis in 37 patients; 31 malignant and 6 benign lesions. Parenchymal haemorrhage, pneumothorax and haemoptysis were seen in 13, 8 and 5 respectively; however, none required active intervention. Emphysema in traversing lung and numbers of pleural punctures used were predictive factors of complication (p value <0.05).Conclusions: The study showed percutaneous image guided core needle biopsy has high diagnostic yield with fewer complication rates and is thus recommended for routine biopsies of lung lesions.
Husband's support towards unmet need family planning incidence on couples of childbearing age in Denpasar city
Authors: Wayan Ari Adiputri Ni , Kadek Widiantari
Published: November 2020

Background: Husband’s support is the most important role in decision making in the family, especially when deciding to use contraceptives.Methods: The research design was analytic observational study with a cross sectional study approach. The population in this study were all couples of childbearing age in the city of Denpasar for the period 2020 and the number of samples in the study was 96 couples of childbearing age. The sampling technique used was proportional stratified random sampling. The data collection method was carried out by distributing online questionnaires (Google form). The data analysis technique used was descriptive univariate analysis and bivariate analysis using chi-square analysis.Results: Most of the couples of childbearing age that is 55 people who received support from their husbands, had used contraceptives as many as 40 people (72.7%). Respondents of couples of childbearing age who do not get support from their husbands are 41 people and do not use contraceptives (unmet need) as many as 33 people (80.5%). The results of bivariate analysis using chi square analysis showed a significant relationship with a value of p=0.000 (p<0.05).Conclusions: There is a significant relationship between husbands’ support with the incidence of unmet need in couples of childbearing age. Pair counselling is very necessary for husbands to increase their knowledge of the importance of using contraceptives.
The relationship between obesity and obstruction risk of lateral inguinal hernia at Negara general hospital in 2019-2020
Authors: Bharata Bagus S. , Triarta Gita B.
Published: November 2020

Background: A hernia is the protrusion of the abdominal contents from the normal cavity through a defect in the fascia and aponeurotic muscle of the abdominal wall, either congenital or acquired. The hole can arise because the embryonic opening does not close or widen, due to high intra-abdominal pressure caused by chronic coughing, heavy lifting, overweight, obesity, and weakness of the abdominal wall muscles. The incidence of inguinal hernias is higher in patients with body mass index (BMI) who are overweight and obese than those with normal body weight. A study that conducted by Sneiders et al stated that each increase of 1 kg/m2 BMI would increase the risk of hernia complications by 1.03 times (p=0.03).Methods: This study used a cross-sectional analytic study. The samples were determined by consecutive sampling. In this study, the sample used was patients with a diagnosis of inguinal hernia who were divided based on the presence or absence of complications and divided according to BMI, then saw whether there was a relationship between BMI in the obesity category and the incidence of complication inguinal hernia. This study uses data from medical records at the Negara General Hospital from 2019-2020.Results: This study used 79 respondents of hernia patients at the Negara General Hospital who met the inclusion criteria and did not meet the exclusion criteria. There were 77 people (97.5%) male respondents and 2 (2.5%) female respondents with a mean age of 53.05 years (SD±19.7 years). As for the underweight body mass index there were 6 people (7.6%), normal as many as 41 people (51.9%), overweight as many as 4 people (5.1%), and obese as many as 28 people (35.4%). The diagnosis of reducible hernia was 52 people (65.8%), 21 people (26.6%) incarcerated hernia, 5 non-reducible hernias (6.3%) and 1 strangulated hernia (1.3%).  Conclusions: The conclusion of this study indicates a significant relationship between BMI and the incidence of complicated hernias. Obese hernia patients were 7.2 times more likely to develop hernia complications than non-obese patients.
The association of risk factors with psychiatric symptoms and quality of life in laryngopharyngeal reflux disease patients
Authors: Ramadhani Ade , Dewi Anna M. K. , Yunika Kanthi , Budiarti Rery , Ruspita Dian A. , . Farokah , . Muyassaroh
Published: November 2020

