bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical correlation with pathology of placenta in medical disorders of pregnancy and its comparison in normal pregnancy
Authors: Siddheshware Ratnamala , Patil Sunil S. , Sambarey Pradip W.
Published: December 2016

Background: Healthy placenta is responsible for maintaining pregnancy and promoting normal foetal development. It reflects the intrauterine status of the foetus.Methods: In the present prospective study, total 50 Placentae from Medical Disorders of Pregnancies were studied and compared with equal number of Placentae from normal Pregnancies.Results: The significant macroscopic changes were calcification and infarction seen in Hypertensive Disorder. Extensive placental infarction was associated with high incidence of low APGAR (82%) and perinatal deaths (66.67%). No significant gross macroscopic changes were seen in Anaemia, Diabetes Mellitus and Heart Disease. Increased syncytial knots, fibrinoid degeneration, vasculo-syncytial membrane paucity were significant microscopic changes in Hypertensive Disorder. In Anaemia stromal fibrosis, increased syncytial knots were seen, whereas in Diabetes Mellitus villous edema was the most significant microscopic finding. No significant microscopic change was found in Heart Disease. Increased syncytial knots, fibrinoid degeneration, vasculo-syncytial membrane paucity, stromal fibrosis were associated with increased perinatal mortality.Conclusions: Gross and microscopic examination of placenta is strongly recommended in cases where maternal co-morbid conditions is likely to have an adverse perinatal outcome.
To study the efficacy of sabina, cimicifuga and thalaspi bursa in management of cases of dysfunctional uterine bleedings
Authors: Aphale Parth , Rajgurav Atul
Published: December 2016

Background: Abnormal uterine bleeding is one of the most common problems among pre and postmenopausal women. Virtually every woman will at some point in her lifetime experiences episodes of bleeding that are perceived as abnormal. Menstrual abnormalities are the cause of discomfort, inconvenience and disruption of healthy social and physical lifestyles among millions of women worldwide. Dysfunctional uterine bleeding is an abnormal bleeding from uterus in the absence of an organic pathology to account for. It commonly occurs in reproductive and perimenopausal age groups. When no systemic or local pelvic cause is evident to the clinician, histopathological examination of the endometrial biopsies remains the only alternative to reach the diagnosis. The following study intends to find out the incidence of various etiopathological factors in cases of dysfunctional uterine bleeding and to study the efficacy of Homoeopathic Medicines in cases of DUB.Methods: 30 cases fitting the case definition were studied. Female patients above 35yrs. age showing abnormal bleeding from the uterus without any underlying pathology were selected for the study. Pregnant women, females below 35yrs., showing abnormal finding on USG were excluded from the study. Criteria for assessment were laid down and scoring was done and analyzed.Results: Scoring was done before treatment and after treatment, t- test was applied. Null and alternative hypothesis were laid down. From the value of t-test, we reject the null hypothesis and accept the alternative hypothesis.Conclusions: Homoeopathic medicines Sabina, Cimicifuga and Thalaspi Bursa were found effective in management of cases of DUB.
Outcomes of transvaginal multifetal pregnancy reduction without injecting potassium chloride
Authors: Gunasheela Devika , Rao Sneha , Jain Geethika , GS Anitha
Published: December 2016

Background: Assisted reproductive technologies and the use of fertility drugs have significantly increased the prevalence of multiple pregnancy in last three decades. Various techniques and routes have been studied so far regarding fetal reduction to achieve healthy viable pregnancy. The current study aims to study different outcomes of multifetal pregnancy reduction without injecting potassium chloride.Methods: Total 57 patients were studied from October 2011 to November 2012 at our centre. 28 were higher order pregnancies who consented for fetal reduction and 29 were nonreduced twins as control group. It was a prospective comparative study. Fetal reduction was done transvaginally between 8-12 weeks by intracardiac puncture followed by manual aspiration of embryonic parts till asystole. Use of KCl was avoided. The most easily accessible sac was chosen for reduction. All were reduced to twins. Reduction to singleton and selective reduction of anomalous fetus were removed from the study as it could have created a bias in the comparison. The primary outcomes like miscarriage, post procedure complications, mean gestational age at delivery, preterm delivery, mean birth weight were studied. The outcomes of reduced twins were compared with that of nonreduced twins. The various secondary outcomes like IUGR, take home baby rate, neonatal morbidity, mortality, maternal morbidity and mortality, associated obstetric complications were studied.Results: Both groups were comparable with respect to age and parity. The average gestation of fetal reduction was 9.46 weeks. Abortion rate was 17.9% (n=5) in reduced group which was statistically significant. 4 patients were lost to follow up. There were no statistically significant differences with regard to cesarean section rate, preterm delivery, mean birth weight, mean gestational delivery between two groups. No incidence of IUGR in the series. One baby died in the control group, none in reduced group. Take home baby rate 79.1%. Overall the antenatal and post-operative complications were higher in control group than in reduced but it was not statistically significant.Conclusions: Fetal reduction is a feasible option for triplets and higher orders multiple pregnancies. Use of KCl is not mandatory for multifetal pregnancy reduction. It is best avoided as there are increased rates of preterm labour and PPROM. There is increase in abortion rate after multifetal pregnancy reduction in comparison to nonreduced twins. So couple should be counseled about the probability of losing the entire pregnancy. The obstetric and neonatal outcomes of reduced and nonreduced twins are comparable, thus fetal reduction as a procedure is not adding any extra risk on pregnancy outcome.
Analytical study to assess fetal and perinatal outcome in booked and unbooked obstetric cases
Authors: Chourasia Sapna , Yadav Kamlesh
Published: December 2016

