bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy and safety of topical 2% dorzolamide and 0.5% timolol in cases of open angle glaucoma in a tertiary care hospital of East Singhbhum: an observational, prospective and comparative study
Authors: Chandra Akash , Kumar Manish , Mishra Amrendra Narayan
Published: June 2018

Background: Present study was undertaken to evaluate and compare the efficacy and side effects of 2% dorzolamide and 0.5% timolol in patients with open angle glaucoma.Methods: There were 60 randomly selected patients were equally divided into Group I (n=30) and Group II (n=30). Further both groups were divided into IA (n=10), IB (n=20), IIA (n=10) and IIB (n=20). 2% Dorzolamide hydrochloride in Group IA and IIA and 0.5% Timolol maleate in Group IB and IIB was administered for 24 weeks. Patients were evaluated for general and ocular examinations on day of enrolment and then at the end of 1st, 4th, 8th and 24th week. Adverse effects of the drug during study period were also noted. Mean±SD, t value, p value and comparison between groups were analysed by graph pad software.Results: At the end of 24 weeks difference in mean reduction of IOP was not significant with 6.2±1.85mm Hg (Right eye) and 5.55±1.68mm Hg (left eye) and 4.72±2.97mm Hg (Right eye) and 5.37±1.24mm Hg (left eye) in Group IA and Group IIA respectively. At the end of 24 weeks difference in mean reduction of IOP was not significant with 5.06±1.62mm Hg (Right eye) and 4.40±1.96mm Hg (left eye) and 4.30±1.41mm Hg (Right eye) and 4.12±2.08mm Hg (left eye) in Group IB and Group IIB respectively. Fall in both systolic and diastolic blood pressure in both the groups were significant. Both drug regimens were well-tolerated, and no serious drug-related adverse effects were reported.Conclusions: Dorzolamide was more efficacious for reduction of intra ocular pressure, well-tolerated, had low allergic response and had a favourable ocular, cardiovascular and respiratory safety profile than Timolol.
Evaluation of cardioprotective effect of Aegle marmelos on doxorubicin induced cardiotoxicity: an experimental study
Authors: Vishwakarma Pinki , Divekar Pratik , Goel Raj Kumar , Sharma Monica , Saini Manish , Saxena K. K.
Published: June 2018

Background: Aegle marmelos (A. marmelos), a medicinal herb, is widely used in the Indian system of medicine for treatment of various ailments. The methanolic extract of A. marmelos leaves had shown antioxidant effect. However, so far aqueous extract of A. marmelos is not scientifically evaluated for its cardio protective potential. Hence the present study was designed to find out cardio protective role of A. marmelos against doxorubicin induced cardiotoxicity.Methods: Thirty rats were randomized into five major groups (n=6). Group I received only 2ml/100g/day normal saline p.o., group II received 2ml/100g/day of normal saline p.o. followed by doxorubicin on 21st day, group III received carvedilol 30 mg/kg/day p.o., Group IV received A. marmelos 250mg/kg/day p.o. and Group V received A. marmelos 500mg/kg/day p.o. for 21days. Doxorubicin 20mg/kg i.p. single dose was given to induce cardiotoxicity in rats of group II, III, IV and V respectively on last day of experiment. Animals were sacrificed 48 hours after doxorubicin administration. Cardiac serum markers creatinine phosphokinase MB, lactate dehydrogenase, serum glutamate oxaloacetate transaminase and serum glutamate pyruvate transaminase were analysed biochemically. Histopathological changes were studied under light microscope.Results: All cardiac serum marker levels were found significantly (p<0.001) increased in doxorubicin group while A. marmelos pre-treated group displayed significant (p<0.001) reduction in rise of these parameters in a dose dependent manner indicating cardio protection. Histological observations further correlated the cardio protective effect of A. marmelos.Conclusions: The present study concluded that aqueous extract of A. marmelos possesses cardio protective potential against doxorubicin induced cardiotoxicity.
Screening of N-Benzoyl Isoserine Methyl Ester (N-bime) for anti-inflammatory analgesic activity and toxicity profile in animals
Authors: Niroomand Maliha , Shah Kalpana U. , Ghongane Balasaheb B.
Published: June 2018

Background: Pain and inflammation are the basic processes involved in the pathogenesis of many diseases. Non-steroidal anti-inflammatory drugs are often used to treat rheumatic diseases. The study compound N-Benzoyl Isoserine Methyl Ester (N-bime) is a newly synthesized propionic acid derivative by National Chemical Laboratory, Pune. Since the biological data of this compound is not available, the present study has been planned to screen this compound for anti-inflammatory, analgesic activity and its toxicity profile in animals.Methods: Single dose toxicity study was carried out in rats. Anti-inflammatory activity was tested by Rat Hind Paw Oedema and Cotton Pellet Implantation method. For Analgesic activity, Acetic acid induced writhing and Tail Pinch method was used. Yeast induced Pyrexia was used for evaluation of anti-pyretic activity. Ibuprofen was the positive control. Data are presented as mean±SEM. Statistical analysis was performed by analysis of variance and students unpaired‘t’ test.Results: The test compound N-bime did not show any apparent adverse effects or mortality in the dose range 1mg - 500mg / 100gm body weight in animals. It showed better anti-inflammatory actions in higher doses as compared to Ibuprofen (p˂ 0.05). In acetic acid induced writhing test N-bime offered better protection against writhes, than Ibuprofen. But, both failed to demonstrate analgesic activity in the Tail Pinch method. N-bime showed a gradual decrease in temperature in the anti-pyretic test (P<0.001).Conclusions: The present study indicates that N-bime does possess anti-inflammatory, analgesic and weak anti-pyretic properties like the NSAIDs. It has proved to be safe in the dose range of 1mg - 500mg / 100gm body weight in rats and mice.
Collection and analysis of adverse drug reactions of antiretroviral therapy in a tertiary care hospital in central India
Authors: Adwal Sandeep Kumar , Bamboria B. L. , Chourishi Ashutosh , Bamboria Aditya
Published: June 2018