Background: Risk factors for laryngopharyngeal reflux (LPR), such as age, gender, BMI, smoking history and dietary habit affect the severity of LPR. These risk factors have a clinical impact on both social and emotional aspects, which can reduce the quality of life. Thus led the researchers to analyse association between these risk factors with psychiatric symptoms and quality of life for LPR sufferers.Methods: Analytical descriptive research with cross-sectional approach to LPR patients in ENT clinic RSUP Dr. Kariadi Semarang. Sixty six samples aged 18-60 years and met the criteria of the researcher were measured using the DASS 21 questionnaire and the RQS questionnaire. Statistical analysis used the chi-square test.Results: Obtained 66 subjects with a mean age of 45.1 years, there were more women than men (75.8%). Analysis of risk factors associated with depression found gender (p=1.000), age (p=1.000), duration of symptoms (p=1.000), BMI (p=0.132), smoking (p=0.452), and diet (p=1.000). Analysis of risk factors with anxiety obtained gender (p=0.340), age (p=0.743), duration of symptoms (p=0.085), BMI (p=0.322), smoking history (p=1.000), and diet (p=1.000). Analysis of risk factors with stress obtained gender (p=0.798), age (p=0.088), duration of symptoms (p=0.324), BMI (p=0.276), smoking history (p=0.606) and diet (p=0.538). Analysis of the gender association related to the quality of life LPR patients (p=0.032).Conclusions: Duration of symptoms, age, BMI, smoking history and diet were not associated with psychiatric symptoms and quality of life in LPR sufferers. Gender is not associated with psychiatric symptoms but is related to quality of life.
Awareness of computer vision syndrome and related factors among information technology professionals
Authors: Jayakumar Gayatri G. , Thampi Bindu , Iyer Mahadevan K. , Sasidharan Rekha R.
Published: November 2020

Background: Extensive use of computers for both professional and personal purpose has led to an increase in computer related health problems. Aim of this study was to evaluate the awareness regarding symptoms and the related factors in computer vision syndrome (CVS) among a group of information technology (IT) professionals.Methods: This study was conducted among 300 IT employees. After obtaining informed consent, structured questionnaire was given and data collected and analyzed.Results: Out of 300 respondents, 194 (64.7%) were males and 106 (35.3%) females. Mean age was 30.5 years.48.3% had more than eight years of computer usage and 77.3% used computers on an average of 8-12 hours per day. About 201 (67%) of the participants had at least one ocular symptom, most common was dryness (96%). 94.7% reported eyestrain and 86.3% reported redness and itching. Dryness and eyestrain were more in males (p<0.05). Dryness, eyestrain and redness were more in those who used computers for more than eight years duration and for 8-12 hours/day (p<0.05). 253 (84.3%) were aware about this syndrome, the main source being internet. The main relief measure adopted was to take a break in between the work hours. Only 51.3% consulted a doctor for their symptoms.  Conclusions: In our study though 84.3% of IT professionals were aware of CVS and 67% had at least one ocular symptom, only 51.3% took professional advice for their problems. There is a definite need for awareness about corrective measures and treatment methods to be adopted for CVS among IT professionals.
Six-minute walking test distance predicts readmission in hospitalized heart failure patient in integrated cardiac centre, Makassar, Indonesia
Authors: Mappangara Idar , Kabo Peter , Amir Muzakkir , Djafar Zaenab , Warliani Melda , Mustafa Asni
Published: November 2020

