bluuebunny/crossref_metadata_2025 huggingface dataset:
St. Petersburg association of family medicine. Chronicle of events
Authors: Kuznetsova Olga Yu , Andryukhin Anton N , Degtyareva Ludmila N , Mohika Estepa Maria O , Yubrina Irina V
Published: January 2018

The article briefly describes the main stages of the formation of the St.Petersburg Association of Family Medicine. The role of the public professional organization in the implementation of continuous medical education is presented.
Diagnosis and treatment of vestibulapathy in ambulatory practice
Authors: Kandyba Dmitriy V
Published: January 2018

The lecture devoted to general practitioners presents modern ideas about clinical diagnostic, treatment and prevention of vestibular disorders from the point of view of neurologists and specialists in the field of otorhinolaryngology.
O choque desencadeia memórias de guerra: Störfall, de Christa Wolf
Authors: Umbach Rosani Ketzer
Published: January 2018

Este trabalho procura analisar as relações entre memória e guerra como estratégia ficcional da autora alemã Christa Wolf em Störfall (Acidente), de 1987, obra publicada pouco depois do desastre nuclear de Chernobyl ocorrido na União Soviética em 1986, há mais de 25 anos, o qual intensificou o movimento contrário ao uso de energia nuclear. O choque causado pelas consequências da explosão do reator – a contaminação da população e de grandes extensões de terras, a aproximação da nuvem radioativa ao continente europeu – serve como ponto de partida para uma escrita que reflete sobre o destino da humanidade, sobre as guerras e o que seria o “ponto cego” de nossa civilização.
Entre mito e propaganda: um olhar sobre o cinema documental franquista
Authors: Jaeckel Volker
Published: January 2018

Resenha de El pasado es el destino. Propaganda y cine del bando nacional en la Guerra Civil, de Rafael R. Tranche e Vicente Sánchez-Biosca.
A escrita feminina do trauma de guerra e a re-sistência do real em A casa das sete mulheres, de Leticia Wierzchowski
Authors: Abreu Denise Borille de
Published: January 2018

O presente artigo propõe aproximações entre estudos literários e psicanalíticos para um maior entendimento do trauma gerado nas mulheres pela guerra e da particularidade da escrita feminina do trauma de guerra, tomando-se como exemplo a narrativa A casa das sete mulheres, de Leticia Wierzchowski.
Criaturas de la guerra. Memorias traumáticas de la guerra civil en el cine español contemporáneo
Authors: Meseguer Manuel Nicolás
Published: January 2018

Este artículo aborda el estudio de un conjunto de películas de la primera década del siglo XXI que, con el trasfondo de la Guerra Civil y la Posguerra, han construido relatos desde las coordenadas del cine fantástico y de terror. Estas películas que se distancian de la tradición del drama social y político, evidencian una forma distinta de mirar y sentir la historia española. Las películas a las que nos referimos son: El espinazo del diablo (2001) y El laberinto del fauno (2006), ambas de Guillermo del Toro; Balada triste de trompeta (2010), de Álex de la Iglesia; y El mar (2000) y Pa negre (2010), de Agustí Villaronga. En todas ellas hay un tema común: una infancia traumatizada por los desastres de la guerra. A través del presente artículo se analizarán estos relatos tomando como eje fundamental la presencia del concepto estético de “lo siniestro”, auténtico motor ficcional para el sustrato histórico de estos filmes.
Guerra aérea na literatura alemã e o caso de Retaliação de Gert Ledig
Authors: Pereira Valéria Sabrina
Published: January 2018

Em 1997, W.G. Sebald apresentou duas conferências na Universidade de Zurique, nas quais defendeu que os ataques aéreos sofridos pela Alemanha não encontravam praticamente nenhum eco nas representações literárias produzidas no país. Com a exceção de uma narrativa escrita por Hans Erich Nossack, as poucas descrições ficcionais eram breves e muito ornamentadas, não oferecendo uma imagem aproximada do que foi o horror dos bombardeios. Suas afirmações tiveram grande repercussão, servindo como um impulso fértil para a discussão do assunto. Nesse contexto, Vergeltung (Retaliação) (1956), de Gert Ledig, tornou-se a bandeira do crítico literário Volker Hage para afirmar que a literatura alemã produziu, sim, obras de relevância sobre o tema, mas o trauma não permitiu que houvesse uma recepção positiva dos leitores em geral, razão pela qual esse livro, assim como outros, caiu no esquecimento. Este artigo apresenta a discussão que envolve a tese de Sebald e algumas das características que podem ter ocasionado uma maior resistência a Vergeltung na época de seu lançamento: a brutalidade crua da destruição física e psíquica que trespassa todo o livro e o tratamento que o autor concede à questão dos bombardeios como retaliação.
Análise Microbiológica da Qualidade das Águas do Rio Cuiabá Perímetro Urbano, a Partir de 4 Pontos de Amostragem
Authors: Oliveira Waléria Finicia de , Pinto Osvaldo Borges
Published: January 2018