Background: The main objective of study is to monitor and analyze the adverse drug reactions (ADRs) of ART and to assess causality and severity of the ADRs detected.Methods: It is a prospective observational study conducted in the ART centre of a tertiary care teaching hospital in central India. The data collected were recorded on standard ADR reporting forms. Causality was assessed by Naranjo’s algorithm. Severity of ADR’s was assessed by modified Hartwig and Seigel scale. Modified Shumock and Thorton criteria used for preventability assessment.Results: In twelve months duration 351 patients on ART were observed for ADRs. Total 166 ADRs detected in 96 patients. Incidence of ADRs was slightly more in female. The common systems involved were gastrointestinal 42.77% followed by nervous system 18.07%, musculoskeletal 15.06% skin/mucous membrane 07.83%, metabolic and nutritional 04.82%, red blood cell disorders 01.20 %, endocrinal 00.60 % and others 09.64%. The causality assessment as per Naranjo’s scale showed that out of 166 ADRs, 28.92% were probable and 71.08% were possible. Severity assessment by modified Hartwig and Siegel scale showed that 83.34% ADRs were mild and 15.66% were moderate. 46.39 % ADRs were probably preventable.Conclusions: Considering the magnitude of ADR related problems, there is a need for greater awareness among health care professionals, to detect and report them. These ADRs if recognized in time and managed properly can prevent treatment interruption.
The comparison the efficacy of budesonide by nebulizer, metered dose inhaler and dry powder inhaler in chronic stable bronchial asthma
Authors: Rizvi Dilshad Ali , Abidi Afroz , Agarwal Abhishek , Ahmad Ali
Published: June 2018

Background: The study has been performed to evaluate the efficacy of budesonide delivery by different form of devices like nebulizer, metered dose inhaler and dry powder inhaler to adult patients of chronic stable bronchial asthma. The changes in pulmonary function test parameters have been consider for evaluation.Methods: This prospective study was undertaken to assess the relative efficiency of budesonide administered from devices like nebulizer, metered dose inhaler and dry powder inhaler in adult patients of chronic stable bronchial asthma. Fifty subjects where administered budesonide (1mg) via nebulizer, budesonide (400 microgram) by metered dose inhaler and dry powder inhaler consecutively each week for four weeks under direct supervision. To analyze the effect of budesonide delivered through different devices pulmonary function test was carried out on the subject before and one hour after administration of the drug on each visit.Results: No significant difference in Peak expiratory flow rate (P=0.77), forced expiratory volume in one second (P=0.851), forced vital capacity (P=0.178) and forced expiratory volume in one second and forced vital capacity ratio (P=0.298) was seen after giving budesonide by different devices.Conclusions: Budesonide delivered by different devices (nebulizer, metered dose inhaler, and dry powder inhaler) have similar effect on lung function in patients of chronic stable bronchial asthma. In the daily clinical practice, the correct choice of an inhaler device should be related with the patient's characteristics. They may be used interchangeably depending on availability, cost and compliance of the patients.
Assessment of awareness towards pharmacovigilance programme of india and reporting of adverse drug reactions among nurses in a tertiary care hospital
Authors: Jain Atul , Singh Arpita , Verma Ajay Kumar , Soni Manish
Published: June 2018

Background: The success of PvPI depends upon spontaneous reporting of ADRs by health care professionals especially nurses as they are usually first contact persons for patients in case of ADRs after use of medicines. Underreporting of ADRs due to inadequate reporting culture among health care professionals is the main hindrance in the path of this programme. So, to assess the awareness, attitude and practices of nurses regarding PvPI and ADR reporting this study was undertaken.Methods: It was a cross-sectional, questionnaire-based study in which 130 nurses responded. The 12-items questionnaire feedback form provided by Indian Pharmacopoeia Commission (IPC) was used to assess the awareness of nurses towards pharmacovigilance programme and Adverse Drug Reaction (ADR) reporting practices.Results: After analysing the questionnaire, it was observed that, despite satisfactory level of awareness and interest of the nurses to participate in this programme, still there is meagre ADR reporting practices among the nurses.Conclusions: Lack of reporting culture and improper communication is the root of problem which should be overcome in future by proper training for patient safety.
Phenotypic characterization and susceptibility of gram negative bacteria from surgical site infections in a tertiary care hospital
Authors: Tomar Akhilesh P. S. , Kushwah Anjali
Published: June 2018