Background: The high perinatal mortality rates are indicators of the poor state of health services and it is pertinent to determine the relationship between the booking status of mother and fetal outcomes.Methods: In the present randomized prospective study of 400 unbooked (study group) obstetric cases were evaluated and compared with 400 booked (control group) obstetric cases over a period of one year.Results: Perinatal outcomes of women in study group were significantly poorer than women in control group due to high preterm delivery, LBW, with low Apgar score at five minutes, with more NICU admission due to RDS, with high perinatal mortality in term of IUD, early neonatal deaths in study group.Conclusions: Findings of the study will help the programmers and service providers in identifying areas where emphasis has to be given in the development of strategies that will promote the utilization of antenatal services, to reduce adverse perinatal and fetal outcome.
Clinicopathological study of hysterectomised specimens
Authors: A. Saravana , Patil Shashikala B. , Patil Savitha S.
Published: December 2016

Background: Hysterectomy is the commonest major surgical procedure performed in gynecology. It can be done by abdominal or vaginal route and with the help of laparoscopy. Hysterectomy is an effective treatment option for many conditions like fibroid, abnormal uterine bleeding, endometriosis, adenomyosis, uterine prolapse, pelvic inflammatory disease and cancer of reproductive organ when other treatment options are contraindicated or have failed, or if the woman no longer wishes to retain her menstrual and reproductive. The aim and objective of the study was to correlate indications of hysterectomy with histopathological findings in hysterectomised patients.Methods: A retrospective study was carried on 113 hysterectomised cases over a period of one year from June 2015 to May 2016. The data regarding the patient’s age, parity, clinical diagnosis, type of hysterectomy and histopathological diagnosis were reviewed by the records and analyzed.Results: A total of 113 cases of hysterectomies were studied. Hysterectomies were distributed over a wide age ranging from 20 years to 75 years. Most common age group was 41-50 years. Among hystectomies majority were done through vaginal route 86 (76.1%) and 26 (23%) cases were done through abdominal route. Most common clinical diagnosis was fibroid uterus in 44(38.9%) cases. Most of the hysterectomies were done for benign conditions. In final histopathological report most common diagnosis was fibroid uterus in 45(39.8%) hysterectomy specimens. It was correlated well with clinical diagnosis. Next most common histopathological diagnosis was Adenomyosis.Conclusions: Histopathological analysis correlated well with preoperative clinical diagnosis in majority of cases. The commonest indication and histopathological finding in our study was fibroid uterus. Next most common histopathological finding was Adenomyosis. Most commonly hysterectomies were done through vaginal route in our study.
Challenges in utilisation of small family norm
Authors: Pathak Varuna , Chandra Madhuri , Bisani Veena Rathi
Published: December 2016

Background: India is the most populous country in the world, sustaining 17.5% of the world’s population on 2.4% of the world’s surface area. Despite of India being the first country to formulate a National Family Planning Programme in 1952, the population of India continues to rise. Therefore a basic question arises, as to why do couple have a third child? For stabilization of population every couple must on an average have 2.2 children, but how far our family planning programmes having an impact on the beneficiaries, in terms of their ideologies and utilisation of the programme. To get answers to the above question the present study was undertaken with the following aims and objectives to determine the views about ideal family size and ideal spacing, to determine the degree of knowledge about various contraceptive methods, to know the family size amongst population not adopting small family norm and to know the reason for non-acceptance of family planning methods.Methods: This was a hospital based case control study. Cases were women with two live children and not practicing family planning. Controls included women who opted for family planning methods and adopted the two child norm. Both cases and controls were asked to fill up a questionnaire.Results: Most people practicing small family norm view ideal number of issues ≤ 2 i.e. 88% of males and 91% of females. 59.8% couples not practicing family planning, think ideal spacing ≤ 2 years. 100% controls had the concept of contraception.Conclusions: Desire for a male child in 30.6% cases is the most common reason for couples not following the 2 child norm.
Leiomyoma of vulva mimmicking bartholin cyst
Authors: Singh Anju , Goel Bharti , Takkar Navneet , Jain Ekta
Published: December 2016

Leiomyoma of vulva are uncommon findings in women of reproductive age group. It is often misdiagnosed as Bartholin cyst as unilateral swelling of vulva in women of reproductive age group is commonly a bartholin cyst or abscess. We describe a case of leiomyoma that clinically mimicked bartholin duct cyst. Identification of leiomyoma or leiomyosarcoma is necessary because of risk of recurrence, need of radiation and or chemotherapy in addition to surgical excision whereas standard treatment for bartholin cyst is marsuplisation.
Mullerian adenosarcoma of the cervix: case report
Authors: Atanda Akinfenwa T. , Agu Osondu C. , Modu Abubakar K. Modu K.
Published: December 2016

