bluuebunny/crossref_metadata_2025 huggingface dataset:
Total intravenous anaesthesia to facilitate bulbocavernous reflex in a 2-year-old child with tethered cord syndrome: A case report
Authors: Rajappa Deepak , Mittimanj Kavya , Masapu Dheeraj , Chandrashekar Shishir , Rudrappa Satish
Published: March 2021

Tethered cord syndrome is a neurological disorder caused by tissue attachments that limit the movement of the spinal cord within the spinal canal. Intraoperative neurophysiological monitoring like somatosensory evoked potentials and transcranial motor evoked potentials can preclude surgically induced lesions to the nervous system and has become standard of care for many neurosurgical procedures. Despite the potential advantages of total intravenous anaesthesia, it is not a widely used anaesthetic technique in children. Recently, a few case reports have been published regarding the presence of metabolic acidosis even with a short term infusion of propofol. We present a case report in which total intravenous anaesthesia was used to facilitate BCR in a 2-year-old child, to monitor the functional integrity of the sacral reflex, which enables bladder and bowel function.
Anaesthetic management of a case of severe preeclampsia with hemiplegia undergoing emergency caesarean section: A case report
Authors: Deb Prakash , Das Rituparna , Bhattacharya Prithwis , Singh Aashish K
Published: March 2021

Cerebrovascular accident in pregnancy may occur as a complication of hypertensive disorders of pregnancy & urgent non-contrast computed tomography brain is required to rule out intracerebral haemorrhage along with other investigations to find the underlying aetiology. Management of cerebrovascular accident during pregnancy may be conservative, neurosurgical or thrombolysis. However, if associated with raised intracranial pressure, priority should be given to airway protection, ventilation, reduction of intracranial pressure & neuroprotection along with the definitive treatment. We report herein a case of cerebrovascular accident who presented at term pregnancy with hemiplegia with impending eclampsia & foetal distress with deteriorating Glasgow Coma Scale requiring urgent stabilisation & emergency caesarean section prior to any brain imaging to establish the cause rendering the anaesthetic management challenging.
A retrospective study - epidemiological analysis of traumatic spinal injuries in Rajasthan, India
Authors: Chand Gautam , Avtar Malav Ram
Published: March 2021

Traumatic spinal injuries (TSI) are major source of morbidity and motility throughout the world. Epidemiological study of TSI has an important role in future planning for prevention and management of them. Aim of this study was determine epidemiology of TSI in Jhalawar Rajasthan state of India.

Retrospective analysis of patients hospital data records, admitted in Jhalawar medical college Rajasthan from January 2018 to Dec. 20019 (Period of Two Years).

One hundred and fifty eight cases of traumatic spinal injuries reported in period of two years from January 2018 to December 2019.

Male to female ratio was 2.16:1, the most prevent age group was 30-39 years (27.8%) followed by 20-29 years (19%). Fall from height (unprotected roof, well, tree, construction site/electric pole) was most common mode of injuries (44.9%) followed by road traffic accidents (43%). Most common level of injury was lumbar spine (55%) followed by thoracic spine (22.78%). Other associated injuries with TSI were head injuries (9.5%) and extremities injuries (9.5%).

Maximum number of TSI cases was reported during summer season (may-14.5% and June 15.8%).

TSI is major source of morbidity and mortality in Rajasthan India. Younger age group and Male are more commonly affected as compare to older age group and female. Accidental fall and RTA are major cause of TSI.
Oral 600mg misoprostol vs manual vacuum aspiration (MVA) for the management of incomplete abortion- a randomized controlled trail
Authors: Dutta Indranil , Mondal Woothvasita , Mondal Debraj
Published: March 2021

Approximately one in five recognized pregnancies are spontaneously miscarried in the first trimester and an additional 22% end in induced abortion. Incomplete abortion occurs when there are retained products of conception (POC) after induced abortion (whether by unsafe or safe methods) or after spontaneous abortion, also known as miscarriage. Some women may resort to self-induction. These conditions increase the likelihood that women will experience abortion complications and will seek treatment for incomplete terminations. Incomplete abortion can be treated with expectant management, which allows for spontaneous evacuation of the uterus, or active management, using surgical or medical methods. Expectant management is not preferred by many providers due to its relatively low efficacy and the fact that the time interval to spontaneous expulsion is unpredictable.

The study was performed in a Durgapur Steel plant hospital, a tertiary care Hospital in West Bengal, India. The institute caters a huge area, both rural and urban. The study was done between 1st January2019 to 31st October 2020.

Study population was drawn from patients attended OPD and patients admitted with incomplete abortions, either of spontaneous or, induced etiology in the Dept. Of Obst, & Gynae, Durgapur Steel plant hospital. A total of 80 women were randomised to either a single dose of 600 micrograms of oral misoprostol or MVA.

160 women were recruited to the trial, of which 80 women were grouped into misoprostol group & another 80 to MVA group. Immediately after abortion, all the patients were available & data collected from all the patients. But during next follow-up after 1-2 wk, 33 in the MVA group & 27 in the misoprostol group did not come (Lost to follow up n=33) for follow-up. So, approximately 41% (33) of participants in MVA group & 34% (27) in the misoprostol group were lost to follow-up.

In our study both MVA & Misoprostol groups had similar age distribution. Mean age in MVA group 23.5 years (± 4.5) and in MISO group 23.4 Years (± 4.8).

For treatment of first-trimester uncomplicated incomplete abortion, both manual vacuum aspiration and 600 µg oral misoprostol are safe, effective, and acceptable treatments.