Background: Gram negative bacteria are the common isolates among the cases of Surgical Site Infections (SSI). Resistant and specially Multi Drug Resistant (MDR) Gram negative isolates are a serious challenge for the treatment to clinicians. Present study was undertaken for phenotypic characterization and susceptibility pattern of Gram negative bacterial isolates from cases of surgical site infections in a tertiary care institute.Methods: This descriptive cross sectional hospital based study was conducted in a tertiary care teaching hospital over a period of one and half year from January 2012 to June 2013. Centers for disease control and prevention (CDC) SSI case definitions were used to label a case as SSI. Only culture proven cases, out of clinically suspected was included in the study for evaluation.Results: During the study period a total of 5949 patients were operated and screened for SSI in the wards under surveillance. Out of which 556 were clinically suspected as a case of SSI. With 408 culture proven cases of SSI the rate of SSI in present study was (6.86%). Rates of SSI were more in dirty (22.54%) and contaminated (13.78%) type of wounds. Among Gram negative bacterial isolates (n=343) from SSI, E. coli (45.18%) was the commonest followed by Pseudomonas aeruginosa (16.03%) and Klebsiella pneumoniae (13.42%). Unpleasant trend in antimicrobial resistance observed during study is a serious concern.Conclusions: The data presented in this study clearly indicate the continuous need of surveillance of SSI. This will clearly help health care personnel in curtailing down the incidences of SSI.
Evaluation of antidiabetic activity of Tinospora cardifolia in alloxan induced diabetes in albino wistar rats
Authors: L. M. Abhijith , Sori Ravi K.
Published: June 2018

Background: The objective was to evaluate the antidiabetic activity of Tinospora cardifolia in alloxan induced diabetes in albino rats in comparison with a currently used oral hypoglycaemic glibenclamide.Methods: there were 24 rats with FBS in the range 80-115 mg/dl were selected for the study. Four groups each containing six rats, were induced diabetes with alloxan (150mg/kg). The diabetic control group (0.5ml normal saline), Standard control group (5mg/kg glibenclimide), Test group I (200mg/kg T. cardifolia) and test II group 400mg/kg T. cardifolia). FBS was recorded on 1, 3, 7, 14, 21 and 28th day using glucometer. Data was analysed by using one way ANOVA and posthoc Tukey’s test SPSS 21Version.Results: Extract of Tinospora cardifolia showed dependent hypoglycaemic action in both low dose (200mg/kg) and high dose group (400mg/kg). Hypoglycaemic action with high dose of Tinospora cardifolia is comparable to that of standard drug glibenclamide.Conclusions: This study demonstrates the hypoglycaemic action of T. cardifolia in diabetic rats. T. cardifolia can be a therapeutic potential to treat type 2 diabetes mellitus.
Evaluation of capsule labelling for its wall contents as gelatin or non gelatin
Authors: Gupta Shallini , Khajuria Kanika , Kumar Niraj , Khajuria Vijay
Published: June 2018

Background: Capsules are the most commonly used solid drug dosage form and are made up of gelatin or non gelatin. Currently the gelatin based capsules drug formulations are more used. However, current issue of vegetarian and non vegetarian capsules has come up due to recent Indian government initiative to promote vegetarian capsules.Methods: There were 100 capsule dosage forms were examined for the gelatin or HPMC wall contents and nature of medicine contained in capsules, whether ayurvedic or allopathic.Results: Out of 100 capsules studied 55 had gelatin wall base while 25 had HPMC and 20 capsule labels did not mention the nature of capsule wall constituent. Out of 55 gelatin capsules 30 were of allopathic while 25 capsules were of ayurvedic medicines. Among HPMC, 15 were ayurvedic while 10 allopathic. 20 capsules had no mention of its constituent and among these non labelled capsule formulations had 11 from ayurvedic and 9 from allopathic medicines.Conclusions: The current study revealed that gelatin capsules forms bulk in Indian market. Even the gelatin capsules contained ayurvedic medicines while 10% of HPMC capsules contained allopathic medicines. Non labelled capsules formed 20% of total capsules. These findings suggest wider scope for promotion of HPMC based capsules.
Drug utilization pattern in ICU in a tertiary health care institution
Authors: Adhikari Karishma , Phukan Swopna
Published: June 2018

Background: The objective of the study was to evaluate the current prescription pattern of drug utilization so as to find out drug use indicators such as utilization of drugs per prescription that can reflect possibilities of drug interaction and patient compliance and to suggest measures for rational prescriptions in patients admitted in Intensive Care Unit for various medical and surgical indications.Methods: It was a retrospective, observational hospital based study which was done for 1 year after obtaining permission from the Institutional Human Ethics Committee. The prescriptions of both genders and of any age groups suffering from any medical or surgical indication who were admitted in Intensive Care Unit were included. The parameters assessed were demographic profile of the patient, most common diagnosis, number of days of ICU stay, ICU outcome, number of drugs/prescription, most common group and route of drugs.Results: Data collected from 560 prescriptions were analyzed using appropriate statistical method and 66% patients were male. Most common age group was 41-60(40%). Cerebrovascular accident (22.9%) was the most common diagnosis followed by septicaemia (20.7%). Average no. of days of ICU stay was 6.22 days/patient. ICU mortality rate was 58.6% which was the most common outcome. At an average 15.8 drugs were prescribed per patient. Antibiotics and proton pump inhibitors were the most commonly prescribed drugs in 100% prescriptions, ceftriaxone (37.1%) being the most common antibiotic. Most common route of drug administration was intravenous route (65%).Conclusions: Prescribing guideline is required to reduce the prevalent poly-pharmacy and to promote appropriate use of antimicrobials based on the culture and sensitivity report.
Drug utilization pattern of antihypertensive drugs in chronic kidney disease stage 5 patients in a tertiary care hospital of central India
Authors: Bharani Kalpana , Bharani Rajesh , Vohra Rubina , Goyal Chhaya
Published: June 2018