Mullerian adenosarcomas are rare tumours that may be found in any part of the female genital tract including cervix. They are more common in the reproductive age group and rare among blacks. When they present in the cervix they may be clinically misdiagnosed as an endocervical polyp and histologically as an adenofibroma. Clinical presentation is mostly as irregular vagina bleeding and as a mass in the vagina. Meticulous histopathological evaluation is crucial for its optimum management.
Chronic non puerperal uterine inversion secondary to uterine leiomyoma misdiagnosed as advanced cervical cancer: a rare case report
Authors: N. Sunanda , HC Lokeshchandra , R. Sudha , Sharma Kavya D.
Published: December 2016

Uterine inversion is an uncommon complication of parturition which often occurs in the immediate postpartum period. The chronic non puerperal uterine inversion is a rare gynaecological clinical condition which usually results from tumour arising from the fundus of the uterus. Here we are present a case of 45 year old lady with non-puerperal chronic uterine inversion secondary to fundal sub mucous fibroid polyp which was initially misdiagnosed as carcinoma cervix. An attempt at vaginal restoration and removal was difficult. Hysterectomy was done by vaginal approach. Pre and Postoperative course in the hospital was uneventful. Early diagnosis and appropriate surgical treatment of the inverted uterus are important to prevent further complications.
Chorioangioma with fetal anemia and polyhydramnios: a case report
Authors: Mahajan Rimmi , Bala Ripan , Nagpal Madhu
Published: December 2016

Chorioangioma is a rare benign vascular tumor of the placenta. Although commonly symptomless, larger tumors may cause serious maternal and fetal complications. We present a case of chorioangioma which was diagnosed as an incidental finding on ultrasound in third trimester and referred to us for management. Color Doppler signified fetal anemia as depicted by hyperdynamic middle cerebral artery flow. Elective casarean section was done and a healthy baby delivered without any adverse outcome.
A rare case of primary peritoneal hydatid cyst
Authors: Singh Sanjay , Reddy Mahesh
Published: December 2016

Primary peritoneal hydatid cyst is a rare entity. A 42 yr old parous female presented with painless lower abdominal lump since 6 months. On clinical examination an immobile abdominopelvic lump of the size of 18-20 weeks pregnant uterus with bosselated surface was noted. Ultrasound Sonography Test (USG) and Contrast Enhanced Computerized Tomography Scan (CECT scan) of abdomen and pelvis revealed large multilocular abdominopelvic cystic mass in continuity with RT ovary. Radiologically a differential diagnosis of hydatid cyst and mucinous cystadenoma was made. All relevant ovarian tumor markers were normal. Serology confirmed increased Echinococcus IgG antibodies (196.60 U/ml, ELISA). The patient underwent complete surgical excision of the lump. Histopathology and Hematoxylin and Eosin (H and E) staining of the aspirate from the cyst confirmed the diagnosis of hydatid cyst. Since no other organs were involved it was diagnosed as a case of primary peritoneal hydatid cyst. The hydatid cyst may mimic an ovarian cyst, thus it is important to keep this rare entity in mind as a differential in ultrasonographically diagnosed pelvic cystic lesions.
Current status of myocardial perfusion imaging radiopharmaceuticals for SPECT and PET imaging modalities
Authors: Aydinbelge Fadimana Nur , Sadic Murat , Korkmaz Meliha
Published: December 2016

Coronary artery disease (CAD) is the leading cause of death and remains a major health problem worldwide. Myocardial perfusion imaging (MPI) with single photon emission tomography (SPECT) and positron emission tomography (PET) has been established as the main functional nuclear cardiology noninvasive technique for CAD over the past years. The studies has been shown that the use of MPI as a useful and important imaging modality for the diagnosis, risk stratification and treatment planning for CAD. The purpose of this article is to review properties of the radiopharmaceuticals used for myocardial perfusion imaging with SPECT and PET.
Critical appraisal of speech in noise tests: a systematic review and survey
Authors: Sharma Suhani , Tripathy Rajesh , Saxena Udit
Published: December 2016

Speech in noise tests that measure the perception of speech in presence of noise are now an important part of audiologic tests battery and hearing research as well. There are various tests available to estimate the perception of speech in presence of noise, for example, connected sentence test, hearing in noise test, words in noise, quick speech-in-noise test, bamford-kowal-bench speech-in-noise test, and listening in spatialized noise-sentences. All these tests are different in terms of target age, measure, procedure, speech material, noise, normative, etc. Because of the variety of tests available to estimate speech-in-noise abilities, audiologists often select tests based on their availability, ease to administer the test, time required in running the test, age of the patient, hearing status, type of hearing disorder and type of amplification device if using. A critical appraisal of these speech-in-noise tests is required for the evidence based selection and to be used in audiology clinics. In this article speech-in-noise tests were critically appraised for their conceptual model, measurement model, normatives, reliability, validity, responsiveness, item/instrument bias, respondent burden and administrative burden. Selection of a standard speech-in-noise test based on this critical appraisal will also allow an easy comparison of speech-in-noise ability of any hearing impaired individual or group across audiology clinics and research centers. This article also describes the survey which was done to grade the speech in noise tests on the various appraisal characteristics.
Hematological profile including alkali resistant hemoglobin of neonates at birth using cord blood in relation to gestational age and maternal diseases
Authors: Bhattacharya Debashis , Chatterjee Sharmistha , Sen Gargi
Published: December 2016

