bluuebunny/crossref_metadata_2025 huggingface dataset:
Tax policy for business entities under the conditions of association with the European Union: features and optimization directions
Authors: Abuselidze George , Gogitidze Inga
Published: April 2020

Under the conditions of EU association, one of the important for Georgia is to create such tax policy that shall be agreeable and settled with the economic systems of developed countries. The efficiency of the tax system depends on the optimal tax policy, according to which highly available and modern standard-oriented business environment is created. In 2017, the Parliament of Georgia passed the reform of profit tax that is aimed to free the business entities from profit tax during the reinvestment process. All the above mentioned maintains the topicality of ongoing reforms in Georgia. The goal of the research is to identify the impact of the new tax system on the Gross Domestic Product, the stream of investments, stimulation of business, and the period, after which the results of the reform will be favourable for the economic. There are various researches and scientific publications on the given issue. According to the study, the reform will produce a long-term macroeconomic effect that will mainly aim to favour small and middle scale businesses. Liberal tax approaches are advancing Georgia’s investment attractiveness, reflecting an increase of investments. This work is based on Estonian experience presented in statistics and international studies. The information processed by experts and researchers helps us to evaluate the impact of this reform on Georgia.
Model of brand value management as a process of strategic increase of enterprise value
Authors: Porokhnya Vasyl , Kravets Olena , Didenko Anastasiia , Penev Vladyslav
Published: April 2020

Constantly increasing the level of competition requires manufacturers of goods and services to individualize their products. Considering this factor, the brand takes on a new level of perception, a level of the strategic asset of the company, which allows evaluating the value of the company. With the pursuit of competitiveness and modernity, domestic companies have only in the last few years begun to view the brand as an integral part of their business, capable of generating additional profits at the expense of increased consumer loyalty. However, there are currently no standard methods for evaluating brand value, and there are some disadvantages to applying them. The article deals with modern research methods of the Interbrand and V-RATIO brand. It is revealed that the results of the calculations by different methods differ depending on the set goal: long-term or short-term costs. 19 brand evaluation criteria are considered. We propose our conceptual model of brand value estimation based on a closed system of factor analysis and modeling. The impact of the criteria on the choice of alternatives for choosing brand value strategies is suggested to be found by the Saati hierarchy analysis method. To enhance the adaptive properties of the selected criteria, it is proposed to use the mechanism of alternative strategies for increasing brand value by incorporating the Kohonen neural network process algorithm. The structure of hierarchies of influence of defined criteria on the brand development scenarios was constructed. Calculations were made by the method of analysis of hierarchies in the author’s developed system, and it was found that having the resources to increase only one criterion of brand development would be the best development of leadership or internationality of the company. Based on the calculations neural network in the MATLAB, it was found that enterprise, which was researched, needed to pay attention to advertising costs or to increase brand value.
A PILOT TRAIL: EFFECTIVENESS OF BIBLIOTHERAPY ON QUALITY OF LIFE, PSYCHOLOGICAL DISTRESS AND DEPRESSION AMONG PATIENT WITH CHRONIC LEG AND FOOT ULCER IN MANGALORE
Authors: P. Kirupa , B. Preetham Rai , U. Srinivasa Bhat
Published: April 2020

Introduction: Many clients living with chronic leg and foot ulcers experience diminished quality of life, pain, psychosocial maladjustment, limited work capacity, and physical disabilities. Bibliotherapy helps the individual to cope up with illness.

Objectives: Assess the pretest level of psychological distress, quality of life and depression in both Interventional and control group. Evaluate the effectiveness of bibliotherapy on quality of life, psychological distress and depression

Methods: Pilot study was conducted among the twenty patients with chronic leg and foot ulcer .Randomized clinical trial comparison with pair group method was used to evaluate the effectiveness of bibliotherapy .Data were assessed by using chronic wound impact schedule, Kessler's psychological distress scale and beck depression inventory were used to assess the quality of life, psychological distress and depression respectively. Simple random sampling by lottery method was used to collect the data.

Results: Findings show that there is mean of the quality of life (56.3), distress (28.3) and depression (22.5) were falls on the moderate level among the patient suffering with chronic leg and foot ulcer. Two way analysis of variance proves that bibliotherapy highly significant in increasing quality of life (F= 20.3,P<0.001) ,decreasing the psychological distress (F=25.2,P<0.01) and decreasing depression (F=5.18 ,P<0.05).

Conclusion. Need based bibliotherapy is effective to meet the psychological aspects of chronic leg and foot ulcer
A MORPHOLOGICAL STUDY OF PLACENTA IN CHILDREN WITH AND WITHOUT HYPOSPADIAS
Authors: S. Bindhu , Avadhani R K , Jacob Meera
Published: April 2020

Introduction: Hypospadias can be defined as an abnormal urethral orifice under surface of the penis with or without chordee and with or without dorsal hood. At a critical time in sexual differentiation of the male fetus, HCG enters fetal plasma from syncytio trophoblast; acts as an LH surrogate and stimulate replication of testicular Ley dig cells and testosterone synthesis to promote male sexual differentiation. The placental insufficiency may disrupt the supply of nutrients and hcG to the fetus leading to growth retardation and hypospadias.

