bluuebunny/crossref_metadata_2025 huggingface dataset:
Factores asociados al uso de servicios de salud oral en adultos mayores peruanos: análisis secundario de encuesta poblacional, 2018
Authors: Azañedo Diego , Vargas-Fernández Rodrigo , Rojas-Roque Carlos
Published: December 2019

Objetivos. Identificar la prevalencia y factores asociados al uso de servicios de salud oral en adultos mayores (AM) peruanos durante el 2018. Materiales y métodos. Análisis secundario de los datos de 4874 AM peruanos de la Encuesta Demográfica y de Salud Familiar (ENDES) 2018. Se consideró el uso de servicio de salud oral (sí/no) en razón de los seis meses previos a la aplicación de la encuesta como variable dependiente, las variables independientes fueron: sexo, edad, área de residencia, nivel educativo, estado civil, dominio geográfico, limitación física, afiliación a un seguro de salud, lengua hablada y quintil de bienestar. Se realizó un análisis descriptivo usando frecuencias absolutas y proporciones ponderadas, y un análisis multivariado empleando modelos lineales generalizados (familia Poisson). Resultados. Del total de AM, 52,6% fueron mujeres, 52,9% pertenecían al grupo de 60 a 69 años de edad, 77% pertenecían al área urbana y 81,1% estuvieron afiliados a un seguro de salud. La prevalencia del uso de servicios odontológicos durante los últimos seis meses fue 24,9%. El análisis multivariado encontró asociación con el área de residencia (p0,001), el nivel educativo superior (p=0,001), la afiliación a un seguro de salud (p0,001), el dominio geográfico (p=0,019) y todos los quintiles de bienestar (p0,001). Conclusiones. La prevalencia de uso de servicios de salud oral en AM fue baja, y sus factores asociados fueron el área de residencia, el nivel educativo, la afiliación a un seguro de salud, el dominio geográfico y los quintiles de bienestar.
Endogamia editorial en la Revista Peruana de Medicina Experimental y Salud Pública
Authors: Arteaga-Livias Kovy , Panduro-Correa Vicky , Mandujano-Valdivieso Luis , Dámaso-Mata Bernardo
Published: December 2019

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Cepillado dental y niveles de flúor en pastas dentales usadas por niños peruanos menores de 12 años
Authors: Hernández-Vásquez Akram , Azañedo Diego
Published: December 2019

Análisis secundario de los datos de 41 330 niños de uno a 11 años de la Encuesta Demográfica y de Salud Familiar (ENDES) 2018. Se reportó la frecuencia de cepillado y el uso de pasta dental según el nivel de flúor (no cepillado, adecuado, inadecuado, no mostró/no usa pasta, e ilegible), según variables socioeconómicas y geográficas. Un 7,8% de los niños evaluados no se cepillaba los dientes, se evidenció diferencias porcentuales significativas (p 0,001) en el uso de pasta dental con concentración inadecuada de flúor entre las categorías extremas de las variables edad (12,3%), uso de servicios odontológicos (7,7%), nivel educativo del responsable (20,4%), índice de riqueza (17,8%), dominio geográfico (11,3%) y área de residencia (9,1%). Un porcentaje considerable de niños peruanos no se cepilla los dientes; además, un gran número de niños que se cepillan emplean pastas dentales con contenidos de flúor sin efecto preventivo.
Relación de revisores del año 2019
Authors: Instituto Nacional de Salud, Perú Rev Peru Med Exp Salud Publica,
Published: December 2019

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Handwriting Character Recognition using Vector Quantization Technique
Authors: Haviluddin Haviluddin , Alfred Rayner , Moham Ni’mah , Pakpahan Herman Santoso , Islamiyah Islamiyah , Setyadi Hario Jati
Published: December 2019

This paper seeks to explore Learning Vector Quantization (LVQ) processing stage to recognize The Buginese Lontara script from Makassar as well as explaining its accuracy. The testing results of LVQ obtained an accuracy degree of 66.66 %. The most optimal variant of network architecture in the recognition process is a variation of learning rate of 0.02, a maximum epoch of 5000 and a hidden layer of 90 neurons which was the result of recognition based on feature 8. Based on these variations, the obtained performance with a mean square error (MSE) of 0.0306 and the time required during the learning process was quite short, 6 minutes and 38 seconds. Based on the results of the testing, the LVQ method has not been able to provide good recognition results and still requires development to generate better recognition results.
Etkin Yük Yaklaşımı Kullanarak Protonlar için Z=2-54 Elementlerin Durdurma Gücü Üzerine Bir Çalışma
Authors: USTA Metin
Published: December 2019