Background: The importance of complete hemogram along with the hematological indices in the diagnosis of neonatal health cannot be overemphasized. There is a severe paucity of relevant data regarding neonatal hematological profile in relation to gestational age and maternal diseases in this part of the country. With this perspective, the authors intended to do a pilot study to analyse the haematological profile of neonates of different gestational ages and different maternal diseases born in a teriary care hospital in Eastern India.Methods: This is a cross sectional study design based on cord blood sample of newborns and their mothers recruited from those admitted in the gynae and obstetric department in IPGME&R. The umbilical cord blood was collected from the newborn babies and then examined for different haematological parameters. The data obtained was statistically analysed.Results: While there has been a sequential rise of fetal red cell count, hemoglobin and the total white cell count neutrophils with gestational age, the mean corpuscular cell volume decreased. All these values were comprised to varying degrees in maternal diseases except for nucleated rell blood cells which conspicuously increased in neonates of diabetic mothers.Conclusions: In this study, a small attempt was made to assess the haematological profile (including alkali resistant hemoglobin) of the newborns in relation to gestational age and maternal diseases in the population attending a tertiary care hospital in Eastern India.
A comparative study of efficacy and safety of vildagliptin against metformin in newly diagnosed patients of type 2 diabetes mellitus
Authors: Wadivkar Pratik Pradip , Zad Vijay Ramakrishna , Shah Kalpana Unind , Mankar Nishikant Nandlal , Vakharia Monali Pradeep
Published: December 2016

Background: Diabetes mellitus is a progressive disease characterised by declining β-cell function. Cornerstone of effective management of T2DM is maintaining strict glycaemic control through agency of various oral hypo-glycaemic agents (OHAs). Metformin (a biguanide) currently forms the preferred treatment in newly diagnosed patients of T2DM. Vildagliptin is a potent, orally administered, competitive and reversible inhibitor of DPP-4, which was launched in 2006 and is now approved in more than 70 countries worldwide.Methods: The study was a single blinded study conducted in a district level tertiary care hospital attached to a medical teaching institute. Newly diagnosed patients were screened and randomised in two groups. Group 1 received metformin (500 mg) twice daily and group 2 received vildagliptin (50 mg) twice daily. FPG, PPPG, HbA1c and Weight were assessed on week 0 and week 12.Results: At the end of 12 weeks, ∆FPG was 39.33±4.72mg/dL and 37.84±6.58mg/dL with metformin and vildagliptin respectively. ∆PPPG was 73.88±13.80 mg/dL and 65.08±13.00mg/dL with metformin and vildagliptin. ∆HbA1c was 1.12±0.46 and 0.95±0.32 with metformin and vildagliptin. ∆Weight was 1.02±0.90 Kg with metformin and 0.69±1.33 Kg.Conclusions: Vildagliptin offers an alternative mode of therapy for newly diagnosed, obese patients of type 2 DM, especially those with impaired fasting plasma glucose.
The accuracy of USG and USG guided FNAC axilla in predicting nodal metastasis in a clinically lymph node negative cancer breast patient
Authors: Shrivastava Vaibhav , Singh Sanjay , Singh Sanjay , Maurya Aklesh Kumar , Maurya Aklesh Kumar , Singh Mayurika , Singh Mayurika , Sam Sabin , Sam Sabin , Gupta Surendra Kumar , Gupta Surendra Kumar
Published: December 2016

Background: Breast malignancies are the second most common cause of cancer-related mortality among women. As the size of the primary breast cancer increases, some cancer cells are shed into cellular spaces and transported via the lymphatic network of the breast to the regional lymph nodes, especially the axillary lymph nodes. Objective of the study was to determine the accuracy of USG and US-FNAC in detecting lymph node metastasis in a clinically lymph node negative CA Breast patient.Methods: This prospective study was conducted on 40 consecutive patients with biopsy proven breast cancer with clinically negative axilla, who had attending the OPD or IPD in our department of surgery, Swaroop Rani Nehru Hospital, Allahabad, during the period of 2014 to 2015. All of these patients were planned to undergo surgery (breast conservation or modified radical mastectomy with axillary clearance).Results: Sensitivity of the study = 97.77%, specificity = 25%, positive predictive value =92.01%, negative predictive value =50%, diagnostic accuracy =90%.Conclusions: Using axillary ultrasound and selective US-FNAC is a rapid, non-morbid method of staging the axilla in newly diagnosed breast cancer patients and should become a routine part of patient care because it can spare many patients particularly those who are undergoing axillary dissection.
Prospective study of cubitus varus deformity, its etiopathology, clinical study and treatment
Authors: Dudhekar Ulhas
Published: December 2016