A ocupação eminentemente urbana dos municípios resultou em um incremento da demanda nos diversos usos das águas do rio Cuiabá e consequente aumento das cargas orgânicas, de nutrientes e de coliformes gerados pelos esgotos domésticos. As microbacias hidrográficas, com vegetação natural remanescente, são áreas muito importantes para manter o abastecimento de água de boa qualidade. O objetivo deste trabalho foi realizar análises microbiológicas da qualidade da água do rio Cuiabá, especificamente no perímetro urbano, a partir de quatro pontos de amostragem, usando os parâmetros microbiológicos, a fim de quantificar Coliformes Totais e Escherichia coli. Foram feitas quatro coletas em pontos aleatórios, uma em 03/11/2014 e as outras três em 22/10/2015. Os resultados obtidos, nas análises feitas com as amostras, apontou como impróprio para o consumo humano, conforme a Resolução nº 357/05 do CONAMA.Palavras-chaves: Qualidade da Água. Bioindicadores, Escherichia coli.AbstratThe eminently urban occupation of the municipalities resulted in an increase in the demand for the different uses of the Cuiabá river waters and consequent increase in the organic loads, nutrients and coliforms generated by domestic sewage. The waters and consequent increase in the organic loads, nutrients and coliforms generated by domestic sewage. Thehydrographic basins with remaining natural vegetation arevery important areas to maintain the supply of  good quality water. The objective of this work was to perform microbiological analyzes of the water quality, specifically at the urban perimeter, from 04 Sampling Points, using the microbiological parameters, in order to quantify Total Coliformes and Escherichia coli. Four collections were performed, one for each point, the first on November 3rd, 2014, another on October 22nd, 2015. The results obtained from the analyses performed with the samples, pointed as inadequate for human consumption, according to Resolution number 357/05 of CONAMA.Keywords: Water Quality. Biological Indicators. Escherichia coli
Produção e Composição do Leite Residual sob Influência da Ocitocina
Authors: Mesquita Alan Andrade , Reis Eduardo Mitke Brandão , Demeu Fabiana Alves , Berbari Neto Felipe
Published: January 2018

Objetivou-se analisar a aplicação da ocitocina influenciando na eficiência da ejeção do leite, ao ponto de ocorrer um aumento da produção e mudanças na composição do leite. Foram utilizados 30 animais, durante 105 dias, divididos em dois tratamentos, no tratamento um, os animais receberam 0,5ml de soro fisiológico, logo após se realizava a ordenha destes animais, sendo considerado o tratamento controle, no tratamento dois, os animais receberam ocitocina ao final da ordenha e se reordenhavam estes animais. Para aferir a produção das vacas foram usados medidores de leite, com pesagens de produção realizadas quinzenalmente. Após aferida, a produção de todos os animais, as amostras de leite foram coletadas e encaminhadas para as análises posteriores. As variáveis físico-químicas do leite analisadas foram: porcentagem de gordura, lactose e proteína. Os resultados foram submetidos à análise de variância e, posteriormente, ao teste de comparação de médias, com diferença estatística significativa de 5%. De acordo com os resultados obtidos, a ocitocina influenciou na produção leiteira com um aumento na produtividade diária por animal, mas não se observaram diferenças significativas nas médias de porcentagem de gordura, lactose e proteínado leite.Palavras-chave: Leite. Ejeção Láctea. Proteínas do Leite.AbstractThis study aimed to analyze the application of oxytocin influence in the milk ejection efficiency, as to occur an increase in production and changes in milk composition. 45 animals were used for 105 days, divided into three treatments, the treatment one received 0.5ml of physiological saline, in the treatment two were given oxytocin to the animals before the milking; and in treatment three the animals received oxytocin at the end of milking. To measure the cow’s milk production, milk meters were used, and were performed fortnightly. After measured the production of all animals, samples were collected and sent to analysis. The physico-chemical variables analyzed were: percentage of fat, lactose and protein. The results were submitted to ANOVA and subsequently the mean comparison test, with statistical significance of 5%. According to the results obtained oxytocin influences the milk production with a significant increase in daily productivity per animal, but there was no significant difference in percentage of fat, lactose and milk protein.Keywords: Milk. Milk Ejection. Milk Proteins.
Análise do Programa Nacional de Controle do Tabagismo do Ministério da Saúde
Authors: Lemes Erick De Oliveira , Fátima Gisele Gisele , Santos Graciene Carvalho Brasil , Costa Joanete Botelho da
Published: January 2018