Durdurma
gücü, hedef içerisindeki elektronlar ve çekirdeğin Coulomb alanı etkileşmesi
nedeniyle yüklü parçacıkların birim uzunluk başına ortalama enerji kaybıdır.
Durdurma gücünün atom fiziği, nükleer fizik ve uygulamaları, radyasyon
dozimetrisi gibi birçok alanlarda önemli uygulamaları vardır. Bu çalışmanın
amacı 1 keV-1 GeV enerjili protonlar için Z=2-54 atom numaralı elementlerin
Bethe-Bloch teorisine dayalı etkin yük yaklaşımı yöntemi kullanılarak çarpışma
durdurma gücünü hesaplamaktır. Bunun için öncelikle hedef elementlerin etkin
yük, etkin ortalama uyarılma enerjileri ve potansiyel enerji fonksiyonları
belirlendi. Elektronik yük yoğunluğu için Roothaan-Hartree-Fock atomik
dalgafonksiyonları seçildi ve hedef atomların etkin yükünün protonların
enerjisiyle değişimi incelendi. Ardından elde edilen hedef atomların etkin yükleri
kullanılarak çarpışma durdurma gücü değerleri hesaplandı. Atom numarası ve
gelen protonların enerjisi arttıkça etkin yük değerlerinin arttığı görüldü.
Durdurma gücü değerlerinin ise atom sayısı arttıkça azaldığı ve durdurma gücüne
ait maksimum noktalarının yüksek enerjilere doğru kaydığı belirlendi. Hedef
elementlerden karbon atomu için hesaplanan durdurma gücü değerleri literatürde
mevcut ICRU 49, SRIM, CasP ve Janni’nin verileriyle karşılaştırıldı. Sonuçların
belirli hata oranlarında literatür verileriyle oldukça uygun oldukları
gözlendi. Ayrıca bu çalışmada kullanılan etkin yük yaklaşımının 1 MeV’den düşük
enerjilerde de kullanılabileceği anlaşıldı.
Çan Linyitinin Sorgum Biyokütlesi İle Gazlaştırılmasında Biyokütle Oranı ve Sıcaklığın Etkisi
Authors: SEÇER Açelya
Published: December 2019

Çan
linyiti ve sorgum biyokütlesi farklı oranlarda sorgum içerecek şekilde
karıştırılarak, 700°C sıcaklıkta birlikte gazlaştırılmış ve karışımdaki sorgum
oranının toplam gaz hacmi ile gaz ürün dağılımına etkileri incelenmiştir. Hem
toplam gaz hacmi hem de üretilen hidrojen gazının miktarı açısından en etkin
sorgum konsantrasyonu % 25 olarak belirlenmiştir. %25 sorgum içeren
kömür/sorgum karışımı, 700, 800 ve 900 °C sıcaklıklarda gazlaştırılarak,
sıcaklık artışının toplam gaz hacmi ve gaz ürün dağılımındaki etkileri
incelenmiştir. En etkin gazlaştırma sıcaklığı 900 °C olarak belirlenmiştir. %25
sorgum içeren 1 gram kömür/sorgum karışımının 900 °C sıcaklıkta birlikte
gazlaştırılmasından %71,4 hidrojen gazı içeren 2729 mL gaz elde edilmiştir.
Minkowski 3-Uzayında Tımelike Normalli Eğrilerin N-Bishop Çatısına göre Slant Helisleri
Authors: KUSAK SAMANCI Hatice , YILDIZ Ayhan
Published: December 2019

Bir eğrinin asli normal vektör alanı sabit doğrultuyla sabit
açı yapıyorsa bu eğri slant helis olarak tanımlanır. Bu çalışmada timelike
normalli bir eğrinin N-Bishop çatısına göre slant helis tanımı verilerek bazı karakterizasyonlar
elde edilmiştir.
Application of Kudryashov Method to Some Equations Used in Physics Science
Authors: YILDIZ Guldem
Published: December 2019

In this study,
Kudryashov Method is used to find the wave solutions of the Gardner equation,
fifth order Caudrey-Dodd-Gibbon equation and Sawada-Kotera equation, which are
non-linear partial differential equations used as a mathematical model in the
physics science field and engineering applications. The exact solutions
obtained are compared with the results in the literature and hyperbolic type
and soliton solutions are obtained.
Efficient Deployment of Energy Antenna for Sensor Nodes with RF Charging
Authors: KOŞUNALP Selahattin , TABAKCİOGLU Mehmet Baris , ZORLU Ahmet
Published: December 2019

A sensor node has
processor, antenna, sensor and energy units. A large number of sensor nodes
generates wireless sensor network (WSN). The main problem of WSN is limited-energy.
A great number of MAC protocols are introduced to compensate the energy problem. In order to supply energy to sensor nodes, an external
solar panel, wind turbine and energy harvester are added to the architecture of
the nodes. Moreover, wireless energy transfer is used to meet the energy
problem of sensor node. Position, height and operating frequency of energy
antenna is so important to charge the sensor nodes efficiently. In this study,
ray theoretical models are used to calculate the electric field and generate
the coverage map. As the energy antenna is deployed to optimum place, charging
will complete in a short time.
Hyponatremia induced by angiotensin converting enzyme inhibitors
Authors: Raghuveer B. , Latha Merugu Padma
Published: December 2019

Background: Hyponatraemia is commonly associated with disease conditions or as an adverse effect of certain drugs. Angiotensin converting enzyme inhibitor (ACEI) and angiotensin II receptor blockers are drugs that have been commonly prescribed for the treatment of hypertension and cardiac diseases. It has become important to evaluate and investigate the incidence of hyponatremia on consumption of these drugs. The study aims to observe the incidence of the adverse drug reaction-hyponatraemia in hypertensive patients on ACEI therapy.Methods: The patient’s data was collected using proforma following which they were randomized into three groups receiving enalapril, ramipril and captipril. Serum sodium levels were assayed by direct ISE method. Statistical analysis of data was performed using SPSS version 21.0. Chi-square test was used to compare occurrence of hyponatremia in the patients on ACEI. P<0.5 was considered as statistically significant.Results: Among all, 26 (52%) of the study population administered with ACEI developed hyponatremia. Predisposition to develop hyponatremia was high in males compared to females. The study also revealed that Enalapril had a higher association with hyponatremia compared to other drugs.Conclusions: Hyponatremia was induced in 52% of patients taking ACEI. This study revealed that monitoring of serum sodium levels in the patients with ACEI administration will help to prevent unexpected adverse reactions like hyponatremia.
A retrospective study of serious adverse drug reactions and associated risk factors in a tertiary care hospital
Authors: Shenoy Smita , Gupta Mohit , Holla Sadhana , Home Madhurima , Thanusubramanian Harish
Published: December 2019