However, misoprostol appears to be somewhat better option than MVA, in regards to availability, low cost of therapy, less pain, less need of expert manpower or specialised instruments.
Comparison of dietary pattern and BMI in South Indian women with PCOS and controls
Authors: Gopalan Ushadevi , Ghose Seetesh , Karnaboopathy Ranganathan
Published: March 2021

Polycystic ovarian syndrome is the most common endocrine and metabolic heterogeneous disorder among reproductive-aged women. Obesity worsens the metabolic, clinical and endocrine features of PCOS, mainly by increasing insulin resistance and hyperinsulinemiaObesity rates are increasing due to changing lifestyles, including unhealthy food habits. The objective of this study was to characterize the dietary pattern and BMI of PCOS women and to compare it with healthy controls.

This study was a case-control study. Study Population was women in the age group 15-45 years with complaints s/o PCOS and age matched control group .PCOS cases were diagnosed using Rotterdam criteria and the controls were age matched women without PCOS. All the women were subjected to a detailed history taking and physical examination. The data was entered in Excel sheet and Statistical analysis was done using SPSS version 23.

The average age of PCOS cases was 24.64 years. There was a statistically significant increase in history of snacking with ingestion of high caloric and oily food in PCOS cases compared to control women. PCOS women were more overweight and Obese compared to Control women and this difference was also statistically significant.

The results of this study suggests with PCOS is associated with an increased intake of food high in calorie and saturated fat and that women who are obese or overweight are more likely to develop PCOS. Lifestyle modifications like healthy diet and regular exercise should be the front line therapy in PCOS women.
Estimation of incidence of Aerobic vaginitis in women presenting with symptoms of vaginitis
Authors: Vidyasagar Veena
Published: March 2021

Vaginitis is found to be quite common among women who present in Gynecology OPD. Aerobic vaginitis is one of the causes of vaginitis which is typically marked by either an increased inflammatory response or by prominent signs of epithelial atrophy or both. The main aim of the study was to analyze the signs, symptoms and laboratory investigations among women presenting with symptoms of vaginitis.

The study consisted of 155 cases of women presenting with symptoms of vaginitis. Brief general, systemic and detailed gynecological examinations were done and analysed.

The incidence of Aerobic vaginitis in the study group was observed to be 7.74%. All cases of Aerobic vaginitis had unusual vaginal discharge as the presenting symptom. It was observed that 50% of cases had additional complaints of pruritus vulvae and vaginal irritation while 25% cases had complaints of dysuria and dyspareunia. pH of vaginal smears of these cases varied from 6 to 10, average being 7.75. On Gram staining, there were moderate to plenty number of pus cells and few to moderate number of epithelial cells. Organisms grown included Coagulase negative Staphylococci; Streptococci and Klebsiella species. Other causes of vaginitis included Candida - 14.19%, Trichomoniasis - 6.45% and Bacterial vaginosis 7.09%.

The study concluded that the incidence of Aerobic vaginitis in the present study was less as compared to other studies. It is advisable to do culture with an antimicrobial sensitivity to find out the cause of vaginitis especially in cases presenting with recurrent symptoms of vaginitis. The type of antibiotics used to treat vaginitis must be very selective in order not to kill the beneficial bacteria that help in preservation of vaginal health and ecosystem.
The comparison of total capacity antioxidant in the serum of people with pterygium and control subjects
Authors:   Department of Ophthalmology, Social Determinants of Health Research Center, Birjand University of Medical Science, Birjand 9717964151, Iran, Behrooz Heydari , Asghar Zarban ,   Department of Ophthalmology, Social Determinants of Health Research Center, Birjand University of Medical Science, Birjand 9717964151, Iran, Abbas Hosseini Rad ,   Department of Ophthalmology, Social Determinants of Health Research Center, Birjand University of Medical Science, Birjand 9717964151, Iran, Akram Feizmohammadi ,   Department of Ophthalmology, Social Determinants of Health Research Center, Birjand University of Medical Science, Birjand 9717964151, Iran
Published: March 2021

