bluuebunny/crossref_metadata_2025 huggingface dataset:
Functional assessment of patients with cervical myelopathy who underwent surgical treatment
Authors: Coutinho Thiago Pereira , Iutaka Alexandre Sadao , Cristante Alexandre Fogaça , Rocha Ivan Dias , Marcon Raphael Martus , Oliveira Reginaldo Perilo , Barros Filho Tarcísio Eloy Pessoa de
Published: May 2014

OBJECTIVE: Evaluate and correlate the functional response of patients with cervical myelopathy with the current clinical scores in patients who underwent surgical treatment. METHODS: We analyzed medical records of 34 patients with cervical myelopathy who underwent four different types of surgery. All patients were evaluated preoperatively and postoperatively with the application of the JOA and Nurick questionnaires. RESULTS: Functional clinical improvement was statistically significant. The mean preoperative JOA was 8.5 ± 3.06 and 10.7 ± 3.9 in the postoperative; Nurick was 3.2 ± 1.1 preoperatively and 2.8 ± 1.3 postoperatively. CONCLUSION: There is benefit with the surgical procedure in patients with cervical myelopathy. The neurological function after surgery depends on the previous function (the higher the duration of the previous symptoms, the greater the progression of the disease and, therefore, worse the neurological function) and the age is not a relevant factor of improvement, as already shown in other series. The clinical functional improvement of patients is visible with surgical treatment, regardless of surgical technique.
Radiographic evaluation of the use of transverse traction device in vertebral arthrodesis for degenerative diseases
Authors: Utino Edgar Takao , Bergamaschi João Paulo Machado , Pellegrino Luciano Antonio Nassar , Umeta Ricardo Shigueaki Galhego , Caffaro Maria Fernanda Silber , Meves Robert , Avanzi Osmar
Published: May 2014

OBJECTIVE: Perform radiographic analysis of the use of Transverse Traction Device (DTT) with respect to fusion rate in patients submitted to vertebral arthrodesis for degenerative lumbar diseases. METHODS: We selected x-ray images on anteroposterior, lateral and oblique views and with maximum flexion and extension dynamics of 23 patients submitted to posterolateral arthrodesis of the lumbar spine with a minimum follow-up period of six months. The images were evaluated and classified by the Linovitz's system by two spine surgeons. RESULTS: We evaluated the radiographs of 23 patients after the minimum postoperative period of 6 months and of these, 11 have used DTT. With regard to the consolidation rate, seven patients (63.6%) in the group of DTT were classified as fusion as well as six patients (50%) who were not submitted to the treatment. There was no statistical difference between the groups regarding the consolidation rate. CONCLUSION: The use of transverse traction device in this study showed no significant difference in the rate of consolidation in radiographic evaluation. Studies on the effective participation of this device in the stability of pedicle fixation systems are still lacking in the literature.
Health-related quality of life and expectations of patients before surgical treatment of lumbar stenosis
Authors: Pacola Lílian Maria , Nepomuceno Eliane , Dantas Rosana Aparecida Spadoti , Costa Herton Rodrigo Tavares , Cunha Débora Cristine Previdé Teixeira da , Herrero Carlos Fernando Pereira da Silva , Defino Helton Luiz Aparecido
Published: May 2014

OBJECTIVE: To evaluate the expectations of patients awaiting surgical treatment of lumbar canal stenosis and the association of Health-Related Quality of Life (HRQoL) with symptoms of anxiety and depression. METHODS: The sample included 49 patients from a university hospital. HRQoL was assessed by the Oswestry Disability Index (ODI) and 36-item Medical Outcomes Survey Short Form (SF-36) and symptoms of anxiety and depression by the Hospital Anxiety and Depression Scale (HADS). Expectations were investigated by means of questions used in international studies. Data were analyzed descriptively and by Student's t test. RESULTS: The mean time of disease progression was 34.5 months, the mean age was 58.8 years and 55.1% of the patients were women. Most patients had the expectation of improving with surgical treatment and 46.9% expected to be "much better" with regard to leg pain, walking ability, independence in activities and mental well being. The scores of anxiety and depression were respectively, 34.7% and 12.2%. We observed statistically significant differences between the groups with and without anxiety in the domains: General Health, Mental Health, and Vitality. Between the groups with and without depression there were statistically significant differences in the General Health and Mental Health domains. CONCLUSION: Patients showed great expectation to surgical treatment and the symptoms of anxiety and depression were related to some domains of HRQoL. Thus, the study contributes to broaden our knowledge and we can therefore guide the patients as to their expectations with respect to the real possibilities arising from surgery.
Key quality factors at urban interchanges
Authors: Dell'Asin Giulia , Monzón Andrés , Lopez-Lambas María Eugenia
Published: May 2014

Quality of service should not be overlooked in public transport planning and policy making, as it influences modal shift from car use to more sustainable means. Little research has been conducted on the quality of public transport interchanges from the perspective of current travellers (i.e. perceived quality). This work thus aimed to identify key quality factors at urban interchanges through an exploratory approach (multiple correspondence analysis) that provides novel elements for further investigation. The methodology was applied at interchanges in Madrid and Gothenburg and the data used in the analysis were collected through customer satisfaction surveys conducted in 2011. The analysis identified five key quality factors per interchange. Ticketing plays a key role at both interchanges while physical and environmental issues emerged at Avenida de América in Madrid, and services, temporal issues and interconnectivity characterise Gothenburg central station. Compared with other quality aspects, classical issues such as safety/security and information are not perceived as important by intermodal travellers.
Recycling glass-fibre-reinforced plastics in the automotive sector
Authors: Regenfelder Max , Faller Jürgen , Dully Stefan , Perthes Harald , Williams Ian , den Boer Emilia , Obersteiner Gudrun , Scherhaufer Silvia
Published: May 2014