Aim: The aim of this study was to observe and document morphological changes of placenta in children with hypospadias and compare with controls.

Materials & Methods: The present study was a case control study from July 2008 to July 2011 The data base of the labor registries of the hospital indicated that there were total 3243 male births during this period. All examined for presence /absence of hypospadias by attending pediatrician. Hypospadias was detected in 17 male newborns. Control cases comprised of 68 male newborns without hypospadias of similar gestational age and birth weight collected by cluster sampling.

Result:

Total number of male birth during the study period was 3243, in that17 children born with hypospadias. The incidence of hypospadias in our hospital was 0.52%. Gestational age, Birth weight, Placental weight, Placental thickness, Placental volume, volume of infarcts, F.P Ratio, Cord length, were similar in children with hypospadias when compared with controls. CONCLUSION: Fetal factors like gestational age, birth weight, placental weight, Feto-placental ratio were not significantly associated with hypospadias. This study shows no role of placenta in the etiology of hypospadias in children with normal birth weight.
STRESS AND BURNOUT ASSESSMENT AMONG POST GRADUATE DENTAL STUDENTS
Authors: Shetty Aditya , Shetty Amrith , Hegde Mithra N , Narasimhan Dhanya , Shetty Shishir
Published: April 2020

Context: High levels of stress and burnout affect the academic, and clinical learning process and long term health of the individual.

Aims: The aim of the study was to assess stress and burnout among post graduate dental students in a dental college in India

Settings and Design: 82 post graduate dental students enrolled in the MDS programme in a dental school in India completed the Graduate Dental Environment Stress (GDES) questionnaire and Maslach Burnout Inventory. Burnout was assessed in three domains Emotional Exhaution, Depersonalization and Personal Accomplishment

Statistical analysis used: Summary statistics (proportions, mean and standard deviation) were used to summarize the responses to the Graduate Dental Environment Stress (GDES) questionnaire and Maslach Burnout Inventory

Results: The statistical analysis revealed that the mean overall score on GDES 30 stress questionnaire was 2.28. Top three stressors among the Postgraduate students was lack of leisure time, examinations and assessments, and insecurity regarding professional future . Females had significantly higher stress rates . 21% of respondents were “cases of burnout” in the Emotional Exhaustion (EE) component, 29 % were “burnout” cases of Depersonalization (DP) while 54% were “burnout” cases in the Personal Accomplishment (PA) domain

Conclusions: Moderate to high levels of stress and burnout were detected among this study sample. There is a need to come up with effective strategies in the postgraduate curriculum to tackle stress and burnout.
ATTITUDE OF COLLEGE STUDENTS TOWARDS ALCOHOL CONSUMPTION IN MANGALORE
Authors: Daniel Deepak , Shetty Devishri , Jose Greeshma Jilson , J. Haritha , Ravi Jeevan , Pillai Lakshmi S , Neghandi Anupa , Kundapur Rashmi ,   Santhosh
Published: April 2020

Introduction: According to various studies conducted, the response of the adolescent towards alcohol is different. Attitudes ranged from acceptance that is to "easy to get" and is "just going to happen, "to personal responsibilities, it's your choice not to drink peer pressure; you end up drinking to be part of group”.

Objectives: To assess the attitude of youngsters towards alcohol consumption.

Materials and methods: A survey was performed in colleges under NITTE University. Students present at the time of visit were covered. A questionnaire was prepared comprising of a set of 14 questions covering the 3 main objectives of the survey.

Statistical analysis used: Summary statistics (proportions, mean and standard deviation) were used to summarize the responses to the Graduate Dental Environment Stress (GDES) questionnaire and Maslach Burnout Inventory

Results: As per our survey of the 1150 students, 26.4% (304) students consume alcohol. Of these who consume alcohol, 188 (61.84%) students felt it was safe to drink. Also a majority of 219 students (72.03%) did not want to stop their drinking habits and 225 (74.01%) students haven't tried quitting. Surprisingly, a good 1050 (91.30%) out of 1150 students responded that they were aware of the harmful effects of alcohol consumption.

Conclusion: We have concluded that the students are well informed and they know the ill effects of alcohol consumption even though, most of them consider it as a part of life style.
PREVALENCE OF NECK AND BACK PAIN AMONG PAEDIATRIC DENTISTS
Authors: Shetty Siddharth M , Shetty Shreema , Hegde Anoop , Babu Nirmal
Published: April 2020

Occupational diseases are present worldwide. Dentists believe that they are at a higher risk for development of musculoskeletal disorders due to the postures attained at work. Hence, we conducted a study for understanding the prevalence of such ailments amongst the paedodontist population. We employed a cross-sectional study of 270 paedodontists who were selected at random and were asked to complete a self-administered questionnaire. The questions were about personal characteristics, job history, specific work habits and mostly pertaining to clinical dentistry with details of any recent occurrence of neck or back pain. Results tabulated showed a 79.6 % of the paedodontists reported having experienced at least one episode of neck or back pain in the immediate past 12 months. This value is way above the occurrence of similar complaints seen among the general population which is estimated to be around 55%. The study concluded indicating that the incidence of neck and back pain among dentists is higher than general population. This may be attributed to extreme postures that may be attained during the clinical work and which may be extreme in paediatric dentists.
PERIODONTAL PROSTHESIS - REVIEW
Authors: Bhat Vinaya S , D. Krishna Prasad , Malli Prakyath
Published: April 2020