Background: Assessment of functional capacity prior to discharge can help identify patients at risk for readmissions in heart failure patients. This research aims to conduct a study in order to assess the distance traveled in the six-minute walk test (6-MWT) as a predictor of readmission rates in patients with congestive heart failure.Methods: This type of research is a quantitative correlational study with a prospective cohort study experimental design. Data were collected when the patient was treated at the Integrated Cardiac Center of Wahidin Sudirohusodo Hospital with a diagnosis of heart failure. The research was conducted from June 2019 to December 2019 after obtaining clearance from the institutional ethical committee. 6-MWT measures the distance that a patient can quickly walk on a flat, hard surface in a period of 6-MWD. To see the correlation between the components of 6-MWT the readmission using one-way anova. To determine the cut-off point, sensitivity and specificity of each component of the 6-MWT to rehospitalization using the receiver operating characteristic (ROC) curve. Statistical analysis was carried out using SPSS and SAP programs.Results: Out of the 93 samples, the 6-MWD has a significant p<0.001 for the readmission incidence≤30 days, meaning that the higher the 6-MWT value, it correlates with the decrease in the number of readmission incidents. In the ROC curve analysis for the 6-MWD parameter, it was found that the 6-MWD had a good predictability of readmission events in≤30 days (C=0.781, p<0.001).Conclusions: 6-MWD can be used to predict readmissions in≤30 days in heart failure patients. The lower the 6-MWD with a cut off of 183 meters, the higher the risk of readmission in≤30 days of heart failure patients. By knowing the cut off value, 6-MWD can be used as a reference to create a comprehensive treatment flow for heart failure patients to prevent increased readmission rates. In the end, it can reduce the burden of treatment costs on heart failure patients.
Clinicoetiological and imaging profile of intracerebral haemorrhage in a tertiary care hospital of Western Odisha
Authors: Karua Purna Chandra , Joy Shiny
Published: November 2020

Background: Intracerebral hemorrhage has an annual incidence of 10-30/100,000 population, accounting for 2 million (10-15%) of about 15 million strokes worldwide each year. The outcome of ICH depends on the clinical presentation and radiological parameters. The objective of current study was to study the etiology, clinical patterns and imaging profile in patients of intracerebral hemorrhage.Methods: All patients admitted in department of medicine, VIMSAR, Burla, with a diagnosis of ICH during a period of November 2017 to October 2019 were evaluated for their clinical presentation, etiology and radiological parameters.Results: A total of 105 patients with a diagnosis of ICH were included in the study. The sites of ICH were basal ganglia (49%) followed by lobar (19%), thalamus (14%), cerebellum (11%) and brain stem (8%). A pre-diagnosis of hypertension was present in 33% of the cases. Headache was the most common presenting symptom, present in 38.2% of patients followed by paralysis in 29.5%, vomiting in 27.6% and seizures in 20.9% of cases. Overall mortality rate was 39%. The mean GCS of patients who expired was 8.8 when compared to 11.28 of those patients who survived (p=0.00009). The mean hematoma size of patients who expired was 20.98 while that of those who survived was 17.41 (p=0.047). The presence of IVC was associated with mortality (p=0.006).Conclusions: A lower GCS at presentation and a mean hematoma volume >20 ml with intraventricular extension at presentation are associated with increased mortality in ICH.
Geriatric social security and welfare services in Gwalior, India: a cross sectional study of awareness, utilization, concerns and solutions
Authors: Dwivedi Shatkratu , Tiwari Ranjana , Sahu Rupesh , Bansal Manoj , Sharma Vikash , Singh Sumit Bhadoria , Kuity Paromita , Tiwari Sakshi
Published: November 2020

Background: Between 2015 and 2050, the proportion of the world's population over 60 years will nearly double from 12% to 22%. In 2050, 80% of older people will be living in low and middle income countries. All countries face major challenges to ensure that their health and social systems are ready to make the most of this demographic shift.Methods: The present Study was a cross-sectional study done for 1 year in 2016 in which 600 households were selected by simple random sampling in Gwalior city in which the knowledge and awareness of various Government health scheme and policies and their day to day utilization in their life were assessed. A predesigned and pretested interview based structured questionnaire was used for data collection. They were analysed and interpreted by appropriate software and various statistical tests were applied.Results: The maximum no. of participants 112 (54.9%) knew about railways/road transport/air travel concessions provided to Senior citizens, 23.04% knew about telephone and postal services, 13.24% were aware of tax exemptions while 9.8% knew about banking and insurance schemes regarding elderly. Males were generally more aware than females. The maximum utilization (59.82%) was found in railways/road transport/air travel concessions while minimum utilization (25.00%) was in Indira Gandhi National old age pension scheme.Conclusions: The system for comprehensive geriatric care to the community was well in place with regular development and growth but there is dearth of awareness and utilization of these services.
Role of magnetic resonance spectroscopy in brain space occupying lesions for detection of malignancy and grading of malignant lesions
Authors: Chandrasekharan Rajsekar , Khanna Ramaiah Rajesh , Kulkarni Chinmay , Moorthy Srikanth
Published: November 2020