Background: Serious adverse drug reactions (ADRs) cause physical, psychological and economic harm to patients and society. This study was undertaken to understand serious ADRs in a tertiary care hospital and risk factors associated with it.Methods: The serious adverse reactions that occurred over a one-year period were assessed. The serious adverse drug reactions, action taken, outcome, predictability, suspect drug, causality, patient demographics and risk factors for the reaction was collected. Chi-square test was applied for observing relationships of predisposing factors for serious ADRs.Results: Out of a total of 984 reported adverse drug reactions, 94 (9.55%) were serious. Hematological disorders (41.05%) were the common serious ADRs followed by electrolyte disturbances (18.94%). Anticancer agents were the suspect drugs for majority of serious ADRs. Serious ADRs contributed to 39 (0.05%) admissions in the hospital. Recovery occurred in 97.87% of the patients. The causality was possible in 91.48% (n=86) and probable in 8.51% (n=8) of the serious adverse drug reactions. Males, patients even with a single concomitant disease and those with more than 2 concomitant medications were at increased risk (p<0.05) for developing serious ADRs.Conclusions: Serious ADRs are a significant problem in health care. Measures should be taken to detect and treat them at the earliest to reduce suffering of the patient.
Evaluation of hyperglycaemic risk of atorvastatin: a dose dependent study on hyperlipidaemic rats
Authors: Prashanth Kumar T. E. , S. Mahammad Juber , M. Swetha Vijetha
Published: December 2019

Background: Statins (β-hydroxy β-methylglutaryl-CoA (HMG-CoA) reductase inhibitors) are the most prescribed medications worldwide to treat hyperlipidaemia with a proven ability to reduce major cardiovascular events. Recent data have revealed that statin therapy is associated with an increased risk for developing diabetes. The risk was most significant in patients taking atorvastatin, rosuvastatin and simvastatin.Methods: Rats were divided into 3 groups, each comprising of 6 rats. Hyperlipidaemia was induced in all the animals after feeding with high fat diet for 15 days. Rats of groups 1, 2 and 3 were given atorvastatin 1.8 mg/kg (low-dose), 3.6 mg/kg (moderate-dose) and 7.2 mg/kg (intensive-dose) respectively orally for 60 days. 12 hours fasted blood samples were collected and analyzed for serum lipid profile, fasting blood glucose and HbA1c levels.Results: The percentage increase in plasma blood glucose after 60 days of treatment in groups 1, 2, and 3 is 29.93%, 60.03% and 72.42% respectively and the variation in all the groups is statistically significant, p<0.0001. Regarding HbA1c values, the variation in low-dose group is statistically insignificant whereas the percentage increase in moderate-dose and intensive-dose groups is 19.45% (p<0.001) and 43.37% (p<0.0001) respectively.Conclusions: In conclusion, there is significant increase in blood glucose and HbA1c levels leading to new-onset diabetes in both moderate-dose and intensive-dose groups. The risk is more in intensive-dose group when compared to moderate-dose group.
Cost comparison of commonly used antidepressant drugs with drug price control order in India
Authors: Kumar Narendra , Abbas Alisha , Ahmad Akhlaque , Choudhary Reshma , Ganguly Arpan , Dixit Rakesh Kumar
Published: December 2019

Background: Price of a drug is an important factor for compliance to the treatment. So, to overcome the high prices of drugs, National Pharmaceutical Pricing Authority (NPPA) under government of India has issued Drug Price Control Order (DPCO) list containing commonly used drugs. Pharmaceutical companies can be punished if they keep their prices higher than the ceiling price mentioned in the DPCO. To find out the price variations of commonly used antidepressant drugs included in DPCO list of 29th April 2019.Methods: A list of all oral antidepressant drugs included in DPCO of 29th April 2019 and available in Indian market was procured from medguide India. Analysis of number of total brands following as well as not following DPCO ceiling price was done.Results: Author found 17 formulations of four antidepressant drugs included in DPCO. Total 556 brands found out of which 84.6% were following the DPCO and 15.4% of brands prices were higher than the ceiling price of DPCO.Conclusions: Though large number of companies are following the DPCO but still strict regulation is needed to further increase the compliance of guidelines.
Antibiotic resistance pattern in patients with urinary tract infection: an observational study
Authors: Mallam Rupa Devi , P. Usha Kiran
Published: December 2019

Background: Urinary tract infection (UTI) is one of the most common diseases caused by bacteria in communities and hospital settings. With the irrational prescription of antibiotics and their misuse leads to constant increase in resistance. This study aims to evaluate the spectrum and antibiotic resistance pattern of uropathogens and to provide a basis for appropriate antimicrobial therapy in patients with UTI.Methods: A retrospective observational study was carried out for a period of 6 months from April 2018 to September 2018 at general hospital Kakinada. Data of 282 positive urine culture reports and their antibiotic susceptibility test results were collected from the records of the Microbiology department and were analyzed and depicted in percentages. Sample processing, identification of organisms, and pattern of antimicrobial sensitivity were carried out as per the Clinical and Laboratory Standards Institute guidelines.Results: Out of 282 positive reports, Escherichia coli was the most common isolated uropathogen with a total of 148 (52.4%) followed by Klebsiella 72 (26%), 20 (7.9%) each of Citrobacter and pseudomonas aeruginosa. E. coli were resistant to nalidixic acid (59.5%), cotrimoxazole (58.1%), ciprofloxacin (54%) amoxyclav (52.7%), ampicilin (45.9%), cefatoxime (37.8%), cefaperazone and salbactum (25.3%). Klebsiella were resistant to amoxyclav (77.7%), cotrimazole (50%), nalidixic acid (41.6%), ampicilin (44.4%), cefatoxime (27.7%), ciprofloxacin (25%). E. coli and Klebsiella were highly susceptible to nitrofurantoin, cefaperazone and salbactum, piperacillin and tazobactum, amikacin, imipenem, gentamicin.Conclusions: The majority of the isolated bacteria were resistant to many antibiotics commonly used in clinical practices. So prior culture reports and institutional antibiograms are necessary for prescribing antibiotics rationally.
Maternal-fetal prognosis of obstetric emergencies at the maternity ward of the Mamou regional hospital
Authors: Diallo B. A. , Bah O. H. , Barry M. S. , Conté I.
Published: December 2019