Planning a course of treatment for periodontially compromised patients is a multidisciplinary approach involving sequential therapy by a Periodontist and a Prosthodontist. Specific problems have to be recognized and a treatment plan has to be formulated from both the disciplines to deliver best professional and clinical skills in management of a periodontially compromised individual. Hence this review article addresses case characteristics, objectives, sequence of therapy and treatment planning in patients receiving periodontal prosthesis.
EFFECTIVENESS OF MASSAGE THERAPY ON RESPIRATORY STATUS AMONG TODDLERS WITH LOWER RESPIRATORY TRACT INFECTION
Authors: M. A Helen Martina , Beulah Hepzibah , David Anita
Published: April 2020

Lower respiratory tract infection is one of the major prevailing respiratory illnesses in children. The aim of the study is to assess the effectiveness of massage therapy on respiratory status among toddlers with lower respiratory tract infection. A sample of 60 toddlers were conveniently assigned to study and control group, in study group routine care and massage therapy was performed for three days in morning and evening then posttest was conducted end of each day whereas control group receives routine care. The result shows that massage therapy was significantly effective in improving lung functions.
VARICELLA ZOSTER VIRAL RETINITIS IN A PATIENT WITH SYSTEMIC LUPUS ERYTHEMATOSIS
Authors: Nagaraj Kalpana Badami , Muralidhar Sonali , Jayadev Chaitra ,   Kirthiraj
Published: April 2020

A young female a known case of systemic lupus erythematosus who underwent renal transplantation for end stage lupus nephritis was on long term immunosuppression for her systemic condition. She had an episode of varicella three months before she presented to us with ocular complaints in the right eye. She was diagnosed to have progressive outer retinal necrosis with a differential of cytomegaloviral retinitis in the right eye and treatment was initiated. She had begun to show improvement in visual acuity but within two weeks her systemic condition worsened rapidly and she succumbed to septic shock.

The ocular infection in an immunocompromised SLE patient can be a precursor of mortality as seen in our patient.

Due consideration is to be given for prophylactic treatment post varicella infection along with a multidisciplinary approach in managing the immunocompromised, to prevent devastating complications or mortality.
ANESTHESIA FOR DAY CARE SURGERY
Authors: Shetty Anil , US Raveendra
Published: April 2020

Day care procedures, diagnostic and therapeutic are increasingly popular, due to advances in anesthesia, surgery and medical technology. Carefully selected patients with optimized co morbid conditions, if any can be taken up for ambulatory surgery which includes sedation, regional and general anesthesia.

Careful selection of drugs and airway devices with a proper plan leads to success. Standard monitoring is mandatory.Complications should be anticipated with the goal of early recognition and management. Appropriate discharge criteria should be applied before sending the patient home. Back up facilities of inpatient treatment should be available
An observational study on breast feeding Success among postnatal mothers
Authors: Nayak Sabitha
Published: April 2020

Background: Under modern health care, human breast milk is considered the healthiest form of milk for babies. It also promotes the health of both mother and infant and helps to prevent disease.1

WHO states that, the vast majority of mothers can and should breast feed, just as the vast majority of infants can and should be breast fed.5

Purpose: The current study has aimed to determine the breastfeeding success among postnatal mothers.

Methods: A descriptive survey approach was conducted on 50 postnatal mothers who were in the postnatal wards of a selected hospital. Observational checklist with 26 items were utilized to collect data.

Results: Through descriptive analysis it was found that majority (44%) of mothers were in the age group of 20 – 25 years. Majority (68%) were Hindus. In type of delivery 84% had full term normal delivery. With regards to parity, 44% were multis. In relation to sex of the baby, 68% were females. The condition of the mother and the baby after delivery was good and normal in 100%. An observational checklist on breastfeeding success shows that the success rate on breastfeeding was high. There were 4 items such as getting ready to feed, Latching on, Feed itself and after feed and each item had 4 to 8 specific items on observational checklists on breastfeeding which indicates that in most of the mothers breastfeeding was a success. By inferential statistics it was found that type of delivery is associated with breast feeding (P < 0.05). Since all other p values are more than 0.05 there was no association between those selected demographic variables with breast feeding at 5% level of significance.

Conclusion:Breast feeding is an age-old practice among most of the post-natal mothers to feed their young ones. In India, most of the mothers, practice giving breast milk to babies for about 1 to 2 years. Assistance by the health workers is not much sought as most of the bystanders assist the mothers in breast feeding. In the present study also, we have come across mothers successfully breastfeeding their babies and they are contented.
KAP study of solid waste disposal of households in Kuttar & Manjanadi Panchayath covered under gramaskhema programme of K.S. Hegde Medical Academy
Authors: Kiran K. G. , Kini Sanjay , K. Ravi , P. Santhosh N. , Kiran N. Udaya
Published: April 2020