Background: Magnetic resonance (MR) spectroscopy is a non-invasive technique that enables tissue characterization on a biochemical level using radio frequency signals emitted by the nuclei in the tissue. Primary aim is at determining the utility of MR spectroscopy to differentiate malignant from benign lesions and to assess its role in grading of gliomas as secondary objectives.Methods: MR system with proton spectroscopic capability using standard head coils and quantum gradients used in a sample size of 50 patients with intracranial space occupying lesions in conventional MRI. The diagnostic accuracy of the spectroscopic data based on the Cho/Naa ratios was used to detect the malignant lesions and distinguish them from the benign lesions.Results: The lesion characterization using the MR spectroscopic data in distinguishing malignant lesions from benign was statistically compared with the histopathological data using chi square tests proved to be significant with p value of less than 0.05. Grading of the malignant space occupying lesion with the available spectroscopic data was done with the corresponding histopathology that proved statistically not significant.Conclusions: Statistical data proves utility of MR spectroscopic data in differentiating malignant occupying lesions from benign. Role of spectroscopic data in grading the malignant lesion to differentiate to low and high grade could not be determined statistically which may be attributed to low sample size in the secondary objective.
Study and analysis of the coagulation factors and their natural inhibitors levels in apheresis derived platelet concentrate units over a five-day storage period
Authors: Pawar Amit A. , Biswas Amit K. , Dubey Rounak , Bhowmik Sujay
Published: November 2020

Background: The possibility of utilizing clotting factors in the plasma phase of apheresis platelet concentrates, as a supplement to the standard FFP transfusion for clotting factor replacement needs to be explored. In this study, it was proposed to assess the effect of storage on clotting factors and inhibitors in stored apheresis platelet concentrates. This would give an insight into the hemostatic potential of the plasma phase of the apheresis platelet concentrates.Methods: This study was conducted on a sample size of 45 apheresis platelet concentrate units harvested on Amicus cell separator. Basic coagulation workup along with various coagulation factors and their natural inhibitors were studied in the apheresis platelet concentrates on day ‘0’ and day ‘5’ of the collection.Results: Prothrombin time and activated partial thromboplastin time of the apheresis platelet concentrates was increased on day ‘5’ of the collection but were within the normal range. Fibrinogen, Factor XII, and VWF: Ag showed an increase on day ‘5’ of collection. Protein C, protein S activity, and antithrombin decreased on day ‘5’ of collection. Also, Factors II, VII, IX, X, XI decreased on day ‘5’. The highest fall in activity was seen in the case of Factors V and VIII. Despite the fall, all the clotting factors were maintained within their normal range.Conclusions: Although the activity of most of the coagulation factors showed a decrease, it was maintained within their normal range and efficacy. Therefore, a reasonable hemostatic potential of the clotting factors is expected to be maintained in apheresis platelet concentrates after a storage period of five days at room temperature.
Study of TORCH infections and its impact on newborn babies and infants: a retrospective study in a tertiary care hospital in Visakhapatnam, Andhra Pradesh, India
Authors: Chilakala Sai Prabha , P. Appa Rao , K. Ramalakshmi , Chaduvula Suresh Babu
Published: November 2020