AIM: To investigate the comparison of total antioxidant capacity in the serum of patients with pterygium and control subjects.
METHODS: This case-control study was conducted on all persons referred to Ophthalmology Clinic of teaching Hospital of Vali-Asr (peace upon to him) with clinical symptoms of pterygium during the year 2016. The control group was selected among patients referred to the Ophthalmology Clinic of Vali-Asr (peace without pterygium) that the two groups were matched in terms of age, gender and place of residence. Sixty-six persons [31 people (47%) in patient group and 35 people (53%) in the control group] were enrolled by convenience sampling. Venous blood sample was taken from all patients after the sampling using ferric reducing antioxidant power (FRAP); FRAP- as a quick 10min measurement, the antioxidant power measurement of samples according to the conversion of ferric iron (Fe3+) to ferrous iron (Fe2+) was checked. The collected data ware entered to software SPSS 21 and were analyzed by chi-square and Mann-Whitney tests at the level of α =0.05.
RESULTS: The mean of antioxidant capacity in patients was 842/55±161/46 μmol/L and antioxidant capacity in healthy controls was 856/77±209/41 μmol/L (P=0.8). In the comparison of mean serum antioxidant capacity in healthy individuals and in the serum of people with pterygium based on gender the results showed that the antioxidant capacity mean in male control subjects has been 894/05± 176/82 μmol/L and in females control 780/01±118/33 μmol/L that the observed difference have been reported statistically significant (P=0.008) but the other comparison according the gender between cases and control does not show any significant difference.
CONCLUSION: The results of this study showed that the full level of serum antioxidant capacity in patients has been less than the mean of antioxidant capacity in control subjects; however, the observed difference has not been significant. The results of this study were consistent with basic results carried out on the damaging effects of oxidative stress in the pterygium pathogenesis. Recommending diet with minerals and vitamins containing antioxidants may be preventing the onset and progression of pterygium.
Transfection of CTGF siRNA inhibits transdifferentiation in human lens epithelium cell line B3 in vitro
Authors:   Eye Center of the First Affiliated Hospital of Fujian Medical University, Fujian Eye Institute, Fuzhou 350000, Fujian Province, China, Zhuang Hua , Wu Jing ,   Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510000, Guangdong Province, China, Xu Wei ,   Eye Center of the First Affiliated Hospital of Fujian Medical University, Fujian Eye Institute, Fuzhou 350000, Fujian Province, China, Hu Jian-Zhang ,   Eye Center of the First Affiliated Hospital of Fujian Medical University, Fujian Eye Institute, Fuzhou 350000, Fujian Province, China, Xie Mao-Song ,   Eye Center of the First Affiliated Hospital of Fujian Medical University, Fujian Eye Institute, Fuzhou 350000, Fujian Province, China, Guo Jian ,   Eye Center of the First Affiliated Hospital of Fujian Medical University, Fujian Eye Institute, Fuzhou 350000, Fujian Province, China, Xu Guo-Xing ,   Eye Center of the First Affiliated Hospital of Fujian Medical University, Fujian Eye Institute, Fuzhou 350000, Fujian Province, China
Published: March 2021

AIM: To investigate the expression of connective tissue growth factor (CTGF) and α-smooth muscle actin (α-SMA) in human lens epithelium cell (HLEC) line B3 after transfection by liposome-coated small interfering RNA (siRNA) targeting CTGF.
METHODS: HLECs were transfected with siRNA targeting CTGF, labeled with 5’-fluorescein isothiocyanate (5’-FITC) and coated with lipofectamine. The transfection ratio was evaluated via fluorescence intensity. Cell counting kit-8 (CCK-8) assay was performed to assess cytoviability of both non-transfected and transfected HLECs. Quantitative reverse transcription-polymerase chain reaction (RT-PCR), cell immunochemistry and Western blot analysis were conducted to detect the expression changes of CTGF and α-SMA after transfection.
RESULTS: A highly effective transfection ratio was observed in siRNA co-transfected with lipofectamine. The transfection ratio reached 95% at 24h. The proliferation of HLECs was inhibited by siRNA after 72h transfection. The expression of CTGF and α-SMA significantly decreased in HLECs after transfected by CTGF siRNA for 24h. This effect was not found in negative control siRNA.
CONCLUSION: siRNA targeting CTGF decrease CTGF and α-SMA expression in HLECs, which is a potential therapeutic strategy for posterior capsular opacification.
Exploring Patient Safety Culture in a Kuwaiti Secondary Care Setting
Authors: Alqattan Hamad , Cleland Jennifer , Morrison Zoe , Cameron Isobel M.
Published: March 2021

Objectives: Qualitative studies can improve understanding of patient safety culture (PSC), which has been relatively neglected by researchers in the Gulf Cooperation Council context. This study employed a qualitative approach to explore healthcare staff and patients’ perceptions of PSC and how it can be improved. Methods: This qualitative study was conducted in a public hospital in Kuwait. Individual face-to-face interviews were used to understand the experience of healthcare staff and patients concerning PSC. After obtaining the required ethical approvals, maximum variation sampling was used. Interviews were recorded and transcribed. The analysis was inductive and thematic. Results: A total of 51 participants were included in this study (35 healthcare professionals and 16 patients). Data analysis revealed four overarching themes relevant to the research question: (1) workload; (2) communication; (3) environmental constraints; and (4) incident reporting. These issues were interrelated in practice. Kuwaiti and non-Kuwaiti participants held different views, particularly about the response to errors and expatriate staff members’ clinical skills. Conclusion: This study revealed multiple factors related to workload, communication, healthcare environment and incident reporting, which hindered the promotion of positive PSC in the included department. The presence of numerous constraints suggests that multiple interventions which target both individual and organisational levels should be implemented.
 
KEYWORDS
Health Services Research; Patient Safety; Safety Culture; Kuwait.
The Lived Experience of Victims of Catastrophic Coastal Erosion
Authors: Yesodharan Renjulal , Jose Tessy T. , Roach Erna J.
Published: March 2021

Objectives: Environmental hazards are part of the Earth’s natural cycle and are ongoing within human history. When vulnerable situations meet environmental hazards, disasters occur where human and natural costs could be enormous. This study aimed to explore the experiences of the victims of coastal erosion during the monsoon season. Methods: Seven victims of catastrophic coastal erosion in the Kollam District of Kerala, India, were interviewed from December 2013 to February 2014. The study followed Edmond Husserl’s descriptive phenomenological method. Result: These interviews constituted the primary data source. Three main themes with eleven subthemes emerged from these data. The main themes were impact, consequences and recovery. The subthemes were living in constant fear, escaping from the catastrophe; cataclysmic sea waves and their tumultuous behaviour, instant damage and destruction, the epoch of losses; agony and suffering; homelessness-helplessness-sleeplessness mixed with fear; government aid only in dreams; haunting memories; never-ending daily needs; first home and native land; and the desire to go back to the site of the disaster. Conclusion: From the derived themes, a phenomenon associated with coastal erosion evolved. The phenomenon is termed “Catastrophic coastal erosion: A cycle of impact, consequences, and recovery”.
 