An important problem faced by many societies across the world is unhealthy disposal of solid wastes. Knowledge, attitude, practices of people plays a crucial role as their view point is extremely vital in providing solutions to future environmental problems. A cross sectional study was conducted among the households of Kuttar and Manjanadi villages and a sample of 120 households were studied. Majority had a good knowledge about the ill effects of improper solid waste disposal and that 82.5% said collectively that it causes disease, unpleasant odour, unpleasant site and rodent nuisance. Majority of them had a positive attitude towards solid waste disposal and 98.3% felt that improper solid waste removal and disposal effects environment. Regarding household waste disposal practice it was found to be unsatisfactory as 78 households disposed of household wastes by just throwing away outside the house. Strict surveillance, supervision and timely removal for disposal of solid waste by management are the key factors in reducing environmental hazards.
A clinical study of adherence of candida albicans to an improved NBR denture soft lining material
Authors: Ahmed Naeem , Bhandari Aruna J. , Sachdev Arti Saluja , Khan Farah , Malhotra Shitanshu , Bashir Taseer
Published: April 2020

30 dentures selected for the study were disinfected using effervescent denture tablets. Then the dentures were trimmed 1.5mm from fitting surface and relined with NBR soft lining material. Sample was scraped from denture fitting surface after one month and two months duration and the changes in colony forming units per mm after each month's time were measured and marked. After one month's duration, 24 samples were reported sterile and 6 showed colonies of Candida albicans & Staphylococcus aureus. After 2 months duration, 28 out of 30 samples became positive with C. albicans & S. aureus colonies and aerobic spore bearing units. NBR soft liner material was sterile till one month of clinical usage so it can be prescribed as a safe soft lining material till one month of clinical usage in a controlled environment of oral hygiene
Does internal cardiac massage play a role in ROSC after prolonged CPR ? : Our experience in a tertiary care hospital
Authors: Kamath Manjunath R. , P. Krishna Prasad , Gopalakrishnan M. , Kiran Amith
Published: April 2020

Cardiopulmonary resuscitation (CPR) is a life-saving skill involving chest compressions & ventilation to pump oxygenated blood through the vital organs of the body. Among different techniques and devices for chest compression, no single method has been definitively shown to produce the best outcome and hence, direct comparisons between them are not possible. Internal cardiac massage is the manual squeezing of the heart through a surgical incision into the chest cavity, when the chest is already open for cardiac surgery. Unlike the usual cardiac arrest scenarios, internal cardiac massage is employed mostly in cardiothoracic surgical patients and will have more chance for survival and favorable neurologic outcomes across all durations of CPR. We describe two cases of return of spontaneous circulation (ROSC) after prolonged CPR with internal cardiac massage performed in hospital setting.
Obstructive sleep apnea - A review
Authors: Sharma S. M. , Gohil Saurabh
Published: April 2020

Sleep related problems affect large group of people of all ages around world. One of the most common disorders is Obstructive Sleep Apnea (OSA) characterized by repetitive, complete or partial collapse of upper airway during sleep. Due to complexity of disease and associated medical conditions, a broad spectrum of clinicians play important roles in treatment of OSA. Evaluation of OSA is best performed using a multidisciplinary team approach.

This article aims to reviewthe exhaustive current literature for relevant information regarding terminology, pathophysiology, prevalenceand treatment including conservative and surgical.
Variation in the origin of right obturator artery - A case report
Authors: Nallathamby Rani , Avadhani Ramakrishna , H. Sivarama C. , Soman Meril Ann , Jacob Meera
Published: April 2020

Most commonly, the Obturator artery arises from the anterior trunk of internal iliac artery. However, origin of the Obturator artery from external iliac artery was reported at 25% by Missankov et al. [3], 1.1% by Bergman et al. [1], 1.3% by Jakubowicz and Czerniawska- Grzesinska [2].Due to its high frequency of variations in course and origin, Obturator artery had drawn the attention of anatomists, surgeons and radiologists. In this case report, we are presenting an anomalous origin of right Obturator artery from right external iliac artery. The knowledge of this variation is important anatomically, radiologically and surgically.
Conservative management of kienbock's disease in a 24 year old adult : A case report
Authors: Shetty Sanath Kumar , Ballal Aditya , Rai H. Ravindranath
Published: April 2020

Kienbock's disease also known as Lunatomalacia is a rare disorder involving the lunate. Damage to the lunate can lead to pain, stiffness, and in late stages, arthritis of the wrist. This disease is most common in men between the ages of 20 and 40 and rarely affects both wrists. Here we present a 35 year old male manual labourer who presented to our department with complaints of progressive pain and stiffness of his dominant wrist.

Radiographically he was diagnosed to have Lichtmann class IIIA Kienbock's disease of the left wrist. He was managed with analgesics and wrist physiotherapy. On a review at three months he had an acceptable range of motion of the wrist he was symptom free.

This article presents our patients history, radiological findings and management.
Scleralfixatedintra-ocularlens : A case report
Authors: Pai Vijay , Shetty Jayaram , Amin Hrishikesh , Shetty Samatha P.
Published: April 2020

In the surgical management of aphakia in cases with deficient posterior capsule1, we have described this particular technique which is cost effective and technically less challenging at the same time with satisfactory results.
Extent of awareness regarding periodontal disease in diabetic patients among medical interns
Authors: Jaiswal Roshni , Shenoy Nina , Thomas Biju
Published: April 2020

Background: Diabetes mellitus is a metabolic disorder characterized by hyperglycemia due to defective secretion or activity of insulin Prevalence of diabetes mellitus has tripled since 1970, hence it is a significant finding for dental professionals, as evidence from clinical research showing a strong relationship between diabetes and periodontal disease is mounting. In fact, periodontitis is often referred to as the sixth complication of diabetes.