Background: Pregnant women may be at risk of unpredictable obstetric complications such as: bleeding, dystocia, acute fetal suffering, pre-eclampsia and eclampsia. This maternal-fetal prognosis of obstetric emergencies is influenced by factors that are most often related to complications that alter the course or outcome of a pregnancy and require prompt care. The objectives of this study are to analyze the factors that influence the maternal-fetal prognosis of obstetric emergencies; determine their frequency, describe the clinical profiles of patients and evaluate the maternal-fetal prognosis.Methods: The study was conducted at the Mamou Regional Hospital. It was a 6-month quantitative, descriptive and analytical study, from July 1st to December 31st, 2016, including all parturient women whose term is greater than or equal to 28 weeks of amenorrhoea.Results: The study covered 377 obstetric emergencies out of a total of 1273 deliveries, or 29.61%. Factors influencing the prognosis were: young age, parity, unfavorable socio-economic conditions and difficult baseline conditions. The main obstetric emergencies recorded were acute fetal suffering, disproportion and narrowed pelvis. The dominant mode of delivery was caesarean section with a frequency of 89.65%. Maternal lethality is 3.44% and fetal lethality is 5.14%.Conclusions: Obstetric emergency is a frequent situation where better management would improve the prognosis of the mother and fetus.
A randomized control trial of hypothermia alert device in low birth weight newborns and the effect on kangaroo mother care and weight gain
Authors: S. Jagadish A. , Benakappa Asha , Benakappa Naveen , Morgan Gini
Published: December 2019

Background: Lack of thermal protection is one of the major challenges faced by developing nations for newborn survival. Early detection and subsequent prevention of hypothermia through Kangaroo Care could lead to significant health outcomes for the newborn. Hypothermia alert device is a bracelet that monitors for early hypothermia by sensing the extremities and sounding an alarm for parents to take action.Methods: In a randomized controlled trial, the effect of the hypothermia alert device on KMC compliance at home and weight gain of newborns on 4th week follow-up was evaluated. New borns discharged from the neonatal intensive care unit at Indira Gandhi Institute of Child Health (IGICH). Neonates who were LBW (less than 2500 grams) were included in the study once they were stable and ready for discharge. Neonates were given a hypothermia alert device to monitor their temperatures for hypothermia for 4 weeks. Weekly follow-ups were held with parents and to record measurements of growth. Additionally, parents were given a KMC diary to track sessions of KMC. Neonates were given either a placebo bracelet or a BEMPU Bracelet. Bracelets were identical and both monitored for hypothermia, however only the BEMPU Bracelet gave an alarm when the newborn was hypothermic.Results: Statistically 44 neonates completed the 4-week trial; 23 were in the control group and 21 were in the BEMPU group; of these, 19 participants in the control group completed KMC diaries and 19 BEMPU group completed KMC diaries. The results of the clinical trial reveal that parents of neonates in the BEMPU group demonstrated better compliance to KMC. In the BEMPU group, the average daily time spent doing KMC was significantly higher in first (3.02 v 1.96 h, p=0.016) and fourth (3.04 v 2.38 h, p=0.094) week of discharge. There was an increase of weight gain in the BEMPU group after the first (25.7 v 20.7 g, p=0.1.85) and fourth (28.3 v 22.9 g, p=0.057) week of discharge.Conclusions: The hypothermia alert device was found to be an effective intervention to promote parent adherence to Kangaroo Care and weight gain.
A prospective study of postoperative outcome following splenectomy in immunocompromised thalassemia patient with special reference to CD4 count
Authors: Patole Monali Madhukar , Patole Mandar Madhukar , Ghosh Manoranjan
Published: December 2019

Background: Thalassemia are inherited blood disorders that can result in the abnormal formation of hemoglobin. Splenectomy is indicated in the transfusion-dependent patient when hypersplenism increases blood transfusion requirement and prevents adequate control of body iron with chelation therapy. Ninety percent of recipients transfused with HIV antibody-positive blood are found to be HIV infected at follow-up. Prevailing literature on effects of splenectomy on CD4 count suggests that splenectomy causes an abrupt and prolonged increase in CD4 cell count. The aims and objectives this is an Institution based prospective observational study with the aim to observe postoperative outcome in immunocompromised thalassemic patients following splenectomy, postoperative outcome following splenectomy in a patient with low CD4 count and to analyze the effect of CD 4 count if any on different patients in terms of wound infection, chest infection , urinary tract infection or infection at any other site.Methods: The study included twenty immunocompromised thalassemia Patients attending in Pediatric Surgery OPD and admitted to Paediatric Surgery department of Medical college and hospital Kolkata with splenomegaly and HIV infection for splenectomy, between January 2015 to December 2016.Simple comparative analysis of gathered data was used to evaluate postoperative outcome m and the preop and the post op CD4 count levels of splenectomised thalassaemic patients.Results: Most patients in this study were in the (3-8) years age group and all are HIV positive patients with thalassemia. In this study author found there was increased CD4 count after splenectomy and postoperative period one patient developed postoperative oral candidiasis.Conclusions: HIV-infected thalassaemic patients on ART can now safely undergo major splenectomy surgery with encouraging results and in patients with a low CD4 count, there is no relation of CD4 count and splenectomy outcome.
Awareness and attitude of mothers of primary school children towards child sexual abuse in Tamil Nadu, India
Authors: Shirley S. Alph , Kumar S. Santha
Published: December 2019