The automotive sector is facing the challenge to become more resource-efficient in the manufacture of cars and their components. One approach is to increase the share of recycled materials. This paper presents the results of a case study for the automotive sector of the EU-funded Zerowin project. A safety-relevant component of the braking system was selected for manufacture using a mechanically recycled composite plastic material (polyethylene terephthalate reinforced with short glass fibres). The case study demonstrated the interdependencies between material and component specification, component design, material properties and the production process: using recycled glass-fibre-reinforced plastics for a safety-relevant component is not just an issue of input substitution, it is an interplay of technological (product development, production process modification, recycling process), organisational (security of supply, network infrastructure) and economic (material cost savings versus adjustment costs, planning horizons) factors resulting from the input substitution of primary material and changes of material properties. An industrial network was established and the case study's findings were transferred to serial mass production. Industrial networks are seen as an appropriate tool for securing the supply and quality of recyclates from traceable sources.
Ring-opening polymerisation of ɛ-caprolactone catalysed by Brønsted acids
Authors: Yao Li-Hui , Shao Shuang-Xi , Jiang Lan , Tang Ning , Wu Jin-Cai
Published: May 2014

Two new Brønsted acids [2,2′-ethylidene-bis (4,6-di-tert-butylphenol)] phosphoric acid (EDBPPOOH) and (3,3′,5,5′-tetra-tert-butylbiphenyl-2,2′-diol) phosphoric acid (TBPO-POOH) were synthesised and fully characterised by 1H NMR and 13C NMR spectra and mass spectra. The ringopening polymerisation (ROP) of ɛ-caprolactone (ɛ-CL) catalysed by the two Brønsted acids proceeded at 110°C without a solvent or at ambient temperature in toluene. Experimental results indicated that the two Brønsted acids were efficient catalysts for the ROP of ɛ-CL with moderate number-average molar mass (Mn) and narrow polydispersity indices (PDI). The catalytic activity of TBPO-POOH is higher than EDBP-POOH in the ROP of ɛ-CL. After benzyl alcohol was added, it was able to accelerate the polymerisation process. The polymerisation can also occur with the addition of water with a monomer/catalyst/initiator mole ratio of 100: 1: 1. The living polymerisation was ascertained by the linear relationships of the Mn vs. monomer conversion, then it was further confirmed by a second-feed experiment of a double monomer producing double Mn. A kinetic study of the relationships between monomer concentration and time revealed a first-order dependence on monomer concentration in the polymerisation. End-group analysis of 1H NMR spectra and electrospray-ionisation mass spectra suggests that the two Brønsted acids are capable of catalysing and initiating the ROP of ɛ-CL.
Umbilical myiasis with sepsis in a neonate
Authors: Mondal Monojit , Biswas Tanmoy , Banerji Nayan , Bose Sayan , Biswas Biswajit , Mandal Pijush Kanti
Published: May 2014

Myiasis is the invasion of host’s tissues by the larval stage (maggot) of non?biting flies. It usually infects domestic and wild animals, but sometimes also affects human and is commonly found in the tropical and subtropical areas. Umbilical myiasis in the neonatal period associated with sepsis is a rare occurrence with few reported cases in the literature. We report a case of a 20?days?old neonate from a rural area of West Bengal, India, presented with neonatal sepsis due to umbilical myiasis caused by larval form of blow fly (Chrysomya megacephala). DOI: http://dx.doi.org/10.3126/ajms.v5i4.10004 Asian Journal of Medical Sciences 2014 Vol.5(4); 106-107
Acute respiratory tract infection among preschool children in Western Maharashtra, India
Authors: Tondare Mahesh B , Raje VV , Mumbare Sachin , Rayate MV , Tondare Sangamesh , Kakade SV
Published: May 2014

Background: Malnutrition and infectious diseases both occur in the same unfortunate children and together they play a major role in causing the high morbidity and mortality in them.In developing countries, mortality from ARTI is 30?70 times higher than in developed countries and it has been estimated that up to 1/3rd of all deaths in children less than 5 years are attributed to ARTI. Aims & Objectives: This study aimed to find the attack rate of Acute Respiratory Tract infection and the socio?demographic variables of pre?school children suffering from Acute Respiratory Tract infections. Method: A Comparative Longitudinal study was carried out among preschool children (3?5 years) who were selected from Private pre?primary school of urban area (155)& Anganwadis (157) of urban slum area of karad town and followed for the period of one year. Mother/guardian/teacher was interviewed by using pre?tested proforma during this period. Results & Interpretation: out of all 97.4% of private pre?primary school children had 1.8 episodes/child/year of ARTI compared to Anganwadi children where all of them had 2.5 episodes/child/year of ARTI. Conclusion: Maximum number of children from private pre?primary schools from urban area also suffered with at least one episode of Acute Respiratory Tract Infection compared to Anganwadi children from urban slum areas. DOI: http://dx.doi.org/10.3126/ajms.v5i4.10044 Asian Journal of Medical Sciences 2014 Vol.5(4); 34-38
Prescribing pattern of antibiotics in the department of pediatrics in a tertiary care medical college hospital in Northern India
Authors: Kanish Ravika , Gupta Kanchan , Juneja Shivani , Bains HS , Kaushal Sandeep
Published: May 2014