O tabagismo é o ato de consumir cigarros, cujo principal componente é a nicotina, um estimulante do sistema nervoso central, que induz à tolerância e à dependência. Na fumaça do cigarro já foram identificadas mais de quatro mil substâncias químicas, sendo que pelo menos 60 dessas são reconhecidamente causadoras de câncer. Além dos malefícios causados à saúde do próprio fumante, a fumaça exalada pelo consumodos derivados do tabaco também é prejudicial para coletividade. O programa de combate ao tabagismo é um importante instrumento para melhoria dos indicadores de saúde, que conta com apoio e aconselhamentos de profissionais adequados para os pacientes, com a finalidade de redução ou abandono do fumo. Dessa forma, pelo conhecimento de que fumar é mais do que um hábito, é um vício, e que traz malefícios grandes, o objetivo desse trabalho se pauta no conhecimento das ações empregadas no Programa Antitabagismo do Ministério da Saúde através de uma revisão bibliográfica de caráter exploratório documental. A pesquisa foi realizada por meio de buscas em livros e bases de dados bibliográficas, como SciELO, Bireme, Pubmed, Cochrane, Portal CAPES. Conseguiu-se, desta forma, estabelecer através de análise documental a eficácia e dimensão alcançada desse programa que realmente tem atingido o objetivo a que se propõe.Palavras-chave: Tabagismo. Saúde Pública. Dependência.AbstractSmoking is the act of consuming cigarettes whose main component is nicotine, a central nervous system stimulant that induces tolerance anddependence. In cigarette smoke, more than  four thousand chemicals have been identified, and at least 60 of these are known to cause cancer. In addition to the harm caused to the smoker’s own health, the smoke exhaled by the consumption of tobacco products is also detrimental to the community. The tobacco control program is an important tool for improving health indicators that counts on adequate professional support and counseling for patients for the purpose of reducing or quitting smoking. Thus, due to the knowledge that smoking is more than a habit, it is an addiction, and that brings great harm, the objective of this work is based on the knowledge of the actions employed in the Anti-Smoking Program of the Ministry of Health through a bibliographic review of Exploratory documentary character. The research was carried out through searches in books and bibliographic databases, such as SciELO, Bireme, Pubmed, Cochrane, Capes Portal. It was possible to establish, through documentary analysis, the effectiveness and the achieved dimension of this program, and that the goal has relly been achieved.Keywords: Smoking. Public Health. Dependency.
Ocorrência do Caramujo Africano Achatina Fulica (Bowdich, 1822) em Várzea Grande-MT: Estudo de Caso na Sede do Ministério da Agricultura
Authors: Da Silva Alves Maria Aparecida , Sales Rodrigues Neiva , Freitag Renata , Bofinger Jakson
Published: January 2018

O objeto de estudo é o Achatina fulica (Bowdich, 1822), uma espécie exótica introduzida no Brasil, frequentemente encontrada em ambientes antrópicos. Esse trabalho tem por objetivo verificar a ocorrência do caramujo africano (A. fulica) na área do Ministério da Agricultura, Várzea Grande/ MT, e investigar os conhecimentos da população sobre o molusco. Utilizou-s  como metodologia a observação durante dois meses, entre 05h00min e 06h00min da manhã, horário de maior atividade do molusco, e foi aplicado um questionário composto por dez perguntas sobre o molusco aos residentes próximos da área de cultivo das hortaliças, e aos funcionários do órgão público. Os resultados demonstraram que o público-alvo possui pouca informação sobre o caramujo africano; 64% disseram que não conhecem o molusco, 36,2% dos entrevistados não sabiam que esses animais podem causar doenças, 83,33% desconheciam a alimentação de A. fulica, 83% responderam que os animais eram mais visualizados no período chuvoso e 47,22% responderam que não acreditavam na existência de um método de controle eficaz. O desenvolvimento de estratégias eficientes para o controle e erradicação de A. Fulica, fundamentalmente, deve contar com envolvimento da sociedade em parceria com o Poder Público.Palavras-chave: Espécies Invasoras Exóticas. Molusco. Informação.AbstractThe Giant African Snail, Achatina fulica, is an exotic species introduced in Brazil, often found in anthropic environments. This study aimed to verify the occurrence of A. fulica in the area of the Ministry of Agriculture, Várzea Grande-MT, and investigate the knowledge of the population about themollusk. The methodology considered the mollusks observation for two months, between 5-6 am, considered the main period of snails activity, and a questionnaire was applied which was composed of 10 questions about the mollusk considering the residents that live nearby, and employees of the public body. The results showed that respondents have low information about the Giant African Snail, 64% said did not know the mollusk, 36.2 % did not know that these mollusks can cause disease, 83.33 % were unaware of the mollusks alimentary items, 83 % answered that the animals were most viewed in the rainy season and 47.22 % answered that they did not recognize any effective method of control. For the development of efficient strategies for A. fulica control is fundamental the involvement of society in partnership with the government.Keywords: Invasive Exotic Species. Mollusk. Information.
Status of package insert guidelines for drugs accessible as over the counter drugs
Authors: Jha Anuja , Joshi Usha , Hishikar Rajesh , Agrawal Manju , Halwai Ajay
Published: January 2018

Background: As per Indian pharmacopoeia, package inserts are part of a label that provides information on the article. It may be the sole source of information for drugs, which are available in the pharmacies without the prescription and it may include both prescription and over the counter (OTC) drugs. So, to aid in safety and efficacy of these drugs, package inserts must follow the standard guidelines (The Drugs and Cosmetics rule, 1945). The objective of this study was to observe the status of the standard guidelines for package insert in drugs accessible as OTC drugs.Methods: Based on the inquiries made with pharmacies, list of drugs commonly bought without prescription was made. 256 drugs were evaluated. Their package inserts were observed for the extent to which the guidelines given by The Drugs and Cosmetics rule 1945, section 6.2 and 6.3 are being followed. Secondary objectives were made to assess if package inserts are physician friendly or patients friendly.Results: Package inserts were missing in 180 (70%) of the drugs.  Therapeutic indications were present in 71% of the available package inserts (76). Pharmaceutical information was given in 57% of the package inserts. English was the preferred language and medicinal terms were used. Only one package insert was patient friendly.Conclusions: Package inserts should be made available in every drug. There should be a separate patient oriented package insert guideline, as per US food and drug administration (FDA), in India as well. This will aid in their safe and effective use.
An evaluation of knowledge, attitude and practice of pharmacovigilance among medical students and doctors at a tertiary care hospital
Authors: Beedimani Ravindra S. , Zaman Sameer Uz , Darb Subrahmanyam , Potturi Sharat Chandra
Published: January 2018