Background: Child sexual abuse leads to several adverse impacts in the affected children. A study on awareness and attitude of mothers towards child sexual abuse will help to formulate better techniques to improve awareness and prevent child sexual abuse. The objective is to study the awareness and attitude of mothers of primary school students towards child sexual abuse.Methods: This cross-sectional observational study was done in the state of Tamil Nadu, India among 186 mothers of primary school children. Data were collected from the mothers using a predesigned questionnaire and analyzed.Results: Only 12.9% of the mothers were aware of the POCSO Act and 32.8% were aware of the child helpline 1098. 76.9% of the mothers were aware of unexplained genital injury as a physical indicator of child sexual abuse. Acute traumatic response (83.9%) and regression in behavior (82.8%) were the commonly aware behavioral indicators of child sexual abuse. Only 25.3% of the mothers believed that boys can be sexually abused. 75.3% of the mothers believed that the offenders were usually unknown persons. 88.7% of the mothers believed that unaccompanied children were a risk factor. 88.2 % of the mother believed that physical and mental disability in children was a risk factor. Majority of the mothers believed that streets (88.7%) and institutions (80.1%) were the common environment for child sexual abuse. Only 23.7% of the mothers had taught regarding good touch and bad touch to their children. 50.5 % of the mothers believed that the major role in preventing child sexual abuse is played by the parents.Conclusions: Awareness regarding child sexual abuse was low among the mothers of primary school children.
Hereditary myoclonus dystonia - rare entity diagnosed in younger children: report of a sporadic case with atypical features
Authors: Mishra Varsha , Sehgal Rachna
Published: December 2019

Hereditary myoclonus dystonia is a rare movement disorder characterized with combination of myoclonic jerks with mild to moderate dystonia. Mostly caused due to changes in SGCE gene. Author report case of a 3 years old girl with atypical features of lower limb onset, mild dystonia, upper limb and neck myoclonic jerks and younger onset. She was detected to have pathogenic variant of SGCE gene. A diagnosis of myoclonus dystonia should be considered at an early age also like in our case so that treatment is initiated early for better results and improved quality of life and development.
Assessment of obesity and visceral fat in diabetic nephropathy patients
Authors: Chandra Kumar Prafull , More Balaji D. , More Anju B.
Published: December 2019

Background: Diabetic nephropathy is one of the most common diabetic microvascular complication that typically develops after 10 years of diabetes diagnosis. The primary aim of this study was to evaluate the prevalence of obesity and visceral fat in Type 2 Diabetes (T2D) cases with nephropathy and without-nephropathy complication.Methods: In this cross-sectional study, diabetic nephropathy was diagnosed on the basis of biochemical tests of urine albumin, serum creatinine, eGFR, BP, and clinical assessment in patients with T2D. The prevalence of diabetic nephropathy estimated and the association between adiposity and diabetic nephropathy in patients T2D was evaluated. Measures of adiposity included body weight, Body Mass Index (BMI), Waist Circumference (WC), body fat percentage, muscle mass percentage and visceral fat percentage. Analysis of variance indicate difference in the various fat analysis parameters in presence and absence of nephropathy. PROC GLM procedure in the SAS Software was used for statistical calculations.Results: A total of 247 patients with type 2 diabetes (mean age 53.46±11.62 years; 39.5% females) were enrolled in this study. The participants were grouped as with Diabetic Nephropathy (DN) 41.60% (N=99) and without Diabetic Nephropathy (NDN) 58.40% (N=139). The comparison of DN and Non-DN groups showed no significant difference in the BMI, body and visceral fat, muscle mass percentage. Conclusions: Irrespective of the nephropathy status the body fat and visceral fat percentage is increased, and the muscle mass percentage is decreased in diabetes patients. As both obesity and diabetes contribute to the development and progression of renal disease, measures should to taken to reduce the body fat.
Clinical study of cardiovascular involvement in patients with hypothyroidism
Authors: Kishan U. , Krishna J. Gopala
Published: December 2019

Background: Hypothyroidism is usually associated with the involvement of the cardiovascular system in the form of the cardiac abnormalities. The Research data on this has been found to be limited. The dysfunction of the cardiac caused by hypothyroidism is usually reversible. Objective was to study the incidence of cardiac abnormalities in patients with hypothyroidism.Methods: Total 40 confirmed cases of hypothyroid disease were included in the present study. General investigations, ECG, ECHO was done in all the patients to assess for cardiovascular involvement. The data was entered in the Microsoft Excel worksheet and analysed using proportions.Results: One fourth of the patients were found to have the bradycardia. The Delayed ankle jerk was seen in 67.5% of the cases and the next common CNS manifestation was the hoarseness of the voice. 30% of the case had normal ECG findings. 40% of the cases had the bradycardia. 35% of the cases had the low voltage complexes. 32.5% of the cases had the normal ECHO reports. 27.5% of the cases had the pericardial effusion. Same proportion of the cases were found to have the diastolic dysfunction. But most of them had the dysfunction and the severe cases were found to be very few. Only two patients had IVS thickness.Conclusions: Majority of the cases of the hypothyroidism in the present study were found to have the cardiovascular involvement. This points towards the importance of the early diagnosis of hypothyroidism and the prevention of complications like the cardiovascular system and the central nervous system involvement.
Etiology and clinical profile in chronic cor pulmonale
Authors: Malipatil Abhishek , Dhulappanavar Chandrasekhar , Chaudhary Hareen , . Hemanth
Published: December 2019