Background: India is experiencing a rapid health transition and is projected to become a major reservoir of chronic diseases like Diabetes and Hypertension and 25 to 40% of these subjects may develop chronic kidney disease and end stage renal disease. Aim and objective of the study was to analyze utilization pattern of antihypertensive drugs in chronic kidney disease patients in a tertiary care hospital.Methods: The present observational cross-sectional study was conducted in Sri Aurobindo Institute of Medical Sciences, Indore (M.P.) from 01.01.2018 to 31.03.2018 on patients with chronic kidney disease stage 5. The drug utilization pattern was studied with respect to age, sex, basic disease, duration of dialysis, type of antihypertensive used, etc. Comparison of mean between gender and dialysis / not on dialysis was done using unpaired ‘t’ test. A p value of < 0.05 was taken as statistically significant.Results: Of 198 patients, 63 (31.8%) were females and 135 (68.2%) were males, showing a male preponderance. Majority of the patients (54%) belonged to the age group 41-60 years. Majority of the patients were having diabetic nephropathy (40.9%), followed by CGN-CKD 5d (18.7%) and CIN-CKD 5d (17.2%). 11.6% patients were not on dialysis, while 88.4% were on dialysis with a mean duration of dialysis of 31.45±34.57 months. Calcium channel blockers were given in 87.4% patients, followed by centrally acting drugs in 56.1% patients, beta blockers in 51.0% and alpha blockers in 39.9%. 93.9% patients were on multidrug antihypertensive therapy. Mean number of antihypertensives required in patients on dialysis was lower than those not on dialysis (2.69±1.44 vs. 3.48±1.16, p <0.05), similarly mean number of antihypertensives use in males was higher than females (2.99±1.41 vs. 2.32±1.37, p <0.05).Conclusions: In order to treat CKD, it is important to treat hypertension as hypertension and CKD are related to each other. Treatment of hypertension will help in controlling future development of comorbidities. Calcium channel blockers and centrally acting drugs are the treatment of choice in patients with CKD stage 5D with hypertension. Multi-drug antihypertensive therapy is a better choice than mono/single-drug antihypertensive therapy.
Preclinical screening of a novel compound, 2-chlorothiophene for analgesic activity in swiss albino mice
Authors: Gondi Surendra Kumar , Kummara Muni K.
Published: June 2018

Background: Pain is often the first indication of disease or injury. Analgesics are the drugs used clinically for controlling pain. They relieve pain as a symptom, without affecting its cause. Currently available options are nonsteroidal anti-inflammatory drugs (NSAIDs) and opioid analgesics for the management of pain. Long term use of existing analgesics causes significant disturbances in the body system. A search for new, safe and cost effective analgesic compound is in progress. Hence a study on 2-chlorothiophene, a novel compound has been carried out in different experimental animal models.Methods: The central analgesic activity of 2-chlorothiophene was evaluated by eddy’s hot plate method and compared to standard central analgesic, morphine. Both central and peripheral analgesic activities of 2-chlorothiophene were evaluated by formalin induced paw licking in mice and compared to a standard drug, aspirin.Results: There were 40mg/kg dose of 2-chlorothiophene has shown maximum Pain Inhibition Percentage (PIP) of 46.15% at 60 min compared to 128% by morphine in eddy’s hot plate method. Under Formalin test, 20mg/kg dose of 2-chlorothiophene has shown maximum PIP of 22.91% in early phase and 52.63% in late phase compared to 12.5% and 47.37% by aspirin. The results were statistically significant with p<0.05.Conclusions: 2-chlorothiophene found to have minimal central analgesic activity and significant peripheral analgesic activity as evident in eddy’s hot plate and formalin tests.
An analgesic to bridge the gap between Narcotics and NSAIDs: opiorphin
Authors: S. Sujatha , R. Priyadharshini , Nejad Niloofar Khansari , B. K. Yashoda Devi , V. Shwetha , T. Pavan Kumar , Azmi Rizwana
Published: June 2018

Pain management is an all-time challenge in dentistry. Discontent to pain management is a concern among patients and professionals. Unrelieved pain affects physical and mental well-being contributing to delayed recovery, psychological distress and anxiety. Studies have revealed that chronic pain interferes with normal daily chores of the individual like exercise, sleep, social life and lifestyle. At one end of pain management spectrum are Non-steroidal anti-inflammatory drugs (NSAIDs) while at the other end are the opioids. These drugs are not without constituent side effects. The quest is for new analgesics with potent and long term analgesia with minimal or no side effects. An analgesic that is intermediate in this spectrum is the need of the hour. Opiorphin is an endogenous peptide isolated from human saliva. Opiorphin produces analgesia, by inhibiting enkephalin (ENK) metabolizing enzymes, thus increasing the half-life of circulating ENKs. Apart from being a potent analgesic it can also be a potential biomarker for various systemic and psychosocial disorders. This review focuses on the pharmacological effects of opiorphin and its potential role as a biomarker in various disease conditions.
Use of mifepristone for termination of intrauterine fetal demise (IUFD) in previously scarred uterus in later half of pregnancy (>20 weeks)
Authors: Arora R. , Patel P. B. , Dabral A. , Sachdeva M. , Arya P.
Published: June 2018