KEYWORDS
Disaster Victims; Ecological and Environmental Phenomena; Natural Disasters; Oceans and Seas; Quality of Life; Qualitative Research; Tsunamis; India.
Bilateral Systematised Epidermolytic Epidermal Nevus
Authors: Kerawala Sabeika R. , Rizvi Najam-us-Saher , Tabassum Saadia
Published: March 2021

Verrucous epidermal nevi (VEN) are benign congenital hamartomas consisting of keratinocytes. Histological examination mostly exhibits hyperkeratosis, acanthosis, papillomatosis and, rarely, the features of epidermolytic hyperkeratosis (EHK). We report a case of a 6-year-old boy who presented at Aga Khan University Hospital, Karachi, Pakistan with bilaterally symmetrical linear epidermal nevi following Blaschko’s lines and showing epidermolytic hyperkeratosis on histology. The patient was treated with topical keratolytics and emolients which led to considerable improvement. To the best of the authors’ knowledge, this is the first report of VEN from Pakistan.
 
KEYWORDS
Verrucous Epidermal Nevus; Mosaicism; Epidermolytic Hyperkeratoses; Hamartoma; Case Report; Pakistan.
Public Health Education through the Lens of Social Media
Authors: Ali Khawla F.
Published: March 2021

NONE
Crystal structure of timothy grass allergen Phl p 12.0101 reveals an unusual profilin dimer
Authors: O’Malley Andrea , Kapingidza A. Brenda , Hyduke Noah , Dolamore Coleman , Kowal Krzysztof , Chruszcz Maksymilian
Published: March 2021

Timothy grass pollen is a source of potent allergens. Among them, Phl p 1 and Phl p 5 are thought to be the most important, as a majority of timothy grass-allergic individuals have IgE antibodies directed against these two allergens. The profilin from timothy grass (Phl p 12) has been registered as a minor allergen, with up to 35% of individuals in populations of grass pollen allergic patients showing IgE binding to Phl p 12. Profilins are primarily minor allergens and are known for a high likelihood of co-sensitization as well as cross-reactivity situations caused by their sequence and structure similarity. The crystal structure of Phl p 12.0101 was determined and it revealed that this allergen may form an unusual dimer not previously observed among any profilins. For example, the Phl p 12 dimer has a completely different geometry and interface when compared with the latex profilin (Hev b 8) dimer that has its crystal structure determined. The structure of Phl p 12.0101 is described in the context of allergenic sensitization and allergy diagnostics. Moreover, the structure of the Phl p 12.0101 dimer is discussed, taking into account the production of recombinant allergens and their storage.
Interactions of new lactoglobulin variants with tetracaine: crystallographic studies of ligand binding to lactoglobulin mutants possessing single substitution in the binding pocket
Authors: Loch Joanna , Bonarek Piotr , Siuda Monika , Wróbel Paulina , Lewiński Krzysztof
Published: March 2021

β-Lactoglobulin (BLG) like other lipocalins can be modified by mutagenesis to re-direct its ligand binding properties. Local site-directed mutagenesis was used to change the geometry of the BLG ligand binding pocket and therefore change BLG ligand preferences. The presented studies are focused on previously described mutants L39Y, I56F, L58F, F105L, and M107L and two new BLG variants, L39K and F105A, and their interactions with local anesthetic drug tetracaine. Binding of tetracaine to BLG mutants was investigated by X-ray crystallography. Structural analysis revealed that for tetracaine binding, the shape of the binding pocket seems to be a more important factor than the substitutions influencing the number of interactions. Analyzed BLG mutants can be classified according to their binding properties to variants: capable of binding tetracaine in the β-barrel (L58F, M107L); capable of accommodating tetracaine on the protein surface (I56F) and unable to bind tetracaine (F105L). Variants L39K, L39Y, and F105A, had a binding pocket blocked by endogenous fatty acids. The new tetracaine binding site was found in the I56F variant. The site localized on the surface near Arg124 and Trp19 was previously predicted by in silico studies and was confirmed in the crystal structure.
Ultrasonik Yöntemler ile Çelik-lif Takviyeli Betonda Eğilme Çatlaklarının Derinlik Tayini
Authors: KIRLANGIÇ Ahmet Serhan
Published: March 2021

Betonda eğilme çatlaklarının derinliklerin tespit edilmesi, yapısal elemanların kalan yük taşıma kapasitelerinin tayini için önem taşımakladır. Uygulamada, mevcut tahribatsız ultrasonik test yöntemleri çatlak derinliğinin tespitinden ziyade ya elemanların kalınlıklarının ölçülmesinde ya da mukavemet tayininde kullanılmaktadır. Bir cisim içinde yayılmakta olan ultrasonik dalgalar bir çatlak ile karşılaştıkları zaman dalga karakteristiklerinde değişim gözlemlenir. Bu değişimin takibi ve ölçümü ile çatlak derinliğinin tayini mümkündür. Bu makale, bu yaklaşıma dayanarak geliştirilen tanı metodunu, 7 adet çelik-lifli beton kiriş numune (50x10x10 cm3) üzerinde gerçekleştirilmiş olan ultrasonik testler üzerinden incelemektedir. Kiriş numeneler çatlak-kontrollü üç-noktalı-eğilme testi ile belli bir çatlak derinliğine ulaşılana kadar hasara uğratılmış ve akabinde gerçekleştirilen ultrasonik testler ile dalga yayılımı kaydedilmiştir. Kaydedilen dalga sinyal serileri, ayrık wavelet dönüşüm ve frekans-dalganumarası analizi gibi dijital sinyal işleme teknikleri ile analiz edilerek iki tip tanı indeksi elde edilmiştir. İlk tanı indeksi malzeme sönüm katsayısı α, dalga sönümünü; diğer tanı indeksi ‘dağılım indeksi DI’ ise, dalgaların faz hızındaki dağılımı temsil etmektedir. Her iki tanı indeksinin de çatlak tespiti ve derinlik tahmininde faydalı oldukları görülmüştür.
A Randomised Double-Blind Trial of Pentoxifylline Alone versus Pentoxifylline Plus N Acetyl Cysteine in the Treatment of Severe Alcoholic Hepatitis in a Tertiary Care Hospital in Mysore, Karnataka
Authors: Lavekar Anurag , Suvarna Deepak , V Aradya , P Nandeesh , R Vijayakumar , Reddy Rithesh
Published: March 2021