Background: Cor pulmonale is a synonym for pulmonary heart disease. The term “cor pulmonale” if broken into its constituents “cor” (heart) and “pulmo” (lungs), means cardiac involvement due to pulmonary diseases. Chronic cor pulmonale is not a single disease entity but resulting secondary to many bronchopulmonary vascular diseases and also from thoracic cage abnormalities. Cor pulmonale accounts for 5-10% of all heart diseases, 20-30% of all admissions for heart failure and 9.2% in the cardiac autopsies.Methods: This was a hospital-based study carried among patients diagnosed with chronic cor pulmonale admitted to the medical wards of Karnataka institute of medical sciences, Hubli. during December 2011- November 2012 using simple random sampling method.Results: The following observations were made in 50 representative cases the age group of patients was between 24 to 85 years. Chronic cor pulmonale was commonly seen in middle and elderly age groups. Incidence below 35 years is very less. Almost every patient of chronic cor pulmonale presented with breathlessness and cough.  All patients in the study had Tachypnoea, Diminished chest movements, Prominent use of accessory muscles of respiration, Cyanosis, Clubbing (in some patients), Crepitations and rhonchi on chest auscultation, Loud P2 and pansystolic murmur in Tricuspid area on cardiac auscultation.Conclusions: The peak incidence of chronic cor pulmonale was found to be in the middle and older age groups with high incidence during winter season. Smoking and dusty environment at the site of occupation were aggravating the primary lung disease. Breathlessness, cough and edema of the feet were the most common symptoms.
Islets of hypoglycaemia: a rare case of adult onset nesidioblastosis
Authors: R. Madhumathi , N. Mohan C. , S. Prabhu
Published: December 2019

A case of diffuse nesidioblastosis in an adult patient is reported in this study. A 24-year-old female with no known comorbidities presented with multiple episodes of documented recurrent hypoglycaemia and Hypoglycaemia induced seizures both in fasting and postprandial state. Her blood investigations revealed low plasma glucose levels, high insulin and C-peptide levels with positive 72-hour fast test. Her transabdominal USG and CECT abdomen did not reveal any abnormality, 68Ga DOTANOC PET CT done showed ill-defined diffuse somatostatin receptor expression in the pancreatic head and tail suggestive of nesidioblastosis. As patient was not willing for surgical treatment, hence started on medical treatment with oral nifedipine. Nesidioblastosis is very rare in adults. It is an important differential diagnosis in adults with hyperinsulinemic hypoglycemia although the incidence is very rare in adults. PET SCAN was used to non-invasively diagnose nesidioblastosis in this case. Surgery being the preferred choice of treatment in nesidioblastosis, there is limited data on medical line of management in nesidioblastosis.
A study of sensory neural hearing loss in chronic suppurative otitis media
Authors: Upadhyay Prakhar , Hiremath Chandrashekharayya S. , Reddy K.R. Prasen
Published: December 2019

Background: The role of chronic inflammatory disease of the middle ear as a cause of sensory neural hearing loss (SNHL) is still debatable. Therefore, the role of this study to see if there is a relation between SNHL and duration of chronic supportive otitis media (CSOM), socio-economic (SE) status and age of patient.

Methods: The hospital based case series study was conducted on all CSOM patients coming to ENT out-patient department in S. Nijalingappa Medical College and Hanagal Shri Kumareshwar (HSK) Hospital, Bagalkot, Karnataka over a period of one and a half years. After clinical examination, hearing evaluation was done using PTA as main tool.

Results: Based on the present study, overall proportion of patients with SNHL was 20.66%. No relation of SNHL was found between sex and SE status of patient. No relation was found between severity of SNHL and age of patient. No relation was found between severity of SNHL and duration of CSOM. This present study shows that patients with CSOM with increased age have a greater chance of developing SNHL. Also, as the duration of CSOM increases there is a greater chance to develop SNHL.

Conclusions: This study shows that the chance of developing SNHL in CSOM increases with age and disease duration. Hence, we can conclude that CSOM should be treated appropriately as early as possible to reduce the risk of developing SNHL in patients with CSOM.
Nasal endoscopic evaluation of patients presenting with frontal headache
Authors: Menon Ravunniarth Lakshmi , Narayana G. K.
Published: December 2019

Background: Headache is a universal symptom affecting most people at some point in their lifetime. The most common cause of headache in ENT is acute sinusitis or an acute exacerbation of chronic sinusitis. Anatomic variations like a massive concha bullosa, enlarged ethmoidal bulla, laterally rotated uncinate can interfere with mucociliary clearance. Thus, a thorough nasal endoscopic evaluation will help us to detect any anatomic abnormality which may predispose to sinogenic headache.