Background: Mifepristone has the potential to be used as an agent for induction of labour by increasing the uterine contractility and increasing the sensitivity of uterus to prostaglandins. The present study is an endeavor to study the effect of mifepristone alone to induce labour in scarred uterus and its risk benefit ratio.Methods: Total 39 patients with IUFD and previous uterine surgery were included in the study after their informed consent. All women in the study were given Tablet Mifepristone 200 mg orally, thrice a day, maximum 6 doses (Max -1200 mg) over a duration of 48 hours. Patients were monitored for vitals, the uterine contractions and any bleeding per vaginum. Next dose of drug was omitted if sufficient uterine contractions or cervical dilatation ≥2.5 cm achieved. Patients were shifted to the labour room after onset of active labour. Labour was augmented with oxytocin wherever required.Results: spontaneous labour occurred in 74.3% (29/39) women while operative (cesarean/ hysterotomy) delivery occurred in 17.9% (07/39). Mean induction (first dose of mifepristone) to delivery interval was 51.5 hrs in second trimester while 59.8 hrs in third trimester women. Oxytocin augmentation was done in 8 (20.5 %) women.Conclusions: The potential advantage of mifepristone over prostaglandins and oxytocin, is mainly in situations where they are contraindicated (i.e., scarred uterus). In this study authors found that with mifepristone only regimen is quite safe and effective, inducing spontaneous labour in 74.3% (29/39) women with IUFD and in reducing the operative (cesarean/ hysterotomy) delivery (17.9%).
Rising rates of second stage caesarean section and its impact on maternal outcome
Authors: Kumaresan Shanmugapriya , Loganathan Malarvizhi
Published: June 2018

Background: There is an alarming rise in caesarean section leading to increased adverse outcomes for both the mother and fetus when compared with vaginal delivery. With this increasing caesarean section rate, there is a concerning increase in the rate of second stage caesarean section. This study highlights includes the rate of caesarean deliveries in the second stage of labour, the indications for delivery and the associated maternal morbidity in this cohort of women.  Methods: This was a prospective cohort review of all women with a singleton, cephalic fetus at term delivered by caesarean section in the second stage of labor between July, 2016 and December 31, 2017 at government medical college hospital Dharmapuri. The main outcome measures were second stage caesarean section, indications and its maternal morbidity.Results: 250 women underwent caesarean delivery in the advanced labor. Among the 250 patient’s majority of them were in the age group of 21-30 yrs. about 76% of the patients were primigravidae and only the remaining 24% were multigravida. The commonest indications for doing caesarean section in the second stage of labor was cephalo pelvic disproportion and non-reassuring fetal heart rate patterns. The difficult task was delivery of the deeply engaged head, the increased likelihood of intraoperative and post-operative complications.Conclusions: Cesarean sections done in second stage of labor are associated with several intra-operative maternal complications and morbidity.
Von Willebrand disease as a significant risk factor for hemorrhage after cervical loop electrosurgical excision
Authors: Ungure Anita , Žodžika Jana , Kuņicina Diāna , Lietuviete Nellija , Rezeberga Dace
Published: June 2018

Loop electrosurgical excision procedure (LEEP) is the first-line treatment for cervical intraepithelial neoplasia (CIN). It is effective, easy to perform and relatively safe for the patient. However, 1-2% of patients experience complications such as hemorrhage and infection, which usually are effectively treated using cauterization and antibiotics. We are presenting a case of repeated cervical and vaginal hemorrhage after the cervical LEEP for a patient without previous medical history of severe bleeding or detected bleeding disorders. A generally healthy 38-year-old female underwent planned LEEP of cervix because of CIN II-III. Procedure was successful. Afterwards she was admitted to the Emergency department several times because of recurrent vaginal and cervical bleeding. She received suturing and coagulation of the cervix and vaginal wall combined with desmopressin and tranexamic acid therapy. Because of suspected bleeding disorder hematologist was invited. Laboratory analysis showed positive results for von Willebrand disease. After VIII/von Willebran factor concentrate treatment bleeding was stopped completely. Before any surgical interventions it is important to take a detailed medical history. If atypical, recurrent and/or severe secondary hemorrhage after the surgical manipulations occur, coagulation disorders should be excluded.
Prevention of subclinical deep vein thrombosis in abdominal surgeries
Authors: D. Tazeem M. , D. Wasim M. , Amin Sabia , Ali Tahmida
Published: June 2018

Background: Deep vein thrombosis (DVT) is a common but elusive illness that can result in disability and death if not recognized and treated effectively. The reported incidence has not changed much over past couple of decades. The aim of this study was to identify the risk of deep vein thrombosis related to the number of days of immobility and the role of low molecular weight heparin in the prevention of deep vein thrombosis.Methods: A total of hundred (n=100) patients undergoing laparotomy were studied in the post-operative period between January 2014 and December 2016. Patients were divided into two groups alternatively; Group I patients did not receive any DVT prophylaxis and Group II patients were given low molecular weight heparin once a day till mobilization. From 3rdPOD, all the patients were evaluated with detailed history and lower limb examination. D-dimer study was done in all the patients and if positive then followed by Color Venous Doppler. Regular follow-ups were done weekly once for a month, every two weeks for next month and once a month thereafter, minimum for 6 months.Results: A total of hundred (n=100) patients, including 65 men and 35 women, with median age of 40 years underwent laparotomies in 2 years by a single unit. The incidence of Lower Limb DVT in Group I was 8%. The risk factors associated with DVT were sex, BMI, smoking and Malignancy. The signs and symptoms associated with DVT were swelling of lower limbs, pain and tenderness, fever and Homan’s and Moses signs. The D-dimer test results were positive in 9 patients. Color Venous Doppler identified DVT in 8 patients. On regular follow- ups, remissions of clinical symptoms were recorded and repeat Doppler scans showed recanalization in all the patients after 6 months.Conclusions: Deep Vein Thrombosis is multifactorial, and post-operative patients account for majority of cases. Early mobilization and Prophylactic Low Molecular Heparin prevents DVT in abdominal surgeries.
Clinical study in management of infected diabetic foot ulcers: superoxidised solution versus povidine iodine solution
Authors: Kantly Ramalingeshwara , Medikeri Abhijit
Published: June 2018