Objective : To assess the extent of awareness of periodontal disease in diabetic patients, among medical interns.

Methods: A cross sectional survey containing 21 questions was answered by 150 medical interns from Mangalore, Karntaka.

Conclusion: The results of this survey indicate that medical interns have thorough knowledge about diabetes and its complications; however, their awareness about periodontal disease in diabetic patients is limited thus further emphasis should be given to the dissemination of knowledge about the inter-relationship of diabetes and periodontal health.
Upper gastro intestinal foreign bodies in pediatrics patients
Authors: Annigeri Venkatesh M. , Gadgade Bahubali D. , Annigeri Rashmi V. , Halgeri Anil B.
Published: April 2020

Aim: Analyzeexperience with presentation, diagnosis and management of accidental ingested upper digestive tract foreign bodies in children.

Materials: A prospective study of 60 pediatric patients from July 2009 to July 2014 with history of accidental ingested upper gastro intestinal foreign bodies. All patients were studied for age, gender, complaints, duration, site of impaction, type and complications. Radiological investigations were taken according to the case. Direct laryngoscopy and Magill forceps or flexible esophagoscopy has been used for retrieval of foreign bodies.

Result: Sixty cases were analyzed age between 6 months to 13 years. Male 42 and female 18. Age group 6 months to 6 years constitutes 85%. Thirty six (60%) patients arrived to hospital within 24 hours. Difficultly in swallowing (70%) was the most frequent symptom. Most foreign bodies were coin in the upper esophagus (70%). Preexisting esophageal disease was present in 20%. Out of 60 patients twenty four (40%) FB retrieved using Magill forceps and rest with Flexible esophagoscopy (60%). Foreign bodies were successfully removed without major complication in all cases. Mucosal erosions were seen in four patients after extraction. All patients except 4 were discharged within 24 hours after the procedure.

Conclusion: Children between 6 month to 6 years is the commonest age group affected. Magill forceps with the aid of a direct laryngoscope is a safe and effective method for proximal esophageal foreign body removal. But flexible esophagoscopy remains the safest method of upper digestive tract foreign body extraction.
A case of Fahr's syndrome with rare atypical presentation as hemiplegia
Authors: Chepuri Venkata Ravikumar , Panta Himabindu
Published: April 2020

Calcification of basal ganglia or Fahr's disease is a rare disease characterized by bilateral and symmetrical intracranial deposition of calcium mainly in cerebral basal ganglia. Basal ganglia calcification secondary to endocrinological cause is known as Fahr's syndrome. Motor and neuropsychiatric symptoms are prominent features. We report a case presented with hemiplegia without any psychiatric symptoms. Radiological findings were suggestive of bilateral calcification of cerebellar hemispheres and basal ganglia. Parathyroid hormone levels were low with no significant findings in other investigations along with negative family history. Based on the radiological and biochemical findings the case was diagnosed as fahr's syndrome.
Variation in the area of distribution of the lateral pectoral nerve and a communicating branch between musculocutaneous and median nerve : A case report
Authors: A. Divia Paul , Gaikwad Manisha Rajanand
Published: April 2020

Variations in the distribution of the lateral cord and its branches in the infraclavicular part of the brachial plexus are common and significant to the neurologists, surgeons, anaesthetists and the anatomists [1]. The present case describes a rare variation of the lateral pectoral nerve giving an additional branch to supply biceps brachii muscle and ends by joining inferior collateral branch of brachial artery. Also it was observed that the musculo cutaneous nerve received communicating branches from the median nerve before and after piercing the coracobrachialismuscle. The above observations were observed during routine dissection of a 55 year old Indian male cadaver. The musculocutaneous nerve, lateral pectoral nerve and its branches were identified and protected. The clinical importance of the variation is discussed.
Fluorescence in situ hybridization on Peripheral blood for Chronic Myeloid Leukaemia - Rapid and reliable method
Authors: A. Meenakshi , D. Prashanth Shetty , N. Suchetha Kumari , Mathias Michelle , Kumar Karuna Ramesh , Shetty Jayaprakash
Published: April 2020

Philadelphia chromosome (Ph) is found in more than 95% of Chronic Myeloid Leukaemia (CML) patients arising from the reciprocal translocation of chromosomes 9 and 22 which results in the formation of chimeric fusion gene BCR-ABL. This paved the path for targeted gene therapy in CML and thus plays a pivotal role in diagnosis and prognosis. Fluorescence in situ hybridization (FISH) is a rapid and reliable technique in molecular cytogenetics to detect BCR-ABL fusion signal in both interphase and metaphase spreads of bone marrow sample. Peripheral blood white cells as a surrogate for bone marrow have been suggested by a few studies.