Background: Drugs are one of the most commonly used interventions in medical therapeutics. Spontaneous reporting of adverse drug reactions (ADRs) is the backbone of pharmacovigilance (PV) program. Under-reporting of ADRs by prescribers was possibly due to lack of knowledge, attitude and practices regarding PV. This study was done to assess the knowledge, attitude, and practice (KAP) of medical students (grouped to sixth and eighth semester) and medical doctors about PV in a tertiary care hospital.Methods: It was a questionnaire based cross-sectional study administered to 246 medical students and doctors. Study tool was a validated questionnaire containing 15 questions to evaluate KAP of PV among medical students and doctors. A descriptive analysis of data was done where necessary, statistical significance for associations between the group and their responses to questionnaire was provided using Pearson Chi square test and Fisher exact test.Results: Sixty-eight percent of the participants (90% doctors; 76% eighth-semester and 46% sixth-semester medical students) know the correct definition of PV. Sixty-one percent of the participants (67% sixth-semester, 61% doctors and 53% eighth-semester) think that reporting is a professional obligation for them. Only 15% of the participants have ever been taught or trained on how to report an ADR.Conclusions: Medical doctors and students lack adequate knowledge and practice of reporting ADRs, but they seem to have a positive attitude towards the PV program. Our study findings strongly suggest that there is a great need to create awareness amongst them to promote reporting of ADRs.
Evaluation of anxiolytic effect of furosemide in Albino rats
Authors: Goyal Malvika , H. Jyothi C. , Damodar Rahul H.
Published: January 2018

Background: Anxiety disorders are the most prevalent class of psychiatric condition. Medications commonly given for treatment can elicit several central nervous system (CNS) side-effects that patients find difficult to tolerate. So there is a need for new pharmacotherapeutic approaches to treat anxiety with greater efficacy and fewer side effects. Hence this study has been taken up to evaluate the anxiolytic effect of furosemide at three different doses (75mg/kg, 150mg/kg and 200mg/kg) in Albino rats.Methods: After obtaining approval from the institutional animal ethical committee 30 Albino rats weighing about 150-200gm were taken and divided into 5 groups of 6 rats each. Group 1: Normal Saline 10ml/kg (control); Group 2: Diazepam 2mg/kg (standard); Group 3: Furosemide 150mg/kg (test group 1); Group 4: Furosemide 200mg/kg (test group 2); Group 5: Furosemide 75mg/kg + Diazepam 1mg/kg (sub threshold dose). The anxiolytic activity of furosemide was tested by elevated plus maze and digital actophotometer models. Data was analysed using one way ANOVA followed by Posthoc Tukey’s test.Results: Furosemide (150mg/kg and 200mg/kg) have shown significant increase in open arm entries (p<0.05) and time spent in open arm (p<0.05) compared to control. Also furosemide (150mg/kg and 200mg/kg) have shown statistically significant decrease in locomotor activity (p<0.05) compared to control in actophotometer model. Potentiation of time spent and number of entries in open arm and decrease in locomotor activity were noticed when sub threshold doses of combination of diazepam and furosemide were used.Conclusions: These results suggest that furosemide possesses significant anxiolytic activity at both the doses. Furosemide given in sub threshold dose potentiates the antianxiety effect of sub threshold dose of diazepam when used in combination. Hence, after further studies, furosemide can be used as an anxiolytic drug.
Effect of pregnancy on packed cell volume and total white blood cells count among Sudanese pregnant women attending antenatal care at Ribat University Hospital (Khartoum state)
Authors: Ahmed Wafa Mubarak M. , Khalid Abdurrahman , Musa O. A.
Published: January 2018

Background: During pregnancy the women undergo several structural and physiological changes almost in all body systems including the hematological profile. The main reported hematological change is the plasma expansion and haemodilution which affect the red blood cells(RBCs) and white blood cells (WBCs) count in addition to other hematological indices including packed cell volume (PCV). The objective of this study was to assess the effect of pregnancy on packed cell volume and white blood cells among Sudanese pregnant women and derive a formula for the normal values in pregnant women in relation to the packed cell volume.Methods: An analytical case control study was conducted in Khartoum state, Sudan 2017. The study included20 Sudanese pregnant women in the second and third trimesters attending the antenatal care at The National Ribat university hospital and 20 Sudanese non-pregnant women in the same age group as control. A questionnaire was used to collect socio-demographic and clinical data.5ml of venous blood was collected in a container containing EDTA. Complete blood count (CBC) was measured by using automated cell counter Sysmex.Results: There was statistically significant decrease in PCV value during 2nd and 3rd trimesters of pregnancy compared to the non-pregnant control group with p values (0.00 and 0.04 respectively), and statistically significant increase in WBCs count during 2nd and 3rd trimesters of pregnancy compared to the non-pregnant control group with p values (0.04 and 0.00 respectively). Also, a progressive increase in WBCs count with gestational age was demonstrated (second trimester 6.65×103/uL, third trimester 7.43×103/uL). The results showed mean WBCs of 7.79×103/uL, when compared to the estimated values the results showed no significant difference with the mean WBCs in 2ndand 3rdtrimesters (p value 0.06 and 0.39 respectively).Conclusions: During pregnancy there was statistically significant decrease in PCV values, statistically significant increase in WBCs count and by considering the haemodilution factor there was a higher increase in WBCs count.
Evaluation of primigravida in labour using modified WHO partograph: comparative study of 100 cases
Authors: D. Nivedita , Anjum Mehvish
Published: January 2018