BACKGROUND Proven therapeutic options for treating severe alcoholic hepatitis are limited. The study was conducted to compare pentoxifylline alone versus combination of Pentoxifylline plus N acetylcysteine in severe alcoholic hepatitis patients. METHODS A randomised, parallel, double blind, active controlled trial was conducted in which, 240 cases were considered for analysis and were divided into two study groups i.e. tablet pentoxifylline alone versus tablet pentoxifylline plus tablet N acetylcysteine. The pentoxifylline group received 400 mg thrice daily for one month and the other group received tablet pentoxifylline 400 mg thrice daily with tablet N–acetyl cysteine 600 mg twice daily for one month. Enrolled patients were called for follow up at one and three months. The parameters were compared between the two study groups statistically and the results were obtained. RESULTS Forty-nine (20.4 %) patients expired in 3 months, out of which 35 (14.5 %) expired at the end of 1st month. There was no significant difference in survival between two groups at the end of one and three months (P = 0.58 and 0.10 respectively). Although liver function test (LFT), PT-INR (prothrombin timeinternational normalised ratio) improved significantly from baseline in both the groups (P < 0.0001), no significant difference was observed between the two groups. Prevalence of hepatic encephalopathy was significantly low in pentoxifylline plus N-acetylcysteine group at one and three months (P = 0.04 and 0.02 respectively). CONCLUSIONS Addition of N acetyl cysteine to pentoxifylline helps in reducing hepatic encephalopathy in patients with severe alcoholic hepatitis; however, it does not improve the short-term survival. KEYWORDS Pentoxifylline, N-acetylcysteine, Alcoholic Hepatitis, Liver Disorder
A Morphological Cross-Sectional Study of Metopic Suture in Human Adult Cadaveric Skulls
Authors: Tale Archana Kundlikrao , Ali Fatima Bhopalwala , Tale Suvarna Kundilkrao , Gupta Jitendra , Fupare Santosh Shravanrao
Published: March 2021

BACKGROUND Metopic suture is located anterior to the coronal suture. There are two types: complete and incomplete metopic sutures. Knowledge regarding the metopic sutures in adults is necessary to avoid misinterpretation of radiographs as frontal bone fracture. Knowledge with regard to metopic suture is helpful for anatomists and medico legal experts. This study has been done to find out the incidence of metopic suture, classify the metopic sutures into complete and incomplete type and further classify the incomplete variety based on shape. METHODS This study was conducted on 50 skulls from the Department of Anatomy, Autonomous Government Medical College and Hospital, Ratlam (MP). Skulls with signs of disease and damaged skulls were excluded from the study. RESULTS In the present study, out of 50 dry adult cadaveric skulls, 2 skulls (4 %) showed complete metopism. Incomplete metopic sutures were present in 28 / 50 (56 %) and absent in 20 / 50 (40 %). Out of 28 incomplete metopic sutures, single linear metopic sutures were present in 12 / 28 (42.85 %). Double linear metopic sutures were present in 7 / 28 (25 %). V-shaped metopic sutures were present in 5 / 28 (17.85 %) and U shaped metopic sutures were present in 4 / 28 (14.28 %). CONCLUSIONS Detailed knowledge of the metopic suture is important for neurosurgeons and radiologists in routine practice. Vertical frontal bone fractures may be easily misdiagnosed with persistent metopic sutures. This anatomical knowledge of metopic sutures is very useful for doctors while treating traumatised patients and during surgical intervention including frontal craniotomy. KEYWORDS Suture, Metopism, Frontal Bone, Nasion, Bregma
Auditory, Visual and Postural Reaction Time Among Middle Aged Type 2 Diabetics and Healthy Individuals – A Cross-Sectional Study
Authors: S Mishra Siddharth , Dhotre Vibha
Published: March 2021

Objective: Study aims to compare Auditory, Visual and Postural RT among middle aged type 2 diabetics and healthy individuals.
Materials and Methods: A Cross-Sectional Study which included 200 Participants that met inclusion and exclusion criteria, were divided into 2 groups. Diabetic group included 100 participants who were clinically diagnosed with type 2 Diabetes and healthy group insldued 100 healthy participants. Both the groups performed Auditory Reaction Time test (ART) and Visual reaction time test (VRT) using Inquisit 4.0 computer software, Ruler drop test (RDT), Wobble Board (WB) Test and Timed up and go test (TUGT) was performed.
Results: Statistical analysis (independent sample T-test) revealed a significant delay in VRT (P-value= 0.001), ART (P-value= 0.001), Wobble Board Test (P-value= 0.001) and TUGT (P value= 0.001) among diabetic group compared to healthy group. There is no significant difference in Ruler drop test (P-value= 0.919) among both the groups.
Conclusion: There was is a significant delay in RT among middle aged type 2 diabetic participants when compared to healthy participants. This is associated with reduced sensory stimuli from various systems and resulting in late response in diabetic group.
Prevalence and Incidence of Obesity, Overweight & Abdominal Obesity in Adults: A 5-year Longitudinal Study in Ahvaz (2009-2014)
Authors: Erfanifar Azam , Latifi Seyed Mahmoud , Shahbazian Hajieh , Moravej Aleali Armaghan
Published: March 2021