Background: TORCH is an acronym for Toxoplasma, others (syphilis), Rubella, Cytomegalovirus and Herpes simplex virus. These are important causes of morbidity and mortality in new-borns, infants and children. Early diagnosis and treatment are essential to reduce the morbidity and mortality.Methods: It was a cross sectional record based retrospective record-based study conducted in King George Hospital, Andhra Medical College, Visakhapatnam, Andhra Pradesh. Samples from clinically suspected cases (newborns and infants) for possible TORCH infections were tested in virology laboratory from January to November 2019 and the samples were collected and tested by EUROIMMUN kit for the respective IgM antibodies and analyzed. Clinical details of newborns and infants were gathered from the patients through telephonic communication.Results: Total number of patients tested were 104 in which 54 (52%) showed positivity in which 36 were positive for CMV, 25 for HSV2, 23 for Rubella, 12 for Toxoplasma and 11 for Varicella zoster infection. Out of 52 positive cases 20.4% were alive and normal, 20% were alive but severely affected, mortality was 16.7%. Out of 16.7% mortalities 22% of deaths were due to nephrotic syndrome. Clinical manifestations include hepato-splenomegaly in 33.3% cases, fever in 30%, low birth weight in 25%, heart disease in 13.7%, microcephaly in 13.7%.Conclusions: Our study showed hepatomegaly, fever and low birth weight as common clinical manifestations. Fever and nephrotic syndrome were typically associated with CMV positive cases. Out of 52 % positively tested cases CMV was very common infection followed by HSV2, Rubella and Toxoplasmosis.
Thyroglossal duct cyst variation in presentation: our experience of 3 years
Authors: Gul Naveed , Manhas Monica , Kalsotra Parmod , Mir Mehak Taban
Published: November 2020

Background: The prime objective of the present study was, to learn incidence of thyroglossal duct cyst in different age and sex groups and variation in its presentation.Methods: The present retrospective study was carried out in department of otorhinolaryngology and head and neck surgery, GMC Jammu from June 2017 to May 2020. In this retrospective study clinical records, medical records and histopathological records were thoroughly reviewed and studied. 20 patients diagnosed as thyroglossal duct cyst were included in the present study.Results: Out of 20 patients, 14 were paediatric patients and 6 were adults. 15 patients presented with cystic swelling while 5 patients presented with fistula. Out of 20 patients, 5 patients had suprahyoid presentation, 4 patients had cyst at the level of hyoid and 11 had infrahyoid presentation. 16 patients underwent sistrunk operation while 4 patients underwent simple excision. Out of 4 patients who had undergone simple excision, 2 patients developed recurrence.Conclusions: In the present study it is concluded that paediatric age group presents most commonly with thyroglossal cyst as a midline, painless swelling. The most common site observed is infrahyoid region. After proper investigations and diagnosis, thyroglossal duct cyst should be excised preferably by sistrunk operation.
Open reduction, triceps lengthening, and collateral ligaments reconstruction in neglected elbow dislocation: a case report
Authors: Tirtosuharto Henry , Karna Made Bramantya , Asmara Anak Agung Gde Yuda , Meregawa Putu Feryawan
Published: November 2020

Neglected elbow dislocations are common in developing countries. Neglected elbow dislocation leads to retraction of triceps muscles and collateral ligaments. This cause limitation of range of movement that is inadequate for the activities of daily living. A 48 years old man presented with stiffness on the left elbow. He fell down with arm in extension position 8 months prior to admission and was treated by a traditional bonesetter before seeking medical treatment. Active ROM of the left elbow was limited to 15ᵒ during flexion. The patient diagnosed as left elbow contracture due to neglected left elbow dislocation. Open reduction, MCL-LCL reconstruction and triceps lengthening was performed. Left elbow ROM was improved and MEPI score was good on 5 months evaluation. Open reduction surgery was done to avoid the risk of fracture or articular surface damage. The posterior approach provides good exposure to the retracted posterior structures and give easier access to perform V-Y plasty used for triceps lengthening. Collateral ligaments repair provides immediate stability and give better functional results. Docking technique was used for collateral ligaments repair using fascia lata tendon graft. Immobilization and physical rehabilitation are done to improve elbow joints range of movement. Open reduction surgery, triceps lengthening and collateral ligaments reconstruction using tendon graft from tensor fascia lata give satisfactory outcome for elbow contracture due to neglected left elbow dislocation.
An unusual 7 cm large typical carcinoid managed by surgery: a rare case report
Authors: Khan Nafees Ahmad , Firdaus Huma , Lall Ajay , Kumar Jaya
Published: November 2020