Methods: 100 patients with frontal headache underwent diagnostic nasal endoscopy and all anatomic variations and pathological abnormalities were noted

Results: 83% cases had a diagnosis of deviated nasal septum or rhinosinusitis, and the rest 17% had non sinonasal cause for headache

Conclusions: Anatomic abnormalities like middle turbinate anomaly, spur, enlarged bulla, hyperplastic uncinate and pathological abnormality like mucopurulent discharge, polypi can be diagnostic of sinogenic cause for frontal headache.
A rare case of mesenchymal hamartoma of cheek masquerading as hemangioma
Authors: Viswambharan Vivek , Narayana M. Lakshmi , Chaithanya N. Reddy , Kumarguru B. N. , Sushma Bijjam
Published: December 2019

Hamartomas are non-neoplastic, tumor-like masses characterized by irregular overgrowth in tissues of its origin, resulting from inborn errors that occur during embryonic development and are present from birth. They may develop from any of the three germinal layers of which mesodermal-derived overgrowth is the most common. Hamartomas may be seen anywhere in the body and most often arises from lung, liver, spleen, kidney, gastrointestinal tract, and rarely in the head and neck region. A 23-year-old lady presented with a painless left cheek swelling for three months. On clinical examination, she had a single, firm and ill-defined swelling of size 2×1cms in left cheek. Ultrasound examination showed an ill-defined hypoechoic lesion measuring 2.1×0.8 cms in the intramuscular compartment of left cheek with few cystic areas. On colour doppler there was minimal peripheral vascularity and flow signal suggesting capillary hemangioma. In view of the tumor’s vascularity, Fine needle aspiration cytology wasn’t performed and she was treated conservatively on oral propranolol. But since no significant response was noted, excision biopsy was done under general anesthesia. The histopathology features were consistent with mesenchymal hamartoma. Post-operative period was uneventful, and she was in regular follow up with no recurrence.
Factors determining the range of motion in primary total knee arthroplasty
Authors: Rathod Mallesh , Kanugula Sandeep Kumar , S. M. Venugopal , Gudaru Jagadeesh
Published: December 2019

Background: Total knee arthroplasty (TKA) ­­­­­­is one of the most successful surgical procedure with over 90% survival rate at 10 to 15 years. It provides a stable, pain free range of motion (ROM) for day to day activities. The aim of this study is to evaluate various factors determining ROM after TKA.

Methods: 348 patients with 390 knees treated with TKA using cruciate retaining (CR) and posterior stabilized (PS) prosthesis were included and analysed. Mean follow up period was 18 months. Patients were analysed for factors like age, sex, diagnosis, body mass index (BMI), pre-operative exercises, ROM, deformity, posterior femoral condylar offset (PFCO), posterior tibial slope (PTS), post-operative rehabilitation and implant design (CR vs PS). Statistical analysis of above factors on knee ROM was done. Patients were assessed pre-operatively, at 6 weeks, 3, 6, 12 and 18 months post-operatively.

Results: Age and sex did not affect the final ROM. The mean knee ROM improved from 86.87° to 96.95°. Factors like BMI, deformity had negative correlation and Pre-operative diagnosis, exercises, knee scores, good preoperative ROM, PFCO, PTS had positive correlation on ROM.

Conclusions: Pre-operative exercises, diagnosis, ROM, deformity, BMI, PFCO and PTS were important factors which influence ROM in TKA. Patient selection and preoperative counselling are important for good clinical outcome.
Functional outcome of modified technique of intramedullary fixation of diaphyseal humeral fractures
Authors: Sharma Mohit , Golhar Anil , Mankar Sushil , Krishna Rishav
Published: December 2019

Background: The aim of this study was to evaluate the functional outcomes with intramedullary fixation using flexible nails and to follow up for any other complications.

Methods: Study was a prospective study in Lata Mangeshkar Hospital, Nagpur during 2014 to 2016. All the patients enrolled in the study were briefed about the nature of the study. All cases in this series were operated by combined antegrade and retrograde approach.

Results: Total of 30 patients of closed diaphyseal humeral fractures was studied. Maximum i.e., 16 (53.33%) were in the age range of 21-40 years, followed by 10 (33.33%) patients in the range of 41-60 years. 21 (70%) cases had fracture union between 10-16 weeks with a score of 8 points, followed by 8 (26.67%) patients with fracture union duration of less than 10 weeks with a score of 10 points. Only one of the patients landed up with non-union. The mean functional score of patients at 3rd month was 64.03±4.99, 9th month was 73.46±2.56. 86.66% patients had good to fair outcome, 3.33% patient each had excellent and poor outcome.

Conclusions: Comparing results of our study with other studies, we found that our results are almost comparable but not better than open reduction and plating. Complications encountered in our series are comparatively less compared to those encountered during interlock nailing. The trauma to rotator cuff is minimum and this method is good alternative method. Thus, multiple nailing gives better functional outcomes as compared to locked nail. 
Paratricepital approach for open reduction and internal fixation of delayed presentation of pediatric supracondylar humerus fracture
Authors: Subbasetty Ramachandra , Manjunath Dayanand , Shivanna Deepak , Murthy Narasimha
Published: December 2019

Background: Delayed presentation of pediatric displaced supracondylar humerus fracture is relatively common. Management of such cases have higher incidence of perioperative complications and usually require open reduction and pinning. Open reduction can be done by various approaches, each having its own advantage and disadvantages.

Methods: A prospective study was done comprising 20 children with displaced Supracondylar fracture presented 2-14 days of injury, Mean patient age was 6 years. 15 were boys and 5 were girls. Children in whom closed reduction and percutaneous pinning was achieved, vascular injury and more than 2 weeks old fracture cases were excluded. Paratricepital approach was used for Open reduction and pinning for all the cases. The functional outcome was assessed using Flynn criteria.