Objective: The data on the changes in the prevalence of obesity and overweight could help policy makers to make better plans for improving the health status of people; hence, the aim of his study is to evaluate the prevalence and incidence of overweight, obesity and abdominal obesity in Ahvaz during five years.
Materials and Methods: Cohort study was the method of choice in this survey, conducted on 605 people aged over 20 years who were selected among the people covered by health centers in Ahvaz. The participants weight, height, and waist circumferences were measured two times in 2009 and 2014. The incidence and prevalence of obesity, abdominal obesity and overweight were evaluated. The SPSS 22 statistical software was used to analyze the data, and paired T-test to compare the level of changes. The significant level for P-value < 0.05.
Results: Among 605 people aged over 20 years, the prevalence of overweight, obesity and abdominal obesity in 2009 and 2014 were respectively: overweight (40% and 38.50%), obesity (26.90% and 27.10%), and abdominal obesity (26.80% and 33. 90%).This prevalence increased from 11.70% to 14.90% in men and from 39.90% to 50.50% in women. The incidence of overweight, obesity and abdominal obesity were respectively 102.50, 22.50 and 76.5 per 1000 person’s year in Ahvaz people.
Conclusion: The findings of our study showed that the prevalence of overweight, obesity and abdominal obesity in adult population in Ahvaz is high. Also, the prevalence of obesity and abdominal obesity in women is higher than men; therefore special attention must be paid to this issue in women. Also the age groups 35-64 years are higher risk.
Risk Factors of Anthroponotic Cutaneous Leishmaniasis Among Residents in Endemic Communities in Southeast of Iran in 2019
Authors: Alizadeh Ismaeil , Gorouhi Mohammad Amin , Sharifi Iraj , Zamaninasab Zahra , Hazratian Teimour , Aghaei Afshar Abbas
Published: March 2021

Introduction: In this study, we aimed to identify the risk factors associated with the incidence of A.C.L in three endemic areas of Kerman City. Moreover, the residents’ knowledge, attitudes, and practices towards A.C.L were assessed.
Materials and Methods: A descriptive cross-sectional study was conducted among 195 residents of three endemic areas in Kerman City involved by A.C.L disease from January to March 2019. The risk factors for A.C.L were recorded using a checklist. Structured questionnaire was administered for data collection. Data were analyzed by ANOVA, correlation analysis, and linear regression via SPSS version 22.
Results: The main risk factors for A.C.L identified in the study areas included construction waste, presence of old and dilapidated houses, poor sanitary conditions, refugee and immigration, as well as the presence of domestic animals in close physical proximity to humans. The response rate of this questionnaire was 100 %. Among the respondents, 41.5 % were males and 58.5 % were females. Majority of the respondents (61%) claimed that they had heard about A.C.L and were familiar with this infectious disease. Only 25%, 66.7%, and 32% of the respondents had good knowledge, attitudes, and practices towards A.C.L, respectively. No significant association was found between the participants’ gender and their levels of knowledge (P = 0.827), attitudes (P = 0.446), and practices (P = 0.603).
Conclusions: The residents of endemic areas had a weak level of knowledge towards A.C.L. So, educational programs should be implemented in order to improve the residents’ knowledge in Kerman City.
Biosafety assessment of Fig (Ficus carica) leaves, an alternative preservative agent
Authors: Bankefa Olufemi Emmanuel , Gabriel-Ajobiewe Ruth Adefolakemi , Evelyn Ajayi Olubunmi , Ayilara-Akande Simbiat Olufunke , Oladeji Seye Julius , Kayejo Gbenga Victor
Published: March 2021

Due to the global disturbance of chemical resurgence in food, Fig leaves (Ficus carica) had been made to be applied as preservatives to extend the shelf life of perishable foods and to address chemical toxicity concern, despite limited information regarding its biosafety. Hence, the need to affirm the safety of this plant in-vivo was studied. Extracts of Fig leaves were mixed with basal diet and used as feed for one group of Wistar albino rats (treated group) while the second group was fed with sole basal medium to serve as control. The blood samples of both groups were taken before the rats were subjected to cervical dislocation. Haematological and histological parameters were studied to know the effects of the extracts and in order to justify the usage of plant extracts as preservatives for perishable foods. The haematological parameters of the treated group were higher than the control except for the insignificant changes in lymphocytes, basophils and eosinophils. Furthermore, the histological study revealed no sign of lesions in the all organs examined from both groups. The adoption of Fig leaf as preservatives has no contra-indication on the organs or blood parameters. Hence the global adoption as alternative preservative agents is undoubtedly recommended.
A survey on the occurrence of aflatoxin M1 in raw milk samples in Bafq and Bahabad, Iran
Authors: Safavizadeh Vahid , Mojkar Mozhgan
Published: March 2021