The objective of the study was to evaluate FISH on peripheral blood specimen as a rapid and reliable method to quantify Ph positive cells in a patient with Chronic Myeloid Leukaemia. FISH was performed on interphase nuclei from cultured peripheral blood sample of the patient using BCR/ABL Translocation, Dual fusion probe. Chromosomal analysis was performed by GTG banding technique. FISH and karyotyping confirmed the presence of reciprocal translocation t (9; 12) (q34.1; q11.2).

Our results confirmed that FISH technique is a rapid, sensitive, quantitative technique which can be used for the evaluation of CML using peripheral blood. FISH helps in the detection of minimal residual disease and disease recurrence with small percentage of abnormal cells. In our experience, this situation is usually associated with very high WBC count which can result in increase in the percentage of Phpositive cells.
Endovascular stenting for treatment of superior vena cava syndrome
Authors: K. Subramanyam , Kamath Janardhan , Johny Dilip , Joyes Paul T.
Published: April 2020

Superior vena cava syndrome (SVCS) is a well-known manifestation of benign and malignant tumors of the upper mediastinum. Superior vena cava (SVC) obstruction and thrombosis caused by indwelling venous catheters is a growing problem in patients on regular haemodialysis. We present a 62-year-old woman with typical signs and symptoms of SVCS, secondary to thrombosis surrounding the indwelling central catheter who was treated with endovascular stenting by the percutaneous approach. We obtained both procedural success with complete restoration of blood flow and immediate relief of symptoms.
Effectiveness Magnesium Sulphate Crystal Fomentation Vs Paste Application for Phlebitis among Children Receiving Peripheral Infusion who are Admitted at Selected Hospital at Mangalore
Authors: D'souza Brincy Loyolla ,   Shivakumar
Published: April 2020

Background: Peripheral cannulation is one of the commonly used procedures in children, as they have to undergo many infusions for the administration of medications. The nurse is responsible for maintaining and monitoring IV infusion site and promptly detecting any complication like phlebitis, infiltration, air embolism, infection and fluid overload. In children phlebitis is the most commonly seen due to their fragile veins and therefore special attention should be given to minimize the occurrence of phlebitis and also to treat it effectively.

Objective: to determine the effectiveness magnesium sulphate crystal fomentation vs glycerin magnesium sulphate paste application for phlebitis among children receiving peripheral infusion.

Setting & Design:Regional Advance Pediatric Care Center (RAPCC), Mangalore.

Material and Methods: Quasi experimental design phlebitis measurement chart and observation checklist for erythema.

Result and Conclusion: the mean pre-treatment scores of phlebitis were significantly reduced after the treatment with magnesium sulphate fomentation and with glycerin magnesium sulphate paste application. The mean post treatment score of phlebitis at p<0.05. Glycerin magnesium sulphate paste was effective in reducing swelling and induration when compared to magnesium sulphate crystal fomentation.
Validation of Standard of Living Scale with Comparison to Other Socio-Economic Scales in a Semi Urban Area of Mangalore : A Pilot Study
Authors: Priyadarisini N. J. , K. Rashmi , Kiran N. Udaya , Badiger Sanjeev
Published: April 2020

Introduction: Socioeconomic status is an important determinant of health condition of an individual or a family. Many tools are being used to assess the socioeconomic status. Each of the scales have their own advantages and disadvantages. But an appropriate and a standardized tool is yet to be developed

Objectives: To compare the standard of living based on different socioeconomic scales in a semiurban area of Mangalore and to assess the appropriateness of socioeconomic scales to be used in a semiurban area of Mangalore

Methodology: A cross sectional study was conducted in households of Kuthar and Manjanady villages of Dakshina Kannada district from June- August 2014. Questionnaire method was used to avail information about the socioeconomic status of the study population. The data was analysed using SPSS 16 software.

Results: Majority (70%) of the study population belonged to class IV of kuppuswamy scale. Whereas according to Modified BG Prasad scale majority of the population belonged to class III (35%) and class II (28%). According to Pareek's scale around 92% of population belonged to class IV. But when standard of living was assessed majority of them (62%) had high standard of Living.

Conclusions: We found that Standard of living is the better option in assessing the socio-economic status of a household as compared to all other scales whether be it urban, rural or semi urban.
Congenital Syndactyly of the Fingers : A Report of Two Cases
Authors: Shetty Sanath Kumar , Hegde Anoop , Mathias Lawrence John , Rai H. Ravindranath
Published: April 2020

Syndactyly is defined as the failure of separation of the digits during early gestation. It is one of the most common congenital anomalies. The incidence of syndactyly is uncertain, but estimates range from 1 in 2,500 live births. During development, the fingers are webbed. This remains so, until apoptosis and skin recession allow for formation of the digital interspaces. Full inter-digital spaces are usually present by the end of the 6th week of gestation.

Here we present two patients and three hands who presented to us with syndactyly of the fingers. The first patient who was a 13 year old girl, had complete complex syndactyly between the ring and middle fingers of both hands. She underwent complete release with full thickness skin grafting in the first sitting. Six weeks later, she was reviewed and was noted to have developed scar contracture of the middle finger for which she underwent contracture release and z-plasty as a secondary procedure. In the final review at four months after the second surgery, the child was noted to have only terminal restriction of movements of the involved fingers of both hands with 'fair results' (as per the criteria of Cortez et al).