Results: In all cases the fracture had united at complete follow-up and the mean follow-up period was 16 months. The outcome was excellent in 15 (75%), good in 3 (15%), fair in 1 (5%), and poor in 1 (5%) patients. The mean Baumann angle was 76º in the affected elbow and 73º in the normal elbow. Average time for complete union in the current study was 7 weeks. Pin tract infection was seen in 2, stiffness in 2 patients, cubitus varus in 1 patient. No case of compartment syndrome or iatrogenic nerve injury was seen was recorded.

Conclusions: Finally, we concluded that triceps sparing paratricepital approach is an easy, simple and safe approach for exposure and internal fixation of supracondylar humeral fractures in children with excellent functional outcome.
Retrospective analysis of unstable thoracolumbar fractures treated by postural reduction and posterior short segment pedicle fixation
Authors: Kalia Sandeep , Singh Jasbir , Parashar Aakash , Verma Amit , Sharma Shalini
Published: December 2019

Background: For unstable dorslolumbar injuries, the controversy in choosing between long versus short segment posterior fixation continues.

Methods: 29 patients (13 males, 16 females) with single level unstable thoracolumbar fracture operated by short segment posterior pedicle screw fixation were evaluated retrospectively in terms of kyphosis correction achieved in immediate post-operative period, loss of kyhposis correction at final follow up and clinical outcome on Denis pain scale and any failure of fixation. Average follow up period was 22.07 months (14-40 months).

Results: Average age of patient was 35.7 years (15-50 years). Mode of injury was fall from height in 27 patients and road traffic accident in 2 patients. 12 fractures were at L1, 9 at D12, 6 at L2 and 2 at L3. Neurologically 11 had paraparesis, 4 complete paraplegia and 14 were without any deficit. Pre-operative kyphotic angle was 23.023±11.14 (8-50 degrees) which improved to 7.03±4.69 (0-18) post operatively. Kyphosis at final follow up was 11.759±5.901 (2-25). Loss of kyphosis correction at final follow up was 4.79±2.042 (2-10 degrees). Load sharing classification score (LSC) was 6.89±1.345 (4-9). Denis pain scale at final follow up was p1 in 11 patients, p2 in 15 patients and p3 in 3 patients. There was no case of implant failure and only one case had kyphosis correction loss of 10 degrees.

Conclusions: Short segment fixation provides stable fixation with good results and there is no correlation between LSC and fixation failure.
A study of an operative outcome of a basitrochanteric fractures of the hip treated by dynamic hip screw and enders nail with percutaneous canulated cancellous screw
Authors: Vyas Ambrish J. , Patel Vijay J. , Patel Keval H. , Panchal Ravi G.
Published: December 2019

Background: Basicervical or cervicotrochanteric fracture of the femur is considered stable variety of fracture pattern. Most common incidence is seen in elderly patient and in young patient with probably high energy trauma. Appropriate Osteosynthesis confers excellent outcome when reduction is optimally achieved.

Methods: 86 basitrochanteric fractures had been treated with enders nail or dynamic hip screw (DHS) at our institute by a single surgeon. Implant selection was done purely based on plain radiograph, associated co-morbidities and fracture geometry. Patients had been followed up at 1 month, 3 month and 6 month.

Results: In our study there were 86 patients out of which 63 patients (73.25%) were treated with enders nail and 23 patients (26.74%) were treated with DHS. Mean age of patients was 57 years. We noted minimum follow up of 8 months while maximum follow up of 4.5 years where as mean follow up duration is 18 months. We almost noted excellent to fair results in both groups.

Conclusions: Most of the implants in basitrochanteric fractures worked on control collapse principle. Both DHS and enders nail with percutaneous cc screw follow this principle and when used with a proper technique, optimal reduction usually fetch the favourable outcomes with minimalistic approach.
A case report on the effect of Cissus quadrangularis on fracture union in 26 years aged man
Authors: L. Naveen Kumar , Joshi Dharitri
Published: December 2019

Ayurveda the ancient science of medicine describes various herb preparations that achieve the hastening of bone healing. Cissus quadrangularis Linn. is an indigenous medicinal plant which belongs to a family of Vitaceae. A case study was undertaken to evaluate the fracture union and effectiveness in reduction of pain and swelling in a 26 year old male with Bennett’s fracture. A quick union of fracture was observed within 6 weeks of treatment with C. quadrangularis. Post treatment radiographic reports showed united fracture with good amount of callus.
Etiological profile of pyodermas in a tertiary care hospital in North-East India and their antibiotic sensitivity pattern
Authors: Devi Bijayanti , Das Kamal , Gupta Suman
Published: December 2019

Background: Hypermelanoses involving predominantly the face and the neck is relatively common and often presents a complex diagnostic problem. The present study was done in the study population of 500 patients of facial pigmentation, attending the skin outpatient department in AarupadaiVeedu Medical College and Hospital from October 2015 to September 2017. Aim and objective of the study was to study various clinical patterns of facial pigmentation, their clinical characteristics, their association with other pigmentary disorders and to evaluate the different etiotogical and precipitating factors.

Methods: In this study, a special proforma was prepared. Patients were thoroughly interviewed and examined to find out dermatological and systemic diseases and they were subjected to investigations to evaluate different etiological factors and diagnose the clinical type of facial pigmentation.

Results: The present study showed a strong female preponderance. Among the total study population there were 55% cases of melasma, 20% cases of Riehls melanosis, 10% cases of periorbital pigmentation and 5% of miscellaneous causes.

Conclusions: Facial pigmentation was commonly seen in the females. 21-30 years age group was the most commonly affected age group in all types of facial pigmentation. Melasma, Riehls melanosis and periorbital pigmentation were the most common clinical types of facial pigmentation observed.