Carcinoid tumors of the lung are uncommon group of pulmonary neoplasms. Most common site is gastrointestinal tract followed by lungs. Typical pulmonary carcinoids are usually small as described in various case series size of a typical carcinoid may ranges from 0.5-2 cm and are managed surgically. Here we present a case of unusually large typical carcinoid measuring up to 7 cm which was managed surgically.
Double acute appendicitis: cecal and epiploic; literature review of a case report
Authors: Pinzon Camilo Levi Acuna , Chavaria Chavira Jose Luis , Nieves Condoy Jefferson Fabian , Ledesma Claudia Ortiz
Published: November 2020

Acute cecal appendicitis and appendagitis are two entities due to the inflammation of the cecal and epiploic appendix respectively. A case of a 34-year-old woman is presented, who is admitted for abdominal pain. Initial blood test and ultrasonography were not conclusive, subsequently with clinical deterioration, surgical intervention was required which noted acute appendicitis and appendicitis that were removed. This is an extremely unusual case, since the simultaneous presentation of these two entities has not been widely described and demonstrates the importance of exploring the abdominal and pelvic cavity in patients with suspected diagnosis of acute appendicitis.
A rare case in an 11-year old child with bilateral primary orbital rhabdomyosarcoma with rapid onset of bilateral proptosis and temporal lobe abscess secondary to chronic suppurative otitis media
Authors: Gupta Bikram K. , Tomar Shubham
Published: November 2020

A rare case in an 11-year old child with bilateral primary orbital rhabdomyosarcoma (RMS) with rapid onset of bilateral proptosis and temporal lobe abscess secondary to chronic suppurative otitis media (CSOM). This article describes the clinical, radiological, histopathological, and immunohistochemical findings. Orbital RMS is always unilateral and mainly presents as proptosis with lid edema and chemosis. The uniqueness of the present case is the simultaneous occurrence of bilateral RMS and temporal lobe abscess.
Essential health services during COVID-19: an unidentified lead
Authors: Jose Hannah , Pathak Vineet Kumar
Published: November 2020

The struggle against COVID-19, which once started as an amicable endeavor with an anticipated climax has now turned into an unending, mysterious puzzle with lesser hope. What impacts more is the deficiency of financial backups in the health sector, for such an unexpectedly long duration. All these are pointing us towards a more sustainable, cost-effective method to fight against COVID-19, where the daily health and lifestyle of people are also considered. Maintenance of provision of essential health care services is important and urgent since this is the only way to decrease the indirect morbidity and mortality from other health conditions, thereby preventing the health system from collapse. Various new reforms have been made in health policies of different vulnerable groups including, people living with chronic diseases, the elderly, children and mothers, and pregnant women. To avoid the re-emergence of vaccine-preventable diseases and also future similar contagious diseases, reforms are also made in immunization services. Implementation of these amendments in the health care sector is a need of the hour and it demands a broader perspective with a long-term goal. Further, identifying gaps for innovative initiatives in the same direction are also to be welcomed, for a sustainable post-COVID-19 phase.
Clinical study of post-operative complications of various stomas (ileostomy versus colostomy) for obstructing distal colorectal malignancies in an emergency setting: a prospective hospital-based study
Authors: Wani Safoora , Gilkar Ishfaq Ahmed , Wani Yaser Hussain , Nowreen Farzanah , Thakur Shiwani , Bashir Younis
Published: November 2020