The second patient was a two years old boy, who presented to us with incomplete simple syndactyly of the ring and index finger of the left hand. He was managed with percutaneous release of the syndactyly. He was reviewed after 4 months and there was full range of movement of the involved digits. He was also noted to have 'fair results' (as per the criteria of Cortez et al).

As we had two different cases with a heterogenous presentation of two different types of syndactyly and who underwent different modalities of management, we are presenting it as an interesting case report in our article.
Laparoscopic Marsupialization of a Giant Non-Parasitic Splenic Cyst (Npsc) in the Paediatric Age Group
Authors: Amonkar Amol Dilip , Raghushankar Raghushankar , Rai Sandeep , Khan Sattar , Ganesh G.V.
Published: April 2020

Nonparasitic splenic cysts are rare clinical lesions of the spleen. The management has entailed partial or total splenectomy via an open approach. Recently, laparoscopic approaches have been developed. In this report, we describe laparoscopic marsupialization of a giant splenic cyst (diameter > 15 cm).A 15-year-old Indian child presented with a four and a half year history of mass in upper left quadrant associated with left upper quadrant pain which increased since 2 days. Physical examination revealed a large, nontender left upper quadrant mass with minimal movement on respiration. Computed tomography scan confirmed a cyst arising from the spleen, measuring 20 x 15 cm suggestive of a primary splenic cyst. Echinococcus and Entamoeba histolytica serologies were negative. Laparoscopic exploration was performed. three liters of brown fluid were aspirated and intraoperative cytology confirmed a nonparasitic cyst. The cyst wall was excised, preserving the spleen. The patient's recovery was uneventful, and he was discharged, tolerating a regular diet on postoperative day 3. At follow-up, the patient was asymptomatic and showed no evidence of recurrence. Non-parasitic splenic cysts are rare lesions. Laparoscopic marsupialization is safe and effective and should be considered the treatment of choice even for giant splenic cyst.
A Descriptive Study on Cultural Practices about Menarche and Menstruation
Authors: Leena Sequira ,   Soumya
Published: April 2020

A descriptive study on cultural practices about menarche and menstruation was done with the objective to identify the cultural practices related to menarche and menstruation among women and to compare the difference in the cultural practices of different religions. A survey approach was used and subjects aged 18years and above were included in the study. Data were collected using demographic proforma and practice questionnaire on menarche and menstruation. Findings of the study revealed that 37% of the sample celebrates menarche and th 13% of the sample offered special pooja after 7th day of menarche.83% of the sample does not offer pooja/namaz and visit temple during menstruation. 68% of the sample do not apply kumkum which is offered to God. Hindus practice different practices like not applying the kumkum (100%) which is offered to God, do not visit temples (100%), enter the pooja room (92%), attend the religious functions (100%). where as Christians are not following any practices and Muslims (100%) cut nails, shave private part and are not doing namaz for seven days.

Conclusion: The findings of the present study revealed that majority of the Hindus believe that menstruation is unclean and they follow different practices.
Awareness on epidemiological factors of HIV/AIDS among nursing students in selected institutions in Dakshina Kannada
Authors: Kamath Neetha
Published: April 2020

Introduction: An integrated approach is strongly suggested for creating knowledge, attitudes, and awareness to control the spread of HIV/AIDS among young people as well as health care students.

Objectives: To determine the awareness on epidemiological factors of HIV/AIDS among nursing students.

Methodology: A quantitative approach with descriptive design was found suitable to conduct the study among 700 first year B Sc nursing students were selected using cluster sampling method from different nursing institutions. After obtaining the consent from the subjects a pretested and valid questionnaire on HIV/AIDs was administered to collect the data.

Results: All the students had information (86.1%) on HIV/AIDS mainly from T.V/Radio. It was found that majority of the subjects (63.3%) had poor awareness, 31.6% had average and only 5.1% of subjects had good awareness on HIV/AIDS.

Conclusion: It is evident from the study findings that the nursing students lack awareness on epidemiological factors of HIV/AIDs there is a need to have an education program before they are active in caring for the patient in hospital.
Effectiveness of Integrated Teaching Module among Final Year Medical students
Authors: Aroor Akshatha Rao , S. Dileep K. , Saya Rama Prakasha , Rao Sudheendra
Published: April 2020

Background: Didactic lectures and the current practice of teaching in Medical colleges has many limitations. Correlation and integration of knowledge into practice becomes difficult in the absence of integrated teaching at appropriate levels in medical curriculum.

Aim: To assess the effectiveness of the vertical integrated teaching method among the final year MBBS students and to study the attitude towards integrated teaching. Materials and Methods: This is a prospective study conducted among 102 final year MBBS students at a tertiary care medical college hospital in South India. The teaching was implemented by the active participation of faculty from the departments of Physiology, Pathology and General Medicine on a single topic. Students' knowledge about the subject before and after the session was evaluated by a questionnaire of 20 questions (Pre-test and Post-test). The mean score before and after the session was compared using the paired't' test. The students were also asked to give their feedback about the usefulness of this method in improving their knowledge.