Background: Prolonged labour has become a rarity in developed countries, but it still poses a problem in developing countries causing increase in maternal and perinatal morbidity and mortality. This study is undertaken to assess the efficacy of modified WHO partograph in monitoring progress of labour in primigravidae with spontaneous onset of labour and in patients with active management and to assess whether active management of labour helps in reducing the duration of labour.Methods: In this study, 100 primigravidae partographs are analyzed, 50 patients are in active management group (early amniotomy and use of oxytocin) and 50 patients are in control group (spontaneously).Results: The mean duration of first stage of labour in the study group is 6.73±2 and in the control group is 11.30±4.51hrs( statistically significant p<0.001).Mean duration of second stage of labour in study group is 33.73±28.77mins and in control group is 38±24.98 mins (p<0.079), mean total duration of labour in active group is 7.17±2.64 hr and  in control group is 11.76hrs±-4.71hrs ( p<0.001).89% of study group patients had Spontaneous Vaginal Delivery as compared to the 80% in control group (p>0.05 ). Assisted vaginal delivery (vaccum) is found in 6% in the study group and 8% in control group patients (p>0.05). LSCS is found 10% in study group and 8% in control group patients (p>0.05).Conclusions: Active management of labour significantly reduces the mean duration of 1st active stage, 2nd stage and total duration of labour, but does not decrease the rate of the caesarean section.
Adnexal torsion-five-year retrospective study
Authors: S. Latha Maheswari , Abraham Reena , Arunachalam Pavai
Published: January 2018

Background: Adnexal torsion is one of the gynecologic emergency conditions requiring prompt diagnosis and surgical treatment to save the ovarian function. This retrospective study is intended to analyze the clinical manifestations and treatment in a tertiary care center.Methods: This is a retrospective study Case records during five-year period of February 2012-2017 in PSG Institute of Medical Sciences and research, Coimbatore, India.Results: Adnexal torsion was seen in all age groups and commonly in reproductive age. It was seen in few pregnant patients also. Lower abdominal pain of acute onset associated with nausea and vomiting was the commonest clinical feature. Ovarian cyst and PCOD were the common risk factors predisposing torsion. Though ultra sound was the common modality used, the diagnosis was done based on strong clinical suspicion with surgical confirmation. The ovaries were preserved in some patients of reproductive age group.Conclusions: Adnexal torsion is one of the gynecologic emergencies. The symptoms and signs are nonspecific and may not have a confirmatory lab or imaging study. Hence a strong clinical suspicion followed by prompt surgical management in both pregnant and non -pregnant patients of any age group saves the ovary and further complications.
Maternal anaemia and its effects on neonatal anthropometric parameters in patients attending a tertiary care institute of Solan, Himachal Pradesh, India
Authors: Behal Manisha , Vinayak Rajeev , Sharma Anuj
Published: January 2018

Background: Anaemia during pregnancy is a significant concern in India. The consequences of iron deficiency anaemia during pregnancy are often serious and long lasting for both the mother and the foetus. Haematocrit measurement is an acceptable and recommended method for anaemia determination especially in situations where limited resources are available, and the technical support is poor. There is a rough conversion factor of 3 which converts the HCT value to approximate haemoglobin level. Present study desires to know the prevalence of anaemia (with classification into mild, moderate and severe) in 3rd trimester pregnancy, to know effect of anaemia in pregnancy on new-born anthropometric parameters and to assess the validity of the threefold conversion between haemoglobin and haematocrit for the determination of anaemia in pregnancy.Methods: The estimation of haematocrit was done by micro-haematocrit method and estimation of haemoglobin was done by automated blood cell analyzer based on cyanmethemoglobin method. Welch's ANOVA, Post Hoc games Howell test and Bland Altman limits of agreement method were used for statistical analysis.Results: Present study showed that 53.75% women in their 3rd trimester were anaemic (mild, moderate and severe anaemic mothers were 22.25%, 28.25% and 3.25% respectively). The standard 3-fold conversion between the haemoglobin and haematocrit was not found to be valid for the assessment of anaemia in the 3rd trimester pregnancy. Finally, while comparing anthropometric measurements between mild/ no anaemia group with severe anaemia group we found that all measurements were less in severe anaemia group and this difference was statistically significant.Conclusions: This study shows that 53.75% women in their 3rd trimester were anaemic, which closely mimic the WHO data but is about 11% more than the prevalence in Himachal Pradesh. Secondly, the standard 3-fold conversion between the haemoglobin and haematocrit was not found to be valid for the assessment of anaemia in the 3rd trimester pregnancy. Finally, birth weight, height, head circumference, chest circumference and mid-arm circumference were significantly affected by third trimester haemoglobin that too the most in severe anaemia cases.
Hysteroscopic evaluation in infertility and abnormal uterine bleeding
Authors: Kaur Navneet , Bhatia Ruby , Kaur Paramjit , Bhopal Surinder K.
Published: January 2018