Background: Systemic antibiotics account for more than one?third of all prescriptions in children; hence, antibiotic prescriptions in children are a major public health concern. Moreover, data regarding rational antibiotic use in children is very limited. Hence, it is essential that the antibiotic prescribing pattern be evaluated periodically for its rationality of use and cost. The aim of our study is to identify the prescribing pattern and to carry out direct cost analysis of antibiotic use in the patients admitted in pediatrics department of a tertiary care hospital of North India. Methods: The study was conducted for two months (June, July, 2012) in pediatric ward and ICU. The data regarding patient demographics and antibiotic use was collected daily in a structured proforma. A descriptive analysis of the data was done. Results: A total of one hundred and ninety one patients were enrolled, most of them belonging to the age group 2?14 years. Majority of them were male pediatric patients (75.9%) with mean age of 4.6 years. On an average 1.9 AMAs were prescribed per patient. The most common AMAs prescribed were cephalosporins followed by aminoglycosides. The preferred route of administration was injectable (92%). The average direct cost of treatment per patient was estimated to be Rs. 3338. The percentage of drugs prescribed by generic name was 58%. Conclusions: Male pediatric patients have better access to tertiary medical care as compared to female pediatric patients. The average number of anti?microbials prescribed is 1.9 which is not too high. Newer generation of antibiotics are more commonly prescribed leading to increased cost of therapy. This baseline study will help in formulating an antibiotic policy and standard treatment guidelines for appropriate use of antibiotics. DOI: http://dx.doi.org/10.3126/ajms.v5i4.10213 Asian Journal of Medical Sciences 2014 Vol.5(4); 69-72
Knowledge, attitude and perceptions of mothers with children under five years of age about vaccination in Mangalore, India
Authors: Mahalingam Soundarya , Soori Abhijna , Ram Pradhum , Achappa Basavaprabhu , Chowta Mukta , Madi Deepak
Published: May 2014

Objective: Vaccination is a cost-effective intervention to prevent major illnesses that contribute to child mortality in the country. Increase in parental knowledge about vaccination will lead to increase in vaccination rates of children The main aim of our study was to assess the Knowledge (K), attitudes (A) and perceptions (KAP) of mothers with children under five years of age about vaccination. We also compared the KAP data between urban and rural setup. Methodology: This cross sectional descriptive study was conducted on mothers attending the Urban Health Centre (in Mangalore city) and on mothers attending a Peripheral Health Centre (Bengre, outskirts of Mangalore) having children under five years of age. A semi structured pre validated questionnaire designed to assess the Knowledge, Attitudes and Perceptions about vaccination was administered to mothers attending the Urban Health Centre and on mothers attending a Peripheral Health Centre having children under five years of age. Results: Among the study participants, 74 were from urban setup and 126 from rural set up. Around 8 (10.8%) from urban area and 78(61.9%) from rural area were illiterate. Mothers were the main decision makers regarding vaccination of the child in both urban and rural setup. The main source of information regarding vaccination differed among urban and rural setup, being the hospital and the anganwadi worker respectively. There was a statistically significant difference between urban and rural mothers when it was asked whether they knew why vaccination was important. A majority of the mothers both in the urban and rural areas believed that vaccines were safe. Among the urban mothers 90.5% and 62.7% of mother from rural were able to identify polio as a vaccine preventable disease. On a net analysis, 64(86.5%) mothers in the urban area and only 64 (50.8%) mothers in the rural area mothers found to have favourable knowledge, attitudes, perceptions and practices towards vaccination. Conclusion: A significant number of mothers in rural areas were unaware about the vaccination and its implications. Even in the urban areas we found significant lacunae in the KAP of mothers towards childhood vaccination. DOI: http://dx.doi.org/10.3126/ajms.v5i4.10306 Asian Journal of Medical Sciences 2014 Vol.5(4); 52-57
Evaluation of serum PSA levels as a biomarker for breast carcinoma in north Indian females
Authors: Gupta Nikhil , Goswami Binita , Khangarot Shyamveer S , Hadke Niladhar S
Published: May 2014

Objective: Breast cancer has emerged as the most common malignancy among females during the last few years. Early diagnosis is essential for disease management so research is underway to identify potential serological bio markers with acceptable sensitivity and specificity. The current study was undertaken to compare the levels of serum PSA in patients with benign breast diseases, carcinoma breast and normal controls. Methods: The study was conducted jointly by the departments of Biochemistry and Surgery. Fifty patients of breast carcinoma were enrolled in the study, along with 50 cases of benign breast disease and 50 healthy controls. Serum PSA levels were estimated by Roche Elecsys modular Cobas e 411(electrochemiluminescence immuno assay) (Manheim Germany). Results: We did not find any significant differences in the PSA levels between normal controls, patients with benign breast disease as well as females presenting with breast carcinoma. No correlation was observed between serum PSA levels with clinical staging as well as histopathological grading. Conclusions: According to previous published studies, tumor levels of PSA are valuable for breast cancer patient prognosis, since patients with PSA positive tumors have much longer disease-free and overall survival. PSA levels in the serum of breast cancer patients are not significantly different from the PSA levels in the serum of normal women. Based on these data we conclude that serum PSA levels are not useful for breast cancer patient diagnosis or monitoring. DOI: http://dx.doi.org/10.3126/ajms.v5i4.7800 Asian Journal of Medical Sciences 2014 Vol.5(4); 25-28
Neurocognitive dysfunction among HIV positive patients using International HIV dementia scale
Authors: Achappa Basavaprabhu , Priyadarshni Shivani , Madi Deepak , Bhaskaran Unnikrishnan , Ramapuram John T , Rao Satish , Chowta Mukta N , Mahalingam Soundarya
Published: May 2014