Results: The mean scores before and after the session were 8.8± 2.87 and 16.88±1.23 (p value < 0.001). Majority of the students (97.1%) opined the need for integrated teaching to be a part of medical curriculum. Most of them (54.9%) felt the need for integrated teaching to be conducted monthly. On self-grading the knowledge on a scale of 1 to 10 before and after the session, the mean scores were 4.73±1.84 and 7.83±1.86 respectively (p value < 0.001). Conclusion: The integrated teaching was found to be an effective method of teaching. Medical students had a positive attitude towards integrated teaching.
A Study To Assess The Effectiveness Of A Planned Teaching Programme On Diabetes Mellitus And Its Management Among Asha Workers In Selected Areas Of Udupi District, Karnataka.
Authors: Thomas Monica Tonia , George Mariamma V. , Devi Elsa Sanatombi
Published: April 2020

Background: Diabetes is a chronic metabolic disorder which is prevalent throughout the world. ASHA workers are the grass root workers who have direct contact with the people in the community who can be of great help in empowering the diabetes individuals in their management.

Methods: The study used evaluative approach with one group pre-testpost-test design. Sixty ASHA workers of selected PHC's and CHC''s of Udupi District were selected for the study using non probability convenient sampling, technique. The instruments used for the study were Demographic Proforma, structured knowledge questionnaire on diabetes mellitus and its management. Descriptive and inferential statistics were used for analysis of the data.

Results: Majority 42(70%) of ASHA workers belongs to the age group of 31-40yrs and 28 (46.7%) of them had experience as ASHA worker with high school education. In the pre-test 17(28.3%)of ASHA workers had poor knowledge but in post-test, 28(46.7%) of them gained good knowledge which indicated that the planned teaching programme on diabetes mellitus and its management was found to be effective in improving the knowledge of ASHA workers. (T value- 14.226, p value -0.002).

Conclusion: The study concluded that the teaching programme was effective in bringing desirable changes in knowledge of ASHA workers.
A Submandibular Sialolith of an Unusual Size Presenting With a Cervical Fistula Mimicking a Branchial Fistula: A Case Report
Authors: Ballal Rajesh , Banu KhamarJaha , Pandya Kalpa
Published: April 2020

Sialoliths greater than 10 mm in size can be called as those of an unusual size. Only 7.65 % of the sialoliths are >15 mm. Cutaneous fistulas due to submandibular sialoliths are even rarer. A case of a submandibular gland sialolith of an unusual size presenting with a cervical fistula mimicking a branchial fistula has been reported. Intra-operatively, the fistulous tract was found to extend upto the supraclavicular space. Complete excision of the gland along with fistulous tract was performed. Histopathology revealed a sialolith with acute and chronic sialedinitis. The lesion also mimicked a Kuttnor's tumour however a final diagnosis of the same could not be made due to inconclusive Ig G value and absence of plasmacytic infiltration.
Dialysis Dependent 'Double Positive Disease' Responding To Immunosuppression: A Case Report
Authors: Baikunje Shashidhar , Vankalakunti Mahesha , Bhandary Adithi , Prakash P.S.
Published: April 2020

The outcome of patients with crescentic nephritis and the presence of both ANCA and anti GBM disease (double positive disease) is controversial. Initial data supported the view that this condition has a more favorable prognosis than anti GBM disease but larger and more recent series found much worse renal outcome especially in patients with severe renal failure requiring dialysis. We present a case with severe renal failure due to double positive disease who recovered renal function with aggressive immunosuppression including steroids, cyclophosphamide and plasma exchange.
A Rare Case of Fulminant Toxic Shock Syndrome Associated with Clostridium Sordellii Septic Abortion
Authors: Elagwany Ahmed S. , Anas Nehal
Published: April 2020

Endometritis and toxic shock syndrome associated with Clostridium sordellii havepreviously been reported after childbirth and, in one case, after medical abortion. Clinical findings included tachycardia, hypotension, edema, hemoconcentration, profound leukocytosis, and absence of fever. We describe a young woman who developed Clostridium sordellii toxicshock syndrome after having had an abortion surgically evacuated five days before admission to our hospital. Although the patient was aggressively treated, death occurred <3 days after admission. It is hoped that very early recognition of this disease will decrease the mortality associated with this rarely reported ailment.
Lower Third Molar Space and Angulation in Individuals with Lower Anterior Crowding
Authors: Cherian Merin , Ravi M. S.
Published: April 2020

Background: The role and involvement of mandibular third molars on mandibular incisor crowding, post retention, in orthodontically treated patients has long been debated. The correlations between lower anterior crowding and lower third molar angulation and space are not completely understood.

Aim: To assess the lower third molar space and its angulation in individuals with lower anterior crowding and to compare it with that of individuals without lower anterior crowding.

Settings and design: Hospital based Prospective, cross-sectional study on randomly selected individuals.

Materials and Methods: Lower third molar space and angulations were measured and compared using orthopantomograph tracings of 80 subjects in the age group of 20-30 years with skeletal Class I malocclusion individuals without lower anterior crowding(Group A) and individuals with lower anterior crowding (Group B).

Statistical Analysis: Both the space and angulations of lower third molar were correlated with the lower anterior crowding using Pearson Correlation Coefficient.

Results: Significant differences were found in third molar space between the study group and the control group. But there was no significant difference in third molar angulation between the groups.

Conclusion: the lower anterior crowding has a significant influence on third molar space but did not have any effect on third molar angulation.