Background: Diabetic foot ulcer is a one of the major challenging problem to every surgeon in day to day practice. Superoxidised solution is an effective concept in the wound management. The present study was aimed to compare the efficacy of dressings with superoxidised solution versus povidine iodine in the management of infected diabetic ulcers.Methods: This is a randomized controlled study conducted over a period of one year. In our study, total of 60 patients presenting with infected diabetic ulcers are included. Patients were randomly divided into two groups of 30 each, group A (Topical superoxidised solution dressing) and group B (Topical povidine iodine dressing). Wound was observed for decrease in size of the ulcer, granulation, tissue quality and discharge from the wound at the end of each week for two weeks.Results: In the present study, 76.67% of patients in group A and B were males and the male to female ratio was 3.2:1. The mean age in group A was 55.90±14.27 years compared to 51.50±13.18 years in group B. The mean initial ulcer area in group A was 3882±1890 mm2 compared to 3992±2000 mm2 in group B. The mean post treatment final area in group A was significantly low (1607±862 mm2) compared to group B (2351±1240 mm2; p=0.009) and the comparison of mean change in ulcer area was significantly high in group A compared to group B (2215±1060 mm2 vs 1641±856 mm2; p=0.024). The mean percentage reduction in ulcer area among patients with group A was significantly high (58.90±5.21 percent vs. 40.90±8.76 percent; p=0.024). The commonest organism isolated in group A was Escherichia coli (26.67%) and in group B, it was staphylococcus. The culture was positive in 26% of the patients in group A compared to 50% in group B (p=0.063).Conclusions: Overall, topical superoxidised solution dressing for diabetic foot ulcer accelerated the healing process resulting in faster recovery through reduction in ulcer area compared to topical povidine iodine dressing.
Completion, timeliness, and under - vaccination of childhood vaccinations in a nomadic pastoralist community of Kenya
Authors: Pertet Anne M. , Kaseje Dan , Odawa Careena O. , Ochieng Jackline , Kirika Lydia , Wanjala Caleb , Jaoko Millicent , Otieno Winnie , Odindo Dan
Published: June 2018

Background: Children from nomadic pastoralist communities might not receive all the recommended doses of vaccines at age-appropriate times due to limited access to immunization services.  Skipped, delayed or missed vaccination doses result in under vaccination which in turn make children vulnerable to preventable diseases.  The purpose of present study was to establish completion timeliness and under-vaccination of all the recommended childhood vaccinations in a nomadic pastoralist community.Methods: Authors used a cluster sampling technique to identify children aged 0 to 24 months at the household level.  Vaccine completion was the accumulation of the required number of doses by infants irrespective of the timing. Timeliness was vaccines administered within the recommended age range. Under vaccination was the sum total of days a delayed vaccine was given after the recommended age range.Results: Completion of all individual antigens did not meet the target of 90%. The mean number of days a child remained under-vaccinated in days was: OPV0, 20 days; BCG, 39 days; measles vaccine, 47 days; PVC3, 121 days; pentavalent, 117 days, and rotavirus, 103 days.  Approximately 42% were severely under-vaccinated for more than six months. Vaccine-specific under-vaccination of more than six months was:  pentavalent 3, 20%; PCV 3, 14%; OPV 3, 9.5%; BCG, 3%, and measles vaccine 20%. Overall children remained under-vaccinated for 185 days.Conclusions: A significant proportion of children remained under vaccinated for extended periods leaving them at risk during a vulnerable period of their life.
Cooking fuel as a risk factor for adenoid hypertrophy in children aged less than five living in an informal settlement, Nairobi County, Kenya
Authors: Senewa Anne , Pertet Anne M. , Otieno-Odawa Careena
Published: June 2018

Background: Fuels used for cooking are major sources of household air pollution, which lead to increased prevalence of upper respiratory tract infections and allergic conditions especially in children. The aim of present study was to investigate whether fuels used for cooking were risk factors for adenoid hypertrophy in children.Methods: Authors used a case-control study design where the exposure was cooking fuel and the disease was adenoid hypertrophy. Cases were children where a post nasal space x-ray showed enlargement of the adenoids. The controls were children with no adenoid hypertrophy or related diseases. The sample consisting of 112 children was hospital based. Parent-administrated questionnaires were used to collect information on cooking fuel.Results: Cooking gas and charcoal were associated adenoid hypertrophy. Adjusted odds ratio (OR) were 1.092 for charcoal and 3.516 for gas. Children in households where gas was predominantly used for cooking were three times more likely to have enlarged adenoids.Conclusions: Exposure to cooking gas which emits nitrogen dioxide was a primarily risk for adenoid hypertrophy. Larger community-based studies are recommended to come up with evidence that guides policy concerning use of household fuels and adenoid hypertrophy.
Evaluation of incidence of cryptorchidism with special reference to anatomical and clinical aspects
Authors: Suresh N. M. , Katttepura Subramanya , Afroze Khizer Hussain , P. Ramesh , Bhaskar Apurva
Published: June 2018