Background: Loss of carrying angle at elbow (Cubitus varus) remains one of the commonest complications of supracondylar fractures. Despite the numerous ways are described of treating supracondylar fractures, cubitus varus remains a significant problem. It can only be prevented by achieving and maintaining accurate reduction. Cubitus varus deformity is not a functional problem, but it may become so disfiguring that correction is indicated.Methods: A total of 10 cases of cubitus varus deformity were treated with modified French osteotomy outcome was measured with by the method of Oppenheim WL, Clader et al.Results: In this study 10 cases treated with modified French osteotomy. In the present study 70% cases were female. All the patients were in the age group of 6-13 years. The average correction of carrying angle was 5.7 0 of valgus. All the patients were having nearly normal range of motion of the affected elbow. Only one patient suffered radial nerve injury. There was no infection or hypertrophic scar or non-union. The study showed result in the form of excellent - 70%, Good - 20% and poor - 10%.Conclusions: Modified French method proved safe and satisfactory as it has improved anatomy and cosmetic results. Loss of correction of cubitus varus deformity does not occur. A proper cases selection and proper planning of osteotomy, attention to the technical details is crucial to the success of supracondylar osteotomy of the humerus for correction of cubitus varus.
Effect of combination of Nigella sativa and Bee’s honey on lung function, respiratory muscle power, and asthma control in patients with persistent asthma
Authors: Abdelrahman Jehan E. , Magzoub Aamir A. , Ibrahim Randa E. , Elnoor Mohamed A. , Musa Omer A.
Published: December 2016

Background: Persistent asthma is a serious global medical problem, usually controlled by long term use of inhaled corticosteroids (ICS). However, ICS are expensive particularly in the developing countries and despite their use, a proportion of patients still suffer from uncontrolled symptoms and may progress into intractable airflow limitation. Nigella sativa and Bee’s honey are relatively cheap and safe natural products with anti- inflammatory and anti-allergic properties; they are used traditionally in treatment of so many diseases.Methods: In this study, we investigated the adjuvant effect of combination of Nigella Sativa and Bee’s honey on lung function, respiratory muscle power and asthma control in patients with persistent asthma. An oral dose of Nigella sativa (2 mg once daily), and bee’s honey (7.5 ml twice a day) were given to patients with uncontrolled persistent asthma (n=30, 14 females and 16 males with mean age of 43.91±5.8) for three months duration. Lung function tests (FEV1, FVC and PEFR) and respiratory muscle power indicators (MEP, MIP) were measured initially as baseline records and monthly for 3 months. The baseline score for asthma control test (ACT) was calculated for all patients and repeated after three months.Results: There was statistically significant improvement in lung function and respiratory muscle power. The need for asthma relieving β2 agonists was remarkably decreased and a significant improvement in asthma control test score in both asthma groups was observed.Conclusions: Combination of Nigella sativa and Bee's Honey as an adjuvant therapy with ICS decreases asthma severity grade and hence the need for both asthma controlling and relieving drugs and improves patient’s quality of life.
Inpatient satisfaction level survey at a tertiary care hospital
Authors: Shekhawat Shivani , Garg Swati , Jain Drishti , Sharma Urvashi
Published: December 2016

Background: Patient satisfaction is an important measure of quality of services in a healthcare organization. Other than the medical care issues, the satisfaction and experience involves personal relationships, attention to pain and health education, and the status of hospital environment. Patient's opinion is an important because dissatisfaction suggests opportunities for improvement of health services in the hospital. This study was done with the aim to assess the satisfaction levels in inpatients of a tertiary care hospital and to compare interdepartmental satisfaction scores in the same hospital.Methods: This cross-sectional survey was done in inpatients of the department of general medicine, general surgery and obstetrics & gynaecology wards of Mahatma Gandhi Medical College & Hospital, Jaipur for two consecutive days. A total of 150 adult female patients were included in the study. Structured questionnaire was developed from previously used survey tools, and validated in present patients group, and patient satisfaction was checked.Results: The demographic data of patients showed that majority of respondents were belonged to age group 20-30 years (50.7%) followed by less than 20 years (20%), more than 40 years (15.3%) and 30-40 years (12%). About 29.33% respondents were uneducated followed by primary level (25.33%), senior secondary level (24%) and graduation (21.33%). 90% respondents belonged to Hindu religion. 36.6% of the respondents were either technicians or doing a clerical job. Almost equal numbers (33.3%) were unemployed and 30% belonged to the labour class. Only 15 patients (10%) were either professionals or on managerial posts.Conclusions: This study highlighted overall patient satisfaction was good regarding the quality of health care services of Mahatma Gandhi Medical College and Hospital. Areas where patient satisfaction was found to be lowest were patience shown by the nursing staff while communicating with patients and hospital ambiance in terms of peacefulness, both of these are important aspects of health care and there is imperative need to address these problems effectively and urgently in order to improve quality of care.
One year prognosis of young Middle Eastern patients undergoing percutaneous coronary interventions
Authors: Alhaddad Zayd I. , Hammoudeh Rawan A. , Tabbalat Rinad R. , Khader Yousef , Alhaddad Imad A. , Hammoudeh Ayman J.
Published: December 2016