Background: This study aims to provide an overview of all complications that may occur after construction of an ileostomy or colostomy (loop or end) for obstructing distal colorectal malignancy in emergency setting.Methods: It was a prospective observational study. Forty-eight patients were included in this study. Patients were divided into two groups, group (A) included patients with ileostomies (number of patients=24) and group (B) included patients with colostomies (number of patients=24).Results: Most common age group in both groups was >60 years, Peristomal skin irritation occurred in 33% of patients who have undergone ileostomy and 13% of patients who had undergone colostomy. 4% of patients who had undergone ileostomy developed retraction of the stoma. None of the patients who underwent colostomy developed retraction of stoma, 17% of patients who had undergone colostomy developed stomal prolapse; Stoma prolapse was seen in only 5% of patients who had undergone ileostomy.Conclusions: Stoma formation is a frequently performed surgical procedure. Ileostomy and colostomy are the most commonly made stomas in surgical practice. Ileostomies have slightly higher complication rate than colostomies. Peristomal skin irritation is the most common complication among all the complications. The second most common complication is stomal prolapse.
An observational study on etiopathogenesis and management in Fistula-in-Ano
Authors: Pancholi Mukesh , Sonvane Shwetal Ravindrabhai
Published: November 2020

Background: Anal fistulas are abnormal communication between the anal canal and perianal skin or result of anal gland obstruction, with secondary abscess formation and external rupture of the abscess perineum. Fistula in ano rarely heals spontaneously and requires surgical therapy to achieve a cure. Surgical techniques like fistulotomy, fistulectomy, primary closure after excision of tract and staged operations have rendered the postoperative period uneventful, short and steep fall in recurrence rate.Methods: In this retrospective study, 30 patients were selected with diagnoses of fistula in ano admitted in New Civil hospital, Surat, Gujarat during April 2016 to April 2017. Patient underwent definitive treatment. Data related to the objectives of the study were collected from case sheets retrieved from hospital records with permission of competent hospital authority and after approval from ethical committee of institute. Appropriate surgical management were performed. Postoperative findings were noted.Results: Maximum number of patients were in the age group of 30 to 60 years. There were 27 (90%) male patients, 3 (10%) female patients indicating that the disease is more common in male with a ratio of male to female is 9:1. In the study the commonest symptom is discharge in all patients with pruritus in 2 (6.66%) patients and Pain or perineal discomfort in 20 (66.6%) of patients. The commonest sign is presence of external opening in all cases and internal opening in 21 (70%) of patients. Regarding the procedures performed, the majority of the patients 20 patients (66.66%) underwent fistulectomy, while 06 patients (20%) underwent fistulotomy. Seton was tried in 04 patients (13.33%) out of which in 02 patients associated fistulectomy was done.Conclusions: We  concluded  that  the  previously burst  opened  or  surgically  drained  perianal  abscess  is the main aetiological  factor for  fistula-in-ano. Operative morbidity is usually low. There is a male preference for the disease and the fistulectomy remains the commonest procedure in our study series.
A retrospective study to analyze local flaps for coverage of facial defects
Authors: Chaudhary Dinesh , Soni Ashutosh , Agarwal Sanjeev , Kumawat J. L.
Published: November 2020

Background: Face is the center of attention during communication and the expression of emotion. Facial defects resulting from trauma and the excision of skin malignancies are relatively common. How this defect is treated is determined by a variety of factors including the location, size and the underlying cause of the defect, the projected functional morbidity, the medical history of the patient, and feasibility of surgery. Aim was to study various local flaps using for coverage of defect, outcomes and complications.Methods: This was a retrospective cohort study. Our study shows result of 92 patients during January 2016 to December 2019 who had facial defects were taken up for the study. Reconstructive options were selected depending on defect size, location. Follow-up of patients ranged from 6 months to 1 year.Results: The most common malignant tumors of the face are basal cell carcinoma, squamous cell carcinoma and melanoma. Local flap is always preferable than skin grafts as it produces a superior match in color and texture with the additional advantage of producing a vascularized soft tissue cover for skeleton and resistant to contractures.Conclusions: In our study, variety of local flaps were used to cover the facial defects of the 92 patients with minimal post-operative complications.