Background: Hysteroscopy an endoscopic procedure for visualization of uterine cavity may be extensively used in both primary and secondary infertility and abnormal uterine bleeding for evaluating intrauterine pathology. The objectives of this study were to visualize and identity intrauterine pathology in both primary and secondary infertility and abnormal uterine bleeding (AUB) by hysteroscopic evaluation and to perform hysteroscopic guided therapeutic procedures like endometrial currettage, polypectomy, adhesiolysis.Methods: Hysteroscopic evaluation of uterine cavity for any intrauterine pathology in AUB and Infertility. Adhesiolysis, polypectomy, endometrial biopsy misplaced copper T removal were carried out under hysteroscopic vision.Results: Intrauterine synechia in 20.51%, Submucous fibroid in 5.13%, bicornuate uterus, endometrial hyperplasia and endometrial polyp were seen in 2.56% patient each were detected in infertility group while 81.95% cases with AUB had abnormal intrauterine pathology commonest being endometrial hyperplasia in 33.33% followed by endometrial polyps in 23.81% cases, submucous fibroid and misplaced copper T in 9.52% each and intrauterine synechia in 4.76% patient. Endometrial biopsy and polypectomy was done in 23.80% each with AUB, misplaced copper T removal in 9.52% and adhesiolysis in 4.76% patient with AUB.Conclusions: Hysteroscopy remains gold standard for evaluating intrauterine lesions in abnormal uterine bleeding and infertility. A safe, simple minimally invasive procedure not only diagnostic but therapeutic modality for adhesiolysis, endometrial biopsy/curettage, polypectomy, misplaced copper T removal under direct vision with minimal complication within reach of every Gynaecologist thereby reducing burden of major surgical intervention.
Management of tuberculosis of the uterine cervix in the University Hospital Center of Treichville
Authors: J. M. Dia , T. C. Saki , Z. Kone , S. Koui , P. E. Bohoussou , A. Diallo , P. Guié , Anongba S.
Published: January 2018

Genital tuberculosis is a rare entity which is classically presented with nonspecific signs posing diagnostic problems. We report the case of a young patient in genital activity, supported in our hospital for tuberculosis of the uterine cervix. She initially consulted for contact metrorrhagia and speculum examination had found an ulcerative budding cervix making suggest a cervical cancer. Finally, the histology of cervical biopsy confirmed the diagnosis of cervical tuberculosis and the patient was treated with anti-bacillary antibiotics. The evolution was favourable marked by declared healing after 6 months of treatment. The objective of this observation is to discuss the epidemiological, clinical and therapeutic characteristics of this affection.
Non-obstetric vulval hematoma is not so uncommon
Authors: Gupta Amit , Kaushal Vivek , Sharma Chanderdeep , Kumar Rajinder , Vij Anju , Gupta Bharti
Published: January 2018

Non-obstetric vulval haematoma is infrequently seen following blunt trauma to perineum. We, here present a series of six cases of non-obstetric vulval haematoma which were reported in our institution in recent years. Evacuation of haematoma and repair of lacerated tissues were successfully performed. Our experience confirms that prompt surgical intervention is the best modality in treating such patients as it reduces the associated morbidity and minimize hospital stay.
Fatal typhoid intestinal perforation in post tubal ligation death with an alleged medical negligence: a rare case report
Authors: Ghormade Pankaj Suresh , Keoliya Ajay Narmadaprasad
Published: January 2018

Worldwide tubal sterilization is commonly used procedure for family planning method. Tubal ligation by minilaparotomy under local anaesthesia is most commonly used method of female sterilization in India. The death rate after tubal sterilizations is 72/100000 for all procedures and mainly due to general anaesthesia or vascular injuries. Iatrogenic injury to bowel can occur in minilaparotomy tubal ligations if there are dense adhesions of intestines or history of previous surgery. In the present case of interval post tubal ligation by minilaparotomy, fatal ileal perforation due to typhoid fever was detected on autopsy which was confirmed after complete histological and lab investigations. Atypical complications of typhoid fever were also noted. In developing countries, typhoid fever is the leading cause of non-traumatic free perforation of intestine and its incidence ranges from 0.9% to 39%, with a high mortality rate. This is rare case of an alleged medical negligence after surgery; in which deciding factor was cause of intestinal perforation i.e. iatrogenic or natural and it posed a difficult challenge.
Frequency of post obturation pain by using ibuprofen and ibuprofen/dexamethasone infiltration in single visit root canal treatment cases
Authors: Rana Mehmood Ahmed , Rana Sadiq Amin Ahmed , Akhtar Mobeen , Rana Muzammil Jamil Ahmed , Kashif Muhammad
Published: January 2018

Background: Pain after root canal treatment is a challenging problem for the operative dentists over the last few years. The development of pain is dependent on the intensity of tissue damage. Inflammation is characterized by a series of vascular events in response to tissue injury. The release of mediators is responsible for much of the pain. The rationale of this study is to use NSAIDs alone or in combination with dexamethasone to reduce post treatment swelling and pain following endodontic therapy. The objective of the study was to compare the frequency of post obturation pain by using ibuprofen or ibuprofen/ dexamethasone infiltration in single visit endodontic cases.