Background: There is scarcity of data about the outcome in young Middle Eastern patients who undergo percutaneous coronary intervention (PCI). We sought to assess clinical and coronary angiographic features and one year outcome of young compared with older patients following PCI.Methods: Baseline clinical and coronary angiographic features and major cardiovascular events from hospital admission to one year were assessed in young patients (<45 years of age) compared with older patients (>45 years of age).Results: Of 2426 patients; 308 (12.7%) were young. Young and older patients were predominantly males (76.3% vs. 79.8%; p=0.18) and had similar prevalence of hypertension, diabetes, dyslipidemia, and cigarette smoking. There were no differences between young and older patients in the rates of acute coronary syndrome as an indication for PCI (75.6% vs. 76.1%; p=0.90). The two groups had similar prevalence of one-vessel coronary artery disease (55.2% vs. 58.1%; p=0.37) and intervention for one vessel (74.0% vs. 72.1%; p=0.53). No significant differences were observed in the incidence of in-hospital adverse events in young compared with older patients. Incidence of adverse events in young patients at one year were not different from those in older patients, including cardiac death (3.63% vs. 2.11%), stent thrombosis (3.63% vs. 2.08%), major bleeding (1.30% vs. 1.18%), and coronary revascularization (3.65% vs. 3.24%); all p=NS.Conclusions: Among Middle Eastern patients undergoing coronary intervention; 13% were 45 years of age or younger. No favourable risk profile, coronary angiographic features or cardiovascular outcome were observed in young compared with older patients.
Neuroimaging in pediatric seizures
Authors: Sahdev Ravinder , Rao Akhilesh , Sinha Shilpa
Published: December 2016

Background: Accurate etiological diagnosis of seizures in children is important to begin an effective treatment. MRI is an excellent neuroimaging tool that is highly accurate. It helps in diagnosis, determining the treatment protocol and predicting the outcome. Dedicated studies in paediatric population using MRI brain have been even fewer till date in India. Current study aims to find the common etiology of pediatric seizures on MRI in a developing country like India.Methods: Hospital based retrospective study. 105 cases in age group between 0 months to 12 years. Seen between 2014 till date included in the study. All cases underwent MRI.Results: Most common imaging findings were inflammatory granuloma in 10 (9.5%). Other findings were- Hypoxic ischemic encephalopathy (HIE) in 5 (4.7%), cerebral atrophy in 2 (1.9%), focal dysmyelination in 3 (2.8%), calcifying granuloma in 3 (2.8%) and periventricular leucomalacia in 2 (1.9%). Uncommon findings were that of lissencephaly, dysgenesis of corpus callosum, mesial temporal sclerosis, AV malformation, periventricular hemorrhage, schizencephaly, abscess and infarction in one child each (0.9% each). 69 children had no abnormal findings in brain.Conclusions: The commonest etiology of seizures is inflammatory granuloma. Early recognition of potentially treatable diseases helps in timely treatment and arrest of progression of disease. It is highly recommended to use MRI as primary investigation for seizures. Every effort should be made to provide facility of MRI for management of seizures in all parts of India.
Expression of gap junctions bearing connexin-43 subunits and glial fibrillary acidic protein in the rat dorsal root ganglia following hind paw incision
Authors: Deshmukh Vishwajit Ravindra , Prasoon Pranav , Ray Subrata Basu
Published: December 2016

Background: Dorsal root ganglion (DRG) neurons mediate the transmission of sensation from the periphery. DRG neurons are pseudounipolar in nature and enveloped by the satellite glial cells (SC). Satellite glial cells have been reported to influence neuronal excitability via gap junctions. Postoperative pain causes induction of various neurotransmitters such as connexin-43 and glial fibrillary acidic protein (GFAP), in the satellite cells surrounding neuronal cell bodiesObjective: To study the expression of connexin-43 and Glial fibrillary acidic protein after hind paw incision.Methods: Male adult Sprague-Dawley rats (n=12) were used. Rats were randomly divided into two groups. Group I (n=6) and Group II (n=6) for immunohistochemical study with glial fibrillary acidic protein (GFAP) and connexin-43 (Cx-43) respectively. In this study, rats were subjected to noxious stimuli on the right hind paw under general anesthesia. Dorsal root ganglia of both sides (L4 spinal nerves) were isolated after transcardiac fixation with 4% paraformaldehyde. The ganglia from the non-incised side were taken as the control group.Results: Unipolar neurons in the DRG were surrounded by satellite cells. The satellite cells were positive for GFAP, which showed increased expression on the surgical side after noxious stimuli. Cx-43 immunostaining also showed an increased expression in the periphery of neuronal cell bodies of surgical side representing the location of gap junctions and hyperexcitability of neurons.Conclusions: Small to medium sized neurons carry pain sensation from the periphery to the central nervous system. Increased gap junctions were noted in small neurons and satellite cells after surgery. Gap junctions might contribute to increased excitability of small neurons in postoperative pain.
Comparative study of hematological parameters along with effect of chemotherapy and radiotherapy in different stages of breast cancer
Authors: Shrivastava Swati , Singh Neelima , Nigam Akshay Kumar , Chandel Sanjay Singh , Shrivastava Reetika , Kumar Sarvesh
Published: December 2016

Background: Breast cancer is one of the most common malignancies found among women in India. Haematological parameters have been shown to predict severity, mortality and treatment follow-up in breast cancer patients. The aim of the study was to compare haematological parameters along with effect of chemotherapy and radiotherapy in different stages of breast cancer patients.Methods: Total 235 human subjects were taken in the study. Out of which 100 normal ages matched healthy subjects were considered as controls and 135 breast cancer patients subjects as cases which were further divided into their respective stages according to TNM classification.Results: Estimation of haematological parameters was done by Sysmex Automated Hematology Analyzer Kx-21. The statistical differences between cases and control were determined by using student independent sample t-test.Conclusions: We found hemoglobin level, polymorphs, lymphocytes, monocytes and RBC count were statistically reduce (p<0.05) while other parameters were non-significant as compared to control healthy subjects. We also found deranged haematological parameters in all four stages of breast cancer. The data also indicated that patients which were on combined therapies i.e. radio and chemo have more deranged and decreased levels of haematological parameters as compared to individual therapies.
Correlation of lipid profile in patients with severity of liver disease: a cross sectional study in a tertiary care hospital
Authors: Muhammed Hashik P. , Jayaraj Kezhakkut
Published: December 2016