Background: HIV associated neurocognitive dysfunction (HAND) ranges from asymptomatic neurocognitive impairment (ANI) to mild neurocognitive disorders (MND) to HIV associated dementia (HAD). Cognitive impairment may impact medication adherence which will ultimately affect morbidity and mortality. Aim: This study was undertaken to evaluate neurocognitive dysfunction among HIV positive patients using the International HIV Dementia scale(IHDS). Materials and Methods: This cross sectional study was conducted in a tertiary care hospital attached to a medical college that caters to a large number of HIV positive patients. The subjects for this study included HIV positive patients belonging to WHO stage 1 or 2. Data collection was done using a pre tested questionnaire. The International HIV Dementia scale(IHDS) was used to assess HAND. Results: Out of the 101 patients studied, 69(68.3%) were males and 32(31.7%) were females. Among these patients, 88 (87.1%) were receiving antiretroviral therapy (ART), 84 (83.2%) were in WHO stage 1. 91 (90.1%) patients had HAND. There were statistically significant differences in the gender and educational level between patients with or without HAND. As age advanced the percentage of patients having HAND also increased. Conclusion: There was high prevalence of HIV associated neurocognitive dysfunction among HIV positive individuals in our study. Also there was an increase in HIV associated neurocognitive dysfunction with increase in age. DOI: http://dx.doi.org/10.3126/ajms.v5i4.8724 Asian Journal of Medical Sciences 2014 Vol.5(4); 61-64
Evaluation of antimalarial and antioxidant activities of the methanol seed extract of Adenanthera pavonina (Linn) in Plasmodium berghei infected mice
Authors: Adedapo Aduragbenro Deborah , Olayinka Juliet N , Abiodun Oyindamola O. , Oyagbemi Ademola A , Azeez Odunayo , Adedapo Adeolu A , Adeyemi Adegoke A , Moody Jones O
Published: May 2014

Objectives: Malaria and oxidative stress are major health problems in the world in general. The goal of the study is to investigate the antimalarial and antioxidant activities of the methanol seed extract of Adenanthera pavonina linn (ADP) in Plasmodium berghei infected mice. Methods: Thirty five mice distributed into seven groups of five animals each were used in this study. Plasmodium berghei, was inoculated into Swiss albino mice intraperitoneally with an innoculum size of 1x107 on day zero (D0). The vehicle (1% DMSO), ADP (100, 200, 400, 600 and 800 mg/kg dose) or chloroquine (10 mg/kg) were thereafter administered from D0 – D3. At the end of the antimalarial studies, the blood samples from these animals were collected through cardiac puncture for biochemical assay. The effect of the ADP on the biomakers of oxidative stress was determined in infected mice. In addition in vitro antioxidant activities of ADP were assessed using the 1, 1-diphenyl-2-picrylhydrazyl (DPPH) based assay. Results: The percentage parasitemia decreased significantly in the parasitized treated group with the crude extract (p < 0.001) compared to the parasitized untreated control group. Also the crude extract, at a dose of 800 mg/kg exerted an antimalarial activity (92.11%) higher than that of chloroquine (88.73%). In the in vitro antioxidant studies, the extract had an IC50> 400 μg/ml which was significantly higher than the standard antioxidant drug, ascorbic acid (IC50 = 1.20 μg/ml). In the case of biochemical and in vivo assay, there was no statistical significant difference (p >0.05) in plasma total protein, malondialdehyde (MDA) and hydrogen peroxide (H2O2) levels in all the treated groups compared to the parasite control group but, there was a statistical significant decrease (p < 0.05) in glutathione (GSH) levels at doses of 400 and 800 mg/kg compared to the parasitized untreated control group. Conclusions: Methanol seed extract of Adenanthera pavonina demonstrated a significant antimalarial activity but did not exert any antioxidant effect over the parasitized treated mice. DOI: http://dx.doi.org/10.3126/ajms.v5i4.9107 Asian Journal of Medical Sciences 2014 Vol.5(4); 44-51
Hypohidrotic ectodermal dysplasia and finger clubbing – An unknown association
Authors: Sarkar Amit , Bandyopadhyay Amitabha , Das Shovan Kumar , Mondal Koushik , Singh Sanjai Kumar
Published: May 2014

The ectodermal dysplasias are heterogenous group of inherited disorders with primary defects in tissues derived from embryonic ectoderm such as hair, tooth, nail and sweat gland. This disorder is broadly divided into hypohidrotic or anhidrotic and hidrotic forms. Here, we present a classical x-linked hypohidrotic ectodermal dysplasia with finger clubbing, the association of which is not being reported earlier. DOI: http://dx.doi.org/10.3126/ajms.v5i4.9457 Asian Journal of Medical Sciences 2014 Vol.5(4); 119-121
Sprengel’s deformity and unilateral absent kidney: A case report
Authors: Sarkar Amit , Bandyopadhyay Amitabha , Das Shovan Kumar , Mondal Koushik , Singh Sanjai Kumar
Published: May 2014