Methods: This study was carried out in the Operative Dentistry, Department (AFID), Rawalpindi, Pakistan from December 2015 to May 2016 after approval from the Institutional Ethical Review Board. After an informed consent, 128 patients fulfilling inclusion criteria were divided in to two equal groups. In Group A, after root canal treatment, an additional single shot local infiltration of 0.5 mg dexamethasone was given in periapical area. Both the patient groups were prescribed ibuprofen 400 mg three times a day. Patient’s pain response was recorded after 24 hours of treatment, using visual analogue scale. Data was analyzed using SPSS version 17.

Results: After 24 hours, 6 (9.4%) patients showed the pain in group A while 16 (25.0%) patients complained of pain in group B.

Conclusions: The results of this study showed, group A showed less postoperative pain as compared to group B where only ibuprofen was given.
Role of homocysteine level as risk factor in the occurrence of cardiovascular events in renal transplant recipients
Authors: Goswami Shraddha , Sepaha Achal , Dube Mukesh , Singh Abhishek , Raju Bhavani Mohan , Awasthi Anand
Published: January 2018

Background: Traditional risk factors like elevated homocysteine levels may not completely explain the higher CVD seen in RTRs. Identification and optimisation of modifiable risk factors may help to reduce the occurrence of CVD in such population. To study the role of homocysteine level as risk factor in the occurrence of cardiovascular events in renal transplant patients. Another objective was to evaluate the other risk factors in the occurrence of CVD in such population.

Methods: Thirty renal transplant recipients and thirty healthy controls were studied. Inclusion criteria were transplant duration >6 months and patients with chronic stable renal function over the last 3 months. Samples for fasting plasma homocysteine were collected and plasma homocysteine was then estimated. All the patients were followed up every month for 6 months and evaluated for occurrence of any cardiovascular event.

Results: The mean hornocysteine levels were found to be 27.4±7.902 µmol/L in cases and 10.86±1.98 µmol/L in controls. There was no statistically significant relationship between homocysteine levels and transplant duration, mean IMT levels, proteinuria, and presence of left ventricular hypertrophy or choice of immunosuppressive regimen. Of the 30 patients, 6 patients (20%) had evidence of cardiovascular event. In the absence of other conventional factors, age of the patient, creatinine clearance (index of graft function) and mean intima-media thickness were more closely related with cardiovascular events.  

Conclusions: Plasma homocysteine failed to show as an independent risk factor for cardiovascular events. New, emerging cardiovascular risk factors (e.g. Lipoprotein (a), high sensitivity C-reactive protein, fibrinogen, tissue plasminogen activator and plasminogen activator inhibitor-1) should be studied to design effective therapy to delay the progression of atherosclerosis and prolong the life of renal transplant recipients.
Feeding practice of infant and young children and their nutritional status among tea worker community of West Tripura district, India: an observational study
Authors: Saha Arjun , Bhattacharjya Himadri
Published: January 2018

Background: People working in tea gardens of Tripura differ from other people in terms of ethnicity, culture, food habit, literacy etc. and limited information is available regarding infant feeding practices and its association if any, with nutritional status of under-five children of this community. Methods: This community based cross-sectional study was conducted during 1st July to 31st August 2016, using a validated interview schedule, among 170 women working in different tea estates of West Tripura district, having children aged 6 months to 2 yr, chosen by multistage sampling. Descriptive statistics and χ2 test were used to present data. P value ≤0.05 was considered statistically significant. Results: Breastfeeding initiation rate within one hr of birth was 50.59%, colostrums was fed to 82.35%, prelacteal feeding was given to 30.59%, 65.88% were exclusively breast fed and overall feeding practice was proper in 51.76% of the study children. Khichdi (34.1%) was the commonest complimentary feed and katori and spoon (64.7%) were the commonest feeding utensils. Prevalence of underweight, stunting and wasting was 9.0%, 12.9% and 7.3% respectively and these were found to be more frequent among children who received prelacteal feeding, late initiation of breastfeeding and early complimentary feeding, though statistically these were not significant. Conclusions: Overall infant feeding practice was better among educated mothers and institutional births; hence improvement in literacy and promoting institutional deliveries will further improve feeding practice in this community. Though underweight, stunting and wasting was prevalent but these had no significant association with feeding practices. Hence further studies are required to investigate the causes of malnutrition among children of this community.
Prevalence and correlates of suicidal ideation with dermatological morbidities
Authors: Bharati Dharmvir Ranjan , Kumari Seema , Jaykar Kranti Chand , Kumar Ajay , Choudhary Sanjay Kumar , Rajak Birendra Kumar
Published: January 2018