Aflatoxins are a group of mycotoxins mostly produced by the fungi called Aspergillus flavus, Aspergillus parasiticus, and Aspergillus nomium. Aflatoxin M1 (AFM1) is the major metabolite of aflatoxin B1 and is a hepatotoxic and carcinogenic toxin. The aim of this study was to determine the level of contamination of cow's milk with aflatoxin M1 in Bafq and Bahabad. For this study, samples of raw cow's milk were collected randomly from milk collection centers around the city of Bafq and Bahabad from March to April. The determination of aflatoxin M1 levels was based on the ELISA method. Contamination was observed in 100% of milk samples. According to the results of the study, the rate of contamination with aflatoxin M1 in 43.3% of milk samples was above the acceptable level (50 ng/L) in Iranian national standard. It is concluded that further monitoring of milk production should be carried out in the spring and winter seasons.
Antibiotic resistant bacteria in raw cow milk and milk products retailed in the northern region of Ghana; a food safety challenge
Authors: Vicar Ezekiel Kofi , Feglo Patrick K. , Acquah Samuel E. K. , Williams Walana , Saba Courage K. S. , Mensah Gloria Ivy
Published: March 2021

The presence of antimicrobial resistant foodborne bacteria is a major food safety challenge for food that is consumed raw. Abuse and overuse of antibiotics in the agriculture sector has been identified as a contributory factor to the rising threat of antibiotic resistance. In many developing countries where milk is marketed and consumed raw through informal channels, the occurrence of bacterial contamination is high and poses a major public health risk. This situation is exacerbated when caused by antimicrobial resistant bacteria. Hence this study was conducted to determine the antimicrobial resistant pattern of bacteria in raw cow milk and milk products retailed in the Northern Region of Ghana. Antibiotic resistance profiles were established for 150 bacteria isolates (Escherichia coli, E. coli O157:H7, Klebsiella pneumonia, Staphylococcus aureus, Pseudomonas aeruginosa, Salmonella spp. Shigella spp. and Proteus spp.) obtained from the culture of raw milk (n=210) and milk products (n=60) retailed within the Northern region of Ghana. Susceptibility to nine antimicrobials commonly used in veterinary and human medical practice was performed on all the isolates using the agar disc diffusion method according to Clinical and Laboratory Standards Institute guidelines. Isolates showed highest resistance to Nalidixic acid followed by Chloramphenicol, Gentamicin, Trimethoprim-sulfamethoxazole and Ceftriaxone but were most susceptible to Ciprofloxacin and Ampicillin. About 25 – 47.6 % of Staphylococcus aureus showed resistance to Cefoxitin. Milk and milk products sold in the northern region of Ghana are contaminated with bacterial pathogens with high levels of antimicrobial resistance. A one health approach is required to curtail the threat of antibacterial resistant bacteria in the food chain.
Occurrence of antibiotic resistant Escherichia coli and Staphylococcus aureus in streetvended beverages accessible in an industrial zone of Bangladesh
Authors: Jahan Mueena , Rahaman Sumon S. M. Mostafizur , Md. Selim Abu Sadeque , Rahman Md. Morshedur
Published: March 2021

The street-vended fruit beverages are considered as a source of disease causing microorganisms despite their high consumer demand and nutritional value. The study was conducted for the assessment of antibiotic resistance food-borne pathogens in street-vended fruit beverages available in an industrial zone of Bangladesh. A total of 50 samples constituting five different types of street-vended fruit beverages were collected from Gazipur city of Bangladesh. All the samples were examined for total viable microbial count followed by isolation, identification and antibiogram profile of Escherichia coli and Staphylococcus aureus. The total viable microbial count ranged from 2.3 to 8.9 log cfu/ml suggesting a significant bacterial load that exceeds the maximum permitted level of microbial load for freshly extracted fruit juices. Of the 50 samples, 29 (58.0%) were appeared as Staphylococcus aureus positive and 24 (48.0%) samples were contaminated with Escherichia coli. Antibiogram profile revealed Staphylococcus aureus resistance to penicillin (82.8%), amoxicillin (75.9%) and oxacillin (17.2%). The resistance to β-lactam antibiotic like oxacillin indicates the presence of highly pathogenic Staphylococcus aureus which is obviously a potent public health issue. In contrary, Escherichia coli isolates were resistant to amoxicillin (100%) and erythromycin (100%). All the isolates were found highly susceptible to ciprofloxacin and gentamicin. The antibiotic resistance pattern of the isolated organisms could complicate the treatment of food-borne illness in people. Development of holistic approach and their effective application could ensure the hygienic quality of these beverages as well as the health standard of the consumers.
Unexpected Neonatal Jaundice as an Early Diagnostic sign of Urinary Tract Infection
Authors: Sagheb Setareh , Mosayebi Ziba , Nikseresht Zahra
Published: March 2021

Background: Determination of contributing factors for jaundice would result in better programming for prevention. This study was performed to determine the prevalence rate of Urinary Tract Infection (UTI) among neonates with jaundice admitted in Arash Hospital from October 2013 to October 2014.
Methods: In this descriptive cross-sectional study, term neonates with non-hemolytic jaundice admitted in Arash Hospital from October 2013 to October 2014 were evaluated for UTI by urine culture and the data were recorded by checklist using medical documents.
Results: A total of 436 term infants were enrolled in the study. Mean age at the time of admission was 6.03±3.355 days with age range of 3-18 days including 291(0.66%) males and 145(0.33%) females. Urine culture was positive in 32 neonates (7.3%).The most common germs were Klebsiella in 37.5%, Escherichia coli (E. coli) in 21.9%, Staphylococcus in 9.4%, Pseudomonas in 3.1%, Enterococcus in 15.6%, Enterobacter in 9.4%, and Group B Streptococcus (GBS) in 3.1%.
Conclusion: Urine culture should be a part of routine clinical evaluation for all icteric neonates at the age of 5-6 days or more who have no risk factors to exclude the possibility of coincidental UTI.
Association of Plant-Based Dietary Patterns with Migraine Headache Severity and Duration among Women
Authors: Askarpour Moein , Sheikhi Ali , Khorsha Faezeh , Setayesh Leila , Togha Mansoureh , Mirzaei Khadijeh
Published: March 2021