The Sprengel’s deformity is a congenital condition where the scapula on one or both sides are underdeveloped or abnormally high in position. An interesting rare case of Sprengel’s deformity and unilateral absent kidney is being reported. The Sprengel’s deformity should not be left undiagnosed. DOI: http://dx.doi.org/10.3126/ajms.v5i4.9494 Asian Journal of Medical Sciences 2014 Vol.5(4); 97-99
Prostatic abscess as a presenting feature of paradoxical TB-IRIS
Authors: Achappa Basavaprabhu , Shenoy Archana , Ching Hsia Mak , Yadlapati Sujani , Madi Deepak , Mahalingam Soundarya
Published: May 2014

Paradoxical tuberculosis – immune reconstitution syndrome (pTB-IRIS) is a well-recognized cause of clinical deterioration in HIV tuberculosis (HIV-TB) co-infected individuals following initiation of antiretroviral therapy (ART). Here, we present a rare presentation of pTB-IRIS which manifested as a prostatic abscess in a case of HIV positive patient. To the best of our knowledge this is the first reported case of pTB-IRIS reported in literature which manifested as a prostatic abscess. Paradoxical TB-IRIS manifesting as prostatic abscess is extremely rare and a high index of clinical suspicion is needed to diagnose and appropriately treat it. DOI: http://dx.doi.org/10.3126/ajms.v5i4.9498 Asian Journal of Medical Sciences 2014 Vol.5(4); 111-112
Nasopharyngeal carcinoma, an analysis of histological subtypes and their association with EBV, a study of 100 cases of Pakistani population
Authors: Umar Beena , Ahmed Rashida
Published: May 2014

Introduction: Nasopharyngeal carcinoma is the most common nasopharyngeal malignancy. In recent decades, it has attracted world-wide attention because of complex interactions of genetic, viral, environmental and dietary risk factors, with an etiological association with the malignancy. Nasopharyngeal carcinoma (NPC) is a rare cancer throughout the world, with the exception of Southeast Asia, Southern China and North Africa. The Epstein-Barr virus (EBV) was discovered 38 years ago by electron microscopy of cells cultured from Burkitt’s lymphoma tissue by Epstein, Achong, and Barr. EBV infection is a common infection in Pakistan due to poor socioeconomic conditions but its association with Nasopharyngeal Carcinoma is yet to be firmly established in Pakistani population and there is scarce local data available. Methods: A total of 100 consecutive cases of Nasopharyngeal Carcinoma, over a period of three years (2009-2011) were retrieved and reviewed from the pathology files at the Section of Histopathology, Aga khan University Hospital. Morphological sub classification of Nasopharyngeal carcinoma was done according to WHO. For the detection of EBV, LMP1 immunostain was used. Results: Among total of 100 cases, the male to female ratio was 3:1, with an age range of 13-78 yrs and an average age of 42 yrs. Similar to other regions of world, Non-keratinizing Carcinoma (92%) is the commonest sub-type with a distinct bimodal age distribution, followed by Keratinizing Squamous Cell Carcinoma (8%) but there were no cases of Basaloid Squamous Cell Cacinoma. EBV-LMP 1 staining was demonstrated in 75/92 cases (81%), while all cases of Keratinizing Squamous Cell Carcinoma were negative for EBV-LMP 1 staining. Conclusion: Prognostic impact of LMP-1 on Nasopharyngeal carcinoma is still unclear and also there are controversial studies regarding the prognostic effect of EBV on chemotherapy and radiotherapy, it is paramount that EBV positive and EBV negative patients be investigated for response to therapy to establish the importance of EBV association in nasopharyngeal carcinoma patients. The association with EBV is also very important because with ongoing research in the etiological basis of the tumors (associated with EBV) patients may also benefit from emerging immunotherapy used in these tumors. DOI: http://dx.doi.org/10.3126/ajms.v5i4.9592 Asian Journal of Medical Sciences 2014 Vol.5(4); 16-20
A bronchogenic cyst with atrial flutter
Authors: Tenekecioglu Erhan , Yılmaz Mustafa
Published: May 2014

The majority of bronchogenic cysts occur in the mediastinum and especially within the pulmonary parenchyma. Bronchogenic cysts have various clinical and radiological manifestations. In adults, these are often asymptomatic and most of them are only incidentally recognized in imaging procedures. In infancy and early childhood, compression of the tracheobronchial tree leads to symptoms and occasionaly life-threatening complications. Bronchogenic cysts have been stated rarely among the causes of an arythmia in early childhood. We reported a 7-years old female presented with paroxysmal palpitation continuing for one month. Contrast enhanced computed tomography showed cystic mass in the right hemi-thorax, compressing the right atrium. After surgical removal histopathologic examination revealed a lining of respiratory epithelium associated with a wall containing smooth muscle, a finding that is characteristic of bronchogenic cyst. DOI: http://dx.doi.org/10.3126/ajms.v5i4.9695 Asian Journal of Medical Sciences 2014 Vol.5(4); 94-96
The prevalence and associated cardiovascular risk factors in resistant hypertensive subjects in Eastern India
Authors: Mandal Pijush Kanti , Day Arpan Kumar , Pramanik Subhraprakash , Das Shovan Kumar , Khotick Sumit , Das Avik , Dutta Sattyendra Nath , Sarkar Amit , Dasgupta Somnath
Published: May 2014