Background: Cryptorchidism is simply defined as the absence of one or both testes from the scrotum. It is the most common birth defect of the male genitalia. The testis may be located intra-abdominal or inguinal. This article mainly deals with embryology, etiology, anatomy and incidence types of cryptorchidism in Tumakuru rural district.Methods: This study was interdepartmental and prospective, consisting of 66 cases conducted at the Department of Pediatric Surgery and Anatomy and the period of study was from April 2013- March 2017. Cryptorchidism has been classified into 1) Intra-abdominal, 2) Inguinal, 3) Ectopic testis (perineum).Results: Out of 66 cases, testis in inguinal canal is the most common incidence followed by the intra-abdominal and Ectopic testis. Least found was ectopic and torsion in the inguinal canal. Complications are torsion and vanishing testis.Conclusions: This condition is repairable in a vast majority of cases. Early diagnosis and surgical intervention have to be carried out to correct this defect.
Study of the prevalence of small for gestational age newborns using clinical assessment of nutritional status of newborn baby at birth (CAN score)
Authors: M. Mathivanan , Subramanian M. Muthu Rama
Published: June 2018

Background: Small for gestational age infants are classically defined as having a birth weight that is more than two standard deviations below the mean or less than the 10th percentile of a population-specific birth weight vs. gestational age plot. IUGR is defined as a rate of fetal growth that is less than normal for the population and for the growth potential of a specific infant. IUGR therefore produces infants who are SGA. The choice of intrauterine growth charts for classification of babies is also not agreed upon. Effect of gender, order of birth, birth weight of previously born babies, maternal factors are also one of the determinants of IUGR in the detection and classification of true Small for gestational age babies. CAN score (clinical assessment of nutritional status at birth in newborn babies), independent of these factors can be used for international comparison of Small for gestational age babies. The objective of the present study was to evaluate the prevalence of Small for Gestational Age newborns using Clinical Assessment of Nutritional status of newborn baby at birth (CAN score).Methods: This study was carried out on 400 consecutive term neonates delivered at the Department of Obstetrics and Gynaecology, Tirunelveli Medical College Hospital, Tirunelveli during June-July 2015. Clinical assessment of nutritional status was done within 48 hours on the basis of the superficial readily detectable signs of malnutrition in the newborn as described by Metcoff. Maximum score of 4 is awarded to each parameter with no evidence of malnutrition and lowest of 1 is awarded to parameter with the worse evidence of malnutrition. Statistics were done using SPSS 16.Results: The study identified 110 (27.5%) babies as IUGR babies using CAN score. This included 56 male babies and 54 female babies. Thus, from the present study, the prevalence of Small for Gestational Age using CAN score was 27.5%.Conclusions: CAN score is the best measure for identifying the IUGR among the neonates.
The relationship between feeding and nutritional status: a prospective and observational study conducted in northern region of India
Authors: Kaur Amarpreet , Singh Karnail , Pannu M. S. , Singh Palwinder , Sehgal Neeraj , Kaur Rupinderjeet
Published: June 2018

Background: The health of Infants to a great extent depends upon the feeding practices and its awareness among the mothers. This study was conducted in Tertiary care hospital to find the correlation between feeding pattern with nutritional status.Methods: Infants in the age group of 14 weeks to 1 year formed the sample of the study. The nutritional status was assessed in relation to breast feeding practice among infants ≤6 months. Among infants >6 months of age, the nutritional status was assessed in relation to adequacy and timely start of weaning. Correlation was observed, and test of significance was applied through chi square test.Results: Total 591 infants were included in the study out of which 232 infants were ≤6 months of age [120 (51.72%) were exclusively breastfed and 112 (48.28%) were top fed]. Out of these breast feed infants, 86/120 (71.67%) had normal nutrition compared to 54/112 (48.21%) of top-fed babies. Infants >6 months of age were 359 in number [116 (32.31%) were having adequate complementary feed, 111 (30.92%) were having inadequate complementary feed and 132 (36.77%) did not receive any complementary feed]. Out of these infants in the age group of >6 months, 56.90% of adequate complementary feed group, 27.03% of receiving inadequate complementary feed and 27.27% of not received complementary feed were having normal nutritional status. The association between nutritional status and breast feeding in ≤6 months and complementary feed in >6 months has been found to be statistically significant (p value < 0.05, d.f =1).Conclusions: Breastfeeding as well as adequate complementary feed has positive correlation to nutritional status in infants even when compared with the malnourished infants of grade I, II, III and IV.
A prospective observational study of morbidity and mortality profile of neonates admitted in neonatal intensive care unit of secondary care centre in central Maharashtra, India
Authors: Adikane Hemant , Surwase Kishor , Pawar Vishal , Chaudhari Kalidas
Published: June 2018