Background: Migraine is a recurrent disorder which can cause socio-economic and public health burdens. Many factors, especially dietary factors are suggested to induce migraine headaches. The aim of this study was to examine the association between plant-based dietary patterns and headache severity and duration among migraine patients.
Methods: A sample of two hundred and sixty-six women with migraine (18-50 years) took part in the present cross-sectional study. Dietary intake data was collected using a validated and reliable food-frequency questionnaire. Three dietary indices were evaluated including an overall plant-based diet (PDI), healthful Plant-based diet (hPDI), and unhealthful plant-based diet (uPDI). Anthropometric measurements, headache duration, Migraine Disability Assessment (MIDAS), and Visual Analog Scale (VAS) were assessed for all cases. Multinomial logistic regression and linear regression models were used to show the association between headaches and plant-based dietary patterns.
Results: An inverse association between higher adherence to hPDI and severity of headaches was found based on VAS (OR=0.40; 95% CI: 0.21, 0.74; p=0.003), and severe disability based on MIDAS (OR=0.50; 95% CI: 0.26, 0.95; p=0.03). Conversely, uPDI scores were positively associated with severe headaches (OR=3.00; 95% CI: 1.72, 5.23; p<0.001), and disability (OR=2.50; 95% CI: 1.39, 4.51; p=0.001). Moreover, headaches duration showed an inverse significant association with hPDI scores (β=-0.21, 95% CI=-4.69, -1.08, p=0.002).
Conclusion: Plant-based diet, particularly healthful plant foods, was inversely associated with lower severity, disability and duration of headaches. In addition, unhealthy plant foods were associated with higher risk of migraine headaches.
Physical Activity and Musculoskeletal Disorders among Iranian Older Adults
Authors: Gharib Masoud , Rashedi Vahid
Published: March 2021

The article's abstract is not available.
Relationship of Students Motivation with National Competency Exam Result in the Nurse Profession Program of Immanuel School of Health Sciences Bandung
Authors: Natalia Lidya , Sinaga Anni
Published: March 2021

Nurses must have a Certificate of Registration and a Certificate of Competency in order to carry out nursing practices in Indonesia. One of the ways to measure nurse competency standards and obtain the Certificate of Competency is through the National Competency Exam. Identifying obstacles is one method used to evaluate the high number of alumni failures in the National Competency Exam. One obstacle that affects students is motivation. The purpose of this study was to analyze the relationship between students motivation and their success when taking the National Competency Exam. The student subjects were alumni from batch 28 of the Nurse Profesion Program of Immanuel School of Health Sciences Bandung. 72 people were selected using the accidental sampling method. The instrument in this study was a student motivation questionnaire and the results of the National Competency Exam in October 2018 which had been tested for validity and reliability. Bivariate analysis was performed using the Chi Square statistical test with p ≤ 0.05. The results showed p-value of 0.561> 0.05, this suggests that there is no significant relationship between student motivation and the exam results. It is therefore suggested that nursing educators explore other factors which could produce poor scores when taking the National Competency Exam.
 
Keywords: Students’ Motivation, National Competency Exam, Nurse Profession Program
Self-Efficacy as a Predictor of Self-Management Behavior Practice Among People with Type 2 Diabetes Mellitus (T2DM)
Authors: Clara Hertuida , Irawaty Dewi , Dahlia Debie
Published: March 2021

Diabetes mellitus is a major health challenge associated with morbidity and mortality. Self-management behaviors are a critical part of diabetes disease management. Empowered or activated patients are more likely to practice better implementation of self-management behaviors. However, self-management behavior practice has not always been applied effectively among these populations. Further investigations are necessary to evaluate the status and factors that influence the practice of selfmanagement behaviors among patients with diabetes. The purpose of this research is to identify the relationship between self-efficacy and self-management behaviors of people with type 2 Diabetes Mellitus. A cross-sectional research design was used in this study; 112 eligible people with type 2 Diabetes were recruited. Several questionnaires were used in this study including demographic and patient characteristics, Diabetes Management Self Efficacy Scale (DMSES), Summary Diabetes Self Care Activity (SDSCA), and Diabetes Knowledge (DKN) Scale. Data analysis was performed through univariate, bivariate, and multivariate analyzes. Most of the respondents studied were women, aged 34-74 years and the highest educational background was secondary education, 33.9% of respondents have a good level of knowledge, and 59.8% have good self-efficacy. The results show the significant relationship between self-efficacy and self-management behaviors (p-value < 0.001). The results of multivariate analysis showed that there was a relationship between self-efficacy and self-management behavior after being controlled by the knowledge and the duration of diabetes. Therefore, nurses need to improve the self-efficacy of people with type 2 Diabetes by providing education about the management of Diabetes, as well as supporting and motivating them.
 
Keywords: self-efficacy, self-management behaviors, people with type 2 Diabetes Mellitus