Background: To study the prevalence and associated cardiovascular risk factors of ‘Resistant’ hypertension (RHT) in hypertensive patients of India.Methods: A descriptive cross-sectional observational study was carried out among 300 hypertensive patients attending ‘Hypertension Clinic’ and providing informed written consent from October 2013 to December 2013 at Burdwan Medical College and hospital, Burdwan, West Bengal in India. A pre-tested interviewer-administered questionnaire was used for data collection. Results: The prevalence of Resistant hypertension was 23.33% among all hypertensives. The patients with Resistant hypertension were significantly associated with older age groups (>55 years) (77.1% vs. 38.3%, p value <0.001, OR 5.446, 95% CI 2.935 and 10.104), Obesity (BMI > 27.5 kg/m2) (67.1% vs. 45.7%, p value 0.002, OR 2.433, 95% CI 1.387 and 4.268), Diabetes mellitus (72.9% vs. 45.2%, p value <0.001, OR 3.252, 95% CI 1.808 and 5.851), Prolonged hypertension (>10 years; 74.3% vs. 43.9%, p value <0.001, OR 3.690, 95% CI 2.033 and 6.696) and co-morbidity like Ischemic Heart Disease (60% vs. 44.8%, p value 0.026, OR 1.850, 95% CI 1.073 and 3.187) as risk factors as compared to patients with non-resistant hypertension. Conclusions: Nearly one fourth of the hypertensive persons were suffering from Resistant hypertension, which was significantly associated with the presence of older age, obesity, diabetes mellitus, longer duration of hypertension and co-morbidity like Ischemic Heart Disease as risk factors. DOI: http://dx.doi.org/10.3126/ajms.v5i4.9737 Asian Journal of Medical Sciences 2014 Vol.5(4); 1-5
Impact of educational stress on cortisol, cardiac autonomic drive and academic performance of medical students
Authors: Upadhayay Namrata , Khadka Rita , Paudel Bishnu Hari
Published: May 2014

Objectives: To assess stressors, heart-rate variability (HRV) and cortisol level in first year medical students (n-85), thrice in a year (beginning vs. mid-year vs. end-year). And we examined the association of these variables with their academic performance. Methods: Stressors were measured by medical student stressor questionnaire (MSSQ). HRV was assessed in eye-closed awake resting state for 5-min by Polar S810i. The salivary cortisol was assayed by ELISA method. Data were compared by Wilcoxon-Sign Rank test. Spearman correlation was applied between measured variables. Data are expressed as median (quartile 1-quartile 3), and significance was set at p≤0.05. Results: On MSSQ, students perceived mild to moderate degree of stress. About 8.24% and 11.8% of students perceived severe degree of stress in academic and inter-intrapersonal related stressors, respectively. Degree of stress in the beginning of the study was significantly high as compared to other visits. It was positively correlated with decreased HRV (decreased vagal activity and increased sympatho-excitation), high cortisol but with better academic performance in the beginning of the study. Cortisol (ng/ml) was significantly high in the beginning as compared to other visits [6.33 (5.05-7.43) vs. 1.33 (1.32-1.37) vs. 5.94 (5.1-6.6)]. The HRV measures showed mirror image of the cortisol among the visits. Conclusion: Stress level is mild to moderate degree in first year medical students which decreased as the year ended. Biochemical markers of stress, cortisol and HRV have similar trend. DOI: http://dx.doi.org/10.3126/ajms.v5i4.9843 Asian Journal of Medical Sciences 2014 Vol.5(4); 73-78
Pattern of mammographic findings in Sokoto, Nigeria
Authors: Danfulani Mohammed , Sa'idu Ahmed Sule , Ma'aji Mohammed Sadisu , Musa Muhammad Awwal
Published: May 2014

Background: Radiological examination of the breast is established as an essential part of the modern multidisplinary approach to effective investigation and management of breast diseases. The standard techniques used for breast imaging are screen film X-ray mammography and real time ultrasound. The aim of this study is to document mammographic findings in females seeking medical attention at the Usmanu Danfodiyo University Teaching Hospital Sokoto, Nigeria. Methods: The study was a descriptive retrospective analysis of the mammographic breast examinations (both screening and diagnostic) seen over a period of one year (February 2012 - January 2013). A total 125 patients were recruited in this study. Relevant parameters extracted from the records included patients age, presenting complain, referring clinic/unit, indications and the reporting radiologist findings (diagnosis). All the data collected were analyzed using a Statistical Package for Social Sciences (SPSS) version 17.0 windows. Results: The age range of the study participants was 18 to 71 years with a mean and standard deviation value of 41.87±10.15. Majority of our patients (44%) were referred from GOPD (General Out Patient Department); followed by SOPD (Surgical Out Patient Department) with 41 patients (32.8%). Other referring clinics included Accident and Emergency (A and E) (3.2%), Staff Clinic (1.6%), Medical outpatient Department (MOPD) 4.0%, Clinic 1 less than 1%. Gynea Clinic (3.2%) and Radiotherapy Unit (1.6%). The commonest indications for these examinations in our patients include Breast Pain (unilateral or bilateral); Breast Lump (unilateral or bilateral), bloody nipple discharge, ?Breast Cancer (left or right), Fibrocystic dysplasia, mastitis among others. The predominant diagnosis observed in our results was BIRADS 1 (normal examination) which constituted 73 (58.4) patients. Conclusion: Most of our patients for diagnostic mammography were found to have Benign breast diseases than breast cancers; suggesting that there is a high diagnostic yield of mammography in the evaluation and management of breast diseases in this environment. DOI: http://dx.doi.org/10.3126/ajms.v5i4.9864 Asian Journal of Medical Sciences 2014 Vol.5(4); 79-83
Vaginal flora in preterm premature rupture of membranes and their sensitivity to commonly used antibiotics
Authors: Rani Shikha , Mehra Reeti , Gupta Varsha , Huria Anju , Chander Jagdish
Published: May 2014