Background: Globally, 2.6 (2.5-2.8) million newborns died in 2016-i.e. nearly 7,000 every day. Neonatal deaths accounted for 46 % of all under-five deaths, increasing from 41 % in 2000. Five countries accounted for half of all newborn deaths including India. NFHS 4 data suggests that neonatal mortality rate (NMR) declined to 30 deaths per 1,000 live births.Methods: Present observational study was conducted at district hospital, Parbhani. Study period was Jan 2017 to Dec 2017. All the admitted babies to NICU were included into study. Data was collected by interview method using a predesigned, semi-structured questionnaire. Various morbidities and reasons for mortality were included.Results: There were total 2471 admission during year of 2017. There was slightly higher admission rate for Males 1432 (57.95%) than females 1039 (42.05%). Pre-term admissions were 501 (20.28%). Majority of admissions were due to low birth weight 1170 (47.35%).Conclusions: In the year of 2017, total 2472 NICU admissions took place. Out of these, 126 (5.09%) died. Respiratory distress syndrome, low birth weight, birth asphyxia were accounting for mortalities. The neonatal jaundice, preterm and low birth weight babies had significantly high mortality even with standard intensive care.
Intraventricular haemorrhage in very preterm neonates
Authors: Kapoor Saurabh , Sharma Ravi , Sapare Anil Kumar , Aggarwal Rajiv
Published: June 2018

Background: The objective of the current study was to evaluate the incidence of intraventricular haemorrhage and its associated risk factors in preterm neonates.Methods: This cohort study done at Neonatal Intensive Care Unit of a tertiary care hospital in south India enrolled 104 preterm neonates with either gestational age <32weeks and/or birth weight <1500 grams at birth. These babies were serially screened for intraventricular haemorrhage by doing a neurosonogram on day3 and day 14 of life.Results: Incidence of IVH was found to be 18.2%. Amongst these cases 52.6% babies had Grade I, 36.8% babies had Grade II and 10.6% babies had Grade III intraventricular hemorrhage with ventriculomegaly, as per Papile grading system. It was seen that hypotension needing use of inotropes and neonatal sepsis were significantly associated with IVH.Conclusions: The incidence of IVH in babies born with gestational age <32weeks and/or birth weight <1500 grams was 18.2% in our study. Neonatal sepsis and hypotension requiring use of inotropes were found to be the significant risk factors in this population.
Prevalence and types of anemia among children at a tertiary care hospital
Authors: Reddy A. Bhaskar , Chandra V. Sharath , Eluzai Zion
Published: June 2018

Background: The anemic children tend to have average or below average academic performance due to effect of anemia on cognitive and behavioral aspect of the child. The objective of the study is to study prevalence and types of anemia among children at a tertiary care hospital.Methods: A total of 6000 patients attended the outpatient department of the SVS hospital, Mahabubnagar during the study period. Out of them 1237 patients were pediatric patients who attended the pediatric outpatient department. Among these 1237 children, 823 children were found anemic. Among these 823 anemic children, 100 were randomly included in the present study for further investigations. Thus, final sample size of the present study was randomly selected 100 anemic children.Results: The incidence of anemia was found to be very high i.e. 66.5%. It was found that the prevalence of anemia was 60.9% among females compared to only 39.1% among male children. The prevalence of anemia was significantly higher in females compared to males. In both males and females, the iron deficiency anemia was the most common type of anemia found in the present study. Maximum prevalence of iron deficiency anemia was seen in 1-5 years of age in females. Maximum prevalence of iron deficiency anemia was seen in 1-5 years of age in males. The most common grade of anemia was moderate grade followed by mild.Conclusions: Iron deficiency anemia is more prevalent in female children. In males also, it is not found to be very low. Its prevalence in males is also noticeable.
A study on common clinical pattern of presentation of skin and hair changes in nutritional deficiencies associated with dietary fallacies in children 1 to 5 years of age
Authors: Kumar D. Pavan
Published: June 2018

Background: Dermatological problems constitute atleast 30% of all outpatient visits to the paediatricians and 30% of all visits to dermatologists involving children. Skin diseases in the paediatric age group can be transitory or chronic and recurrent. The chronic dermatoses are associated with significant morbidity and psychological impact. Skin disorders caused by deficiency generally, or less often by an excess of one or more nutrients is called nutritional dermatoses. The objective of the present study was to assess the common clinical pattern of presentation of skin and hair changes in nutritional deficiencies associated with dietary fallacies in children 1 to 5 years of age.Methods: A hospital based cross sectional study consisting of all children between the age group of 1 to 5 years with Nutritional skin and hair lesions diagnosed with clinical examination in the OPD of the Pediatric Department were included in the study from the month of November 2012 to October 2013. A minimum sample size of 100 children is required for this study. However, author included 150 children.Results: In the present study, maximum numbers of children were in the age group of 12 – 24 months, 33.33 % (50) of study subjects. The proportion of males 58.00% (87) is higher than females 42.00% (63). Majority of children belonged to Class IV 60.66% (91) socioeconomic status. 76.00% (114) of children fall in the group of under nutrition and this can be attributed to the associated Dietary fallacies of 73.33% (110) children as causative factor. Nutritional anemia associated pallor and sparse hair were the common finding among all other nutritional deficiencies.Conclusions: Lower socio- economic condition and dietary fallacies were the two most causative factors which had an adverse effect on nutritional status of child causing dermatoses. In the present study, majority of children had nutritional anemia, vitamin A deficiency and vitamin B12 deficiency associated dermatoses with overlapping of the clinical features because of complex interlinking of different dietary factors.