Background: Many previous studies concluded variation in the lipid parameters such as total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL) and low density lipoprotein (LDL) with severity of liver disease. Hence, this study was conducted to find out the correlation of lipid profile in patients with severe liver disease.Methods: A cross sectional study which included 170 patients admitted with chronic liver disease. Severity of liver disease according to Child Pugh Turcotte Score. The patients were subjected to routine investigation and fasting lipid profile test. Correlation was studied using the Pearson correlation coefficient and the comparison of lipid parameters was also done.Results: Total of 170 consecutive chronic liver disease patients were analysed over a period of one year. Majority of the patients were of the age 51 to 60 years (39.8%). Among the total, 24 patients were in Child Pugh Turcotte Score class A, 47 patients were in class B and 52 were patients in class C. We could observe a significant (p<0.001) negative correlation of all the lipid profile parameters with the severity of liver disease.Conclusions: Serum TC, LDL TG and HDL were decreased in patients with cirrhosis and they are inversely correlated to severity of disease.
Vermal cerebellar hemorrhage as the initial manifestation of undiagnosed hypertension
Authors: Iyagba Alagoma , Onwuchekwa Arthur
Published: December 2016

Vermal cerebellar haemorrhage is bleeding affecting the midline region of the cerebellum. It is uncommon, accounting for 5-13% of all intracerebral haemorrhages. It is a grave condition with a high mortality. The diagnosis must be made early, if not, most patients would die within 48 hours. A 70-year-old lady presented to the accident and emergency department with a six hours history of sudden onset generalized tonic-clonic seizures following activity and loss of consciousness. She was unconscious with a Glasgow coma score of 3/15 with neck stiffness, generalized hypotonia and globally diminished reflexes. Her blood pressure was 240/120 mmHg with a mean arterial pressure of 160 mmHg. The brain computerized tomographic scan showed a hyperdense area in the cerebellar vermis with extension to both hemispheres and fourth ventricle. Consciousness was regained after three weeks of conservative management following which she became extremely restless and noticed to have developed titubations with nystagmus of both eyes. She also developed intention tremors, scanning dysarthria, generalized hypotonia, dysmetria, dysdiadochokinesia and intentional bilateral tremors. Her recovery was slow and gradual. Once she was able to stand with support, she was noticed to have florid truncal ataxia, lower limbs ataxia, and titubations.
An atypical case of fatal chikungunya infection in pregnancy
Authors: Panwar Shivali , Kapur Anu , Gupta Dheeraj Kumar
Published: December 2016

Chikungunya viral infection is a mosquito borne illness which is known to have a limited course and complete recovery is seen in most of the patients. However the virus has been reported to have atypical manifestations and lethal complications have been reported in patients suffering from chikungunya infection. In the present outbreak of chikungunya virus in the national capital territory of Delhi we report a case of chikungunya fever in a pregnant female with no significant medical history. The patient developed thrombocytopenia, hepatic injury and disseminated intravascular coagulation and ultimately succumbed to the illness due to cardiovascular collapse.
Bilateral post-traumatic forearm and hand compartment syndrome: a case report and review of literature
Authors: Das Saubhik , Trikha Vivek , Gaba Sahil , M. Arkesh , Agrawal Prabhat , Yadav Gajanand
Published: December 2016

Acute compartment syndrome is a condition in which interstitial tissue pressure within a closed osteo-fascial compartment is elevated to a nonphysiologic level causing decrease in tissue perfusion, which if left elevated for sufficient time, can lead to tissue necrosis and devastating loss of function. It poses a diagnostic and therapeutic challenge for treating surgeons. We present a case of acute post-traumatic bilateral forearm and hand compartment syndrome in a 12 year old boy associated with fracture of distal ulna and metacarpals. Patient regained excellent function with emergent fasciotomy of volar forearm and hand followed by wound management with vacuum-assisted wound closure system (VAC), delayed primary closure and split-thickness skin graft (SSG). Early diagnosis and emergent fasciotomy are crucial to avoid debilitating complications.
Complication profile of scrub typhus and its association with total leucocyte count
Authors: Gupta Palak , Gurjar Umesh , Sharma B. S. , Gupta M. L.
Published: December 2016

Background: Recent reports from several parts of India indicate that there is a resurgence of scrub typhus. There have been a few studies analysing the association of various complications of scrub typhus with leukocyte count. The objective of this study was to study the association of various complications of scrub typhus with leukocyte count in children.Methods: A prospective study done at SPMCHI, SMS Medical College, Jaipur from August 2014 to November 2014. 75 Scrub typhus positive children were included in the study group. A detailed history of signs, symptoms, complications, demographic background was taken and relevant laboratory investigations done. The association between the complications of scrub and the total leukocyte count was studied, statistical analysis was done using Chi Square test.Results: Meningoencephalitis was most commonly seen complication in 14.7% followed by ARDS (9.3%), hepatitis (8%), AKI (6.7%), shock (6.7%) and myocarditis (1.3%). Meningoencephalitis and acute renal failure were more frequent among Scrub Typhus cases with leucopenia (p = 0.006, P = 0.011 respectively). It was observed that hepatitis was more frequent with leukocytosis, but was not statistically significant.Conclusions: Our study revealed that leukopenia has a significant association with meningoencephalitis and acute kidney injury.
Parent stress in neonatal intensive care unit: an unattended aspect in medical care
Authors: Agrawal Ruma , Gaur Ajay
Published: December 2016