Background: Ascending infection is one of the most common etiologies in preterm premature rupture of membranes (PPROM). Antibiotics are used in PPROM to prolong the pregnancy and to prevent infection. But to prevent drug overuse and resistance, microorganism directed antibiotics should be used. So, this study was planned to evaluate vaginal flora in pregnant women with PPROM and their sensitivity to commonly used antibiotics. Methods: In this prospective cross-sectional study, 50 pregnant women (cases) preterm premature rupture of membranes and 28 pregnant women (controls) without complication were assessed for the type of vaginal flora and its sensitivity to commonly used antibiotics. Results: Among cases 18 (36%) women showed bacteria on Gram’s staining of vaginal swabs with Gram?negative bacteria (10/18) being the most common. Among controls, 16 (57%) women showed bacteria on Gram’s staining with Gram?positive bacteria being most common. Among cases Escherichia coli and Staphylococcus aureus were the commonest isolates. Of 8 (16%) positive bacterial cultures in cases, 6 (10%) were sensitive to Gentamicin and 2 (4%) to Ampicillin. Conclusion: Lower genital tract flora of pregnant women with PPROM predominantly consists of Gram?negative bacteria, which are sensitive to Gentamicin. DOI: http://dx.doi.org/10.3126/ajms.v5i4.9889 Asian Journal of Medical Sciences 2014 Vol.5(4); 58-60
Teenage pregnancy – A Socio-demographic study at a Rural Medical College Hospital in Southern India
Authors: Dutta Indranil , Jha Nidhi , Dutta Dilip Kumar
Published: May 2014

Aim: This study is aimed to analyze the socio-demographic factors of teenage pregnancy compared to adult pregnancies. Method: A Hospital based prospective study of all teenage pregnant females admitted to Rural Medical College Hospital in Karnataka. Data was collected by detailed history taking and following up the patient from admission till delivery by using a proforma devised for the study. For each teenage two simultaneous adults primigravidas were studied. Result: Most of teenage mothers (53.5%) haven’t had primary education itself compared to 8.1% in adults. In the present study, majority of the population 47.5% in teenage and 72.5% in adults belonged to middle socioeconomic class (upper and lower) and 43.75% of teenage belong to low socioeconomic class compared to 15% of adults. In my study 98% of the population belonged to rural area. 61.25% of teenage mothers were booked. In present study the TT Immunization was adequate for both the groups. Conclusion: Teenage pregnancy is still a huge problem in India mainly related to early menarche, early age at marriage, low education, unemployment, joint family structure, lack of antenatal care. The problem of teenage pregnancy cannot be removed instead focus can be diverted towards reducing chances of early pregnancy which can be difficult for a teenage girl. DOI: http://dx.doi.org/10.3126/ajms.v5i4.9970 Asian Journal of Medical Sciences 2014 Vol.5(4); 29-33
Long-course chemoradiation versus short-course radiation for rectal cancer and overall comparison
Authors: Kundu Subhrokanti
Published: May 2014

DOI: http://dx.doi.org/10.3126/ajms.v5i4.9976 Asian Journal of Medical Sciences 2014 Vol.5(4); 122-124
Democracy, Democracies and Democracy Discourses in Nepal: An Anthropologist’s Engagement
Authors: Dhakal Suresh
Published: May 2014

Democracy is conceptualized and practiced differently in different times and places; and may exist in various forms and levels with various degrees and dimensions. Therefore the use of the word “democracy” occurs neither alone, nor steadily, nor completely; it is, “historically” and “ethnographically emergent”. Following an extensive review, the paper concludes that democracy (ideals, institutions and practices) is depended upon effective state vis-à-vis strong civil society. Effectiveness of the state and the strength of the civil society, both depend on a common denominator, that is, participation. This paper, excavates some of the traces of, what we may like to refer today as democracy, in our own historical context; and, portrays how the meaning of democracy shifting along with the shifting of the local terms for democracy. DOI: http://dx.doi.org/10.3126/dsaj.v7i0.10440 Dhaulagiri Journal of Sociology and Anthropology Vol. 7, 2013; 133-156
Debate of Ethnic Identity in Nepali Politics: An Examination of the debate from the Kisan Community of Eastern Nepal
Authors: Kattel Shambhu Prasad
Published: May 2014

The Kisan is an ethnic group of Nepal lived in Jhapa district only. It is a Tarai origin group with 773 populations which is traditionally organized under its own political organization, the Mahato system. The Mahato is a hereditary community head which is supported by Wokil (minister) and Sipahi (Police). These traditional authorities run a well functional community court which maintains peace and harmony in the community and works for the preservation of cultural practices. Along with the establishment of multiparty democracy, the community is exposed to external situations: political parties and economic organizations, advocacy groups, donor agencies and so on. A few literate Kisans seeking employment opportunities interfaced with the advocates of National Federations of Indigenous Nationalities and Action Aid Nepal after multiparty democracy. As a result, they had motivated and established a non-governmental organization for ethnic welfare. After establishment of the Kisan Community Development Academy (club in the Kisan language), the community is formally divided into two groups: the illiterate Kisans involved in community court under their traditional authorities and the literate Kisans involved in the newly established club. The club ran literacy and sanitation programs and constructed toilets and water taps. Mainly, it was involved in socio-cultural change and identity politics by the support of the above mentioned organizations. On the contrary, the traditional authorities involve in the preservation of community culture and maintain peace and harmony. The literate Kisans involved in identity politics are motivated for salaried jobs, not for cultural preservation for Kisan identity. DOI: http://dx.doi.org/10.3126/dsaj.v7i0.10441 Dhaulagiri Journal of Sociology and Anthropology Vol. 7, 2013; 157-172
Not all one and the same: Sexual identity, activism, and collective self-esteem
Authors: Gray Amy , Desmarais Serge
Published: May 2014

This study examines important distinctions in sexual orientation identities by exploring the relationships among sexual identity, activism, and collective self-esteem. Past research has revealed that individuals who label themselves as belonging to certain minority sexual identities may experience different types of outcomes; for instance, bisexual individuals have been shown to experience more psychological hardships (Brewster & Moradi, 2010; Browne & Lim, 2010), whereas Queer individuals' politicization may buffer against some of these negative experiences and increase their psychological well-being (Galinsky et al., 2013; Klar and Kasser, 2009; Riggs, 2010). We explored whether these important differences could be attributed to a person's choice of a sexual identity description. An online survey was distributed to Facebook groups affiliated with 33 universities across Canada, which yielded responses from 265 participants. Four distinct sexual identity categories were created and compared in two multiple regression models that controlled for measures of personal and social identity. In the first model, we tested group differences in collective self-esteem and, in the second model, we assessed group differences in political activism. As predicted, collective self-esteem was significantly lower for those who identified as bisexual, and activism was most likely among those who identified as Queer. Our research highlights the need for caution when either measuring or studying aspects of sexual orientation, since these identity categories reflect different personal and political points of reference.
Proportionality and justification
Authors: Cohen-Eliya Moshe , Porat Iddo
Published: May 2014

Proportionality: Constitutional Rights and their Limitation is the most comprehensive and authoritative account of the vast literature on proportionality and would be indispensable to anyone interested in the field. Barak evaluates several justifications for the use of proportionality and several defences of proportionality against its critics. This review article concentrates on one such defence: viewing proportionality as a structured and analytically coherent set of tests requiring the government to provide reasons and justifications for all of its actions. We identify several prominent recent writers, Barak among them, who represent a shift in the literature on proportionality towards a justification-based approach, and assess their rationales for the duty of the government to give justifications and provide reasons for its actions. However, we claim that those rationales do not necessarily support proportionality and that a more categorical approach, such as ‘exclusionary reasons,’ follows just as much from the ideas underlying justification and provides a better anchor for proportionality.
How to redistribute? A critical examination of mechanisms to promote global wealth redistribution
Authors: Benshalom Ilan
Published: May 2014

The literature on global redistributive justice deals primarily with the important, yet unresolved issues of why global wealth redistribution may be morally justified or beneficial. However, philosophers and economists who address these issues often do not address the question of how such redistribution should take place. This article seeks to rectify this deficiency and argues that, if a certain level of global wealth distribution is morally justified and, more importantly, beneficial, the question of how it should be promoted is far from trivial. In this context, the analysis opens a new discussion of what form of redistributive measures should be adopted in a multistate reality.

The article analyses the potential distributive impact of international tax arrangements. It first explains how international tax arrangements, as an indirect method of redistribution, can promote global distributive objectives. It then assesses whether international tax arrangements offer a more effective global wealth redistribution mechanism when compared to other (indirect) alternatives such as fair trade, international labour, and environmental regulation. The article evaluates the strengths and weaknesses of different redistributive arrangements through the lenses of three criteria: the scope of redistribution, the efficiency of redistribution, and the political feasibility of redistribution. It concludes that, under certain plausible circumstances, international tax redistributive efforts would offer a more effective redistributive option compared to other alternatives.
Valuation of Wind Energy Projects: A Real Options Approach
Authors: Abadie Luis , Chamorro José
Published: May 2014

We address the valuation of an operating wind farm and the finite-lived option to invest in it under different reward/support schemes: a constant feed-in tariff, a premium on top of the electricity market price (either a fixed premium or a variable subsidy such as a renewable obligation certificate or ROC), and a transitory subsidy, among others. Futures contracts on electricity with ever longer maturities enable market-based valuations to be undertaken. The model considers up to three sources of uncertainty: the electricity price, the level of wind generation, and the certificate (ROC) price where appropriate. When analytical solutions are lacking, we resort to a trinomial lattice combined with Monte Carlo simulation; we also use a two-dimensional binomial lattice when uncertainty in the ROC price is considered. Our data set refers to the UK. The numerical results show the impact of several factors involved in the decision to invest: the subsidy per MWh generated, the initial lump-sum subsidy, the maturity of the investment option, and electricity price volatility. Different combinations of variables can help bring forward investments in wind generation. One-off policies, e.g., a transitory initial subsidy, seem to have a stronger effect than a fixed premium per MWh produced.