Background: The birth of an infant that needs care in a neonatal intensive care unit (NICU) can be stressful for the parents. The parent-infant bonding process that occurs during the newborn period establishes the foundation for a lifelong relationship. This typical process does not occur when the infant spends the first several weeks or months in the NICU. Quantifying stress levels of parents and identifying the greatest environmental stressor by understanding the aspects of infants, parents and the environment that can cause stress may be useful in assisting the health personnel in understanding their importance and in improving the quality of care. The objective of the study was to quantify stress levels of parents of babies admitted in NICU and compare the sources of stress for mothers and fathers.Methods: This was a cross-sectional, observational, hospital based study where stress levels were assessed using Parental Stressor Scale: neonatal intensive care unit (PSS: NICU) questionnaire among parents of 400 newborn admitted in NICU. Stress was quantified using 5 point Likert scale from 1 (not at all stressful) to 5 (extremely stressful). The overall stress levels were calculated for each subscale and total scale and compared.Results: NICU environment is moderately stressful for both mother and father. The highest score was in the field of Relationship with the baby and parental role for mothers as well as for fathers. Mothers had significantly higher stress scores for each subscale and the total scale compared to fathers.Conclusions: NICU parents are under significant stress and this is need of time to give family centered care.
Augmented BMI and waist to height ratio as screening tools for overweight and obesity among school going children aged 5 to 15 years
Authors: C. B. Ushakiran , Jagadeeshwara Sowmya , Lingaraju Bharathi
Published: December 2016

Background: Worldwide raising trend in obesity among children is causing serious public health concerns and in developing countries it is threatening the viability of basic health care delivery. The objective of this study was to screen for overweight and obesity among school going children using the established methods as well as the newer screening tools and to compare the efficacy of the various screening toolsMethods: Prospective cross sectional study was conducted various government and non-government schools within city limits. And participants involves 1000 children in the age group of 5 to 15 years who met the predefined criteria were selected by purposive sampling.Results: Using BMI as a screening tool, 6.3% were identified as overweight and 5.8% as obese. Using Waist circumference alone, 5.2% were identified as overweight and 4.5% as obese. 13.8% and 5% were identified as overweight and obese respectively by waist circumference to height ratio. Using augmented BMI, 14.7% were identified as overweight and 4.3% as obese.Conclusions: Using WHTR and Augmented BMI, larger percentage of children were identified as overweight while the percentage of children identified as obese remained similar to using BMI or Waist circumference alone.
A cross-sectional study on depression among school going adolescent girls in Barabanki district, Uttar Pradesh, India
Authors: Shukla Nirpal Kaur , Shukla Mukesh , Ahmad Siraj , Shukla Ram , Khan Zainab
Published: December 2016

Background: Depression is one of the common and ignorant psychiatric problems in adolescents now days. It has profound adverse effect on their physical as well as mental health. The objective of this study was to study the prevalence of depression among school going adolescent girls.Methods: A cross sectional study was conducted among 336 school going adolescent girls in Barabanki district from June 2016 to September 2016. Multistage sampling was used to enroll the study subjects. Bio-social parameters such as age, socioeconomic status etc. were assessed by direct interview of adolescent girl as well as its confirmation with school records. Six items KADS (Kutcher Adolescent Depression Scale) was used for assessment of depression among adolescent girl.Results: Out of 336 adolescent girls screened 18.7% were found positive for depression. Lower socio-economic status was found as one of the independent predictor of depression. Girls belonging to lower socioeconomic groups (odds ratio ([OR] 2.08; 95% confidence interval [CI] 1.18-3.21; p = 0.03) were more susceptible for depression. However on multiple logistic regression no statistical association was observed between depression with respect to age group, class, religion, caste and mothers education, and type of family (p>0.05).Conclusions: The study highlights need for timely diagnosis and treatment of problem through school based periodic screening programmes. There is also need of increasing awareness among teachers and parents about depression.
Pulmonary penicilliosis in HIV negative child simulating pulmonary tuberculosis
Authors: Kariyappa Mallesh , B. M. Nagabhushan
Published: December 2016

Penicillium marneffei (P. marneffei) is a rare human pathogen, unique among species of penicillium by its thermal dimorphism and its propensity to infect the lungs and reticulo endothelial system and to proliferate within histiocytes either in healthy or immunocompromised hosts. Penicillium marneffei is a rare in HIV negative child. Clinical characteristics of study were 9 years old male presented with fever, cough and loss of appetite for 6 months that persisted despite ante tuberculosis treatment. Broncho alveolar lavage showed typical elements and culture yielded the growth of penicillium marneffei. Outcome of this study was child responded to amphotericin and did not relapse on itraconozole prophylaxis. Penicilliosis mimics pulmonary tuberculosis.