Background: The dermatologic consultation might be a precious opportunity to recognize and treat depression associated with suicidal ideation in these patients. This study aimed to find the prevalence of suicidal ideation among patients with dermatologic conditions, and identifying demographic variables of suicidal ideation. Methods: This institution based cross-sectional study was conducted during February to March 2017, at dermatological out-patients department of the teaching hospital Indira Gandhi Institute of Medical Sciences (IGIMS), Patna, India. Results: Of 396 adults with skin disease 272 (68.69%) were male. Prevalence of suicidal tendency was significantly more among young adults and higher in females (38.7%) than males (1.5%). In males, suicidal tendency was in patients suffering from tinea infection while among females, significantly more observed among patients suffering from tinea 38.71%, psoriasis 22.58% and chronic idiopathic urticaria 16.13%. The risk of suicidal tendency in males were significantly higher among 18–20 years, unemployed, belongs to smaller family, having lower body mass index and suffering from depression. While in females, suicidal tendency was significantly higher among early adulthood, not or lower education, unemployed, no personal income and vegetarian, belongs to large family, no family support, having lower body mass index and suffering from depression as well as suffering from some other medical comorbidity in addition to skin diseases. Conclusions: Risk correlates of suicidal ideation with skin diseases were early adulthood, lower education, unemployment with no personal income, vegetarian diet, large family, no family support, lower body mass index and suffering from depression and comorbidities.
Pattern of psychiatric disorders among young persons attending psychiatric clinics in Benin city: implications for health
Authors: Ogboghodo Esohe O. , Omuemu Vivian O. , Obarisiagbon Otaniyenuwa E. , Olaniyi Kolade , Francis Imonikkhu B. , Michael Innocent O.
Published: January 2018

Background: Psychiatric disorders are one of the leading causes of disability worldwide. From a lifespan perspective, youth is the peak period for the onset of mental illness and it is the young who carry the burden of mental ill-health. This study was carried out to assess the pattern and determinants of psychiatric disorders among young persons attending psychiatric clinics in Benin City, Edo State. Methods: A descriptive cross-sectional study was carried out among young persons attending psychiatric clinics in Benin City using a multi-stage sampling technique for selection. Pretested interviewer-administered questionnaire was used for data collection. Data were analyzed with IBM SPSS version 21.0 software. Bivariate analysis between socio-demographic variables/risk factors and the psychiatric disorders of the respondents was done. The level of significance was set at p<0.05. Results: A total of 427 young persons with mean age (SD) of 20.3±4.0 years participated in the study. One hundred and six (24.8%) of the respondents suffered schizophrenia while depression, mania and unspecified psychosis accounted for 74 (17.3%), 49 (11.5%) and 36 (8.4%) respectively. One hundred and thirty eight (32.3%) of the respondents had a history of substance abuse and over three quarters 376 (88.1%) had family support. Majority of the respondents 412 (96.5%) were currently on psychotropic medications. Conclusions: This study showed that schizophrenia was the commonest psychiatric disorder followed by depression, mania and unspecified psychosis. Efforts should be made by relevant stakeholders to educate the public about mental health disorders and its predisposing risk factors.
Assessment of knowledge, attitude and practices of risk factors of oral cancer among the adult population of rural field practice area of Bangalore Medical College and Research Institute
Authors: Crastha Sofiya , Thangaraj Selvi , Sobagiah Ranganath Thimmanahalli
Published: January 2018

Background: Cancer is the non-communicable disease of public health importance. The oro-pharyngeal cancer is more common in developing than in developed countries. In India, oral cavity cancer is among the top five most common cancers in both sexes. Oral cancer is multi-factorial in nature, most of these risk factors can be prevented.The survival rate in oral cancer is directly related to the stage of diagnosis. Early diagnosis increases the probability of cure and minimizes the deformity. This study intends to find out the knowledge, awareness and practice of risk factors of oral cancer among rural population and to provide them health education about the prevention and early diagnosis. Methods: The cross sectional descriptive study was conducted in the rural field practice area of BMCRI (Bangalore Medical College and Research Institute), among 311 adults. Results: Majority, 195 (62.8%) of the population did not know the site of oral cancer, 248 (79.8%) did not know any clinical features of the oral cancer and 117 (37.6%) did not know about any risk factors of oral cancer. About 177 (56.90%) people agreed that there is a need for screening and regular oral examination to detect the lesions early. Only 42 (13.5%) had undergone oral examination done in the last 1 year. Conclusions: There is a need to generate awareness regarding the risk factors and about the good and harmful practices in the community.
Trends in contraceptive demands and unmet need for family planning in migrant population of Uttarakhand
Authors: Singh Sadhna , Priya Neha , Roy Debabrata , Srivastava Anurag , Kishore Surekha
Published: January 2018

Background: The knowledge of contraceptive use and unmet need is important to know the constraints for unmet need based on user perspective. The aim of the study was to find the prevalence of Contraceptive use, Contraceptive preferred and the Un-met demand for contraceptives. Methods: Married, non-pregnant women of reproductive age group (15-49 years) from the migrant population were interviewed by Census method using pre-designed and pre-tested instrument by cross-sectional survey. Operational definitions for unmet need for spacing, limiting and unfelt need used in the study were as per NFHS -4 findings and traditional methods of contraception like abstinence, withdrawal were included in Un-met need for contraceptive due to its very high failure rate. Results: 58.44% study subjects had ‘Ever Used FP’ and 56.78% are currently using FP methods. The CPR is 56.7% by ‘Any Method’ and 43.0% by ‘Modern method’. The method which is most popular is ‘Sterlisation 29% and 20.96% and ‘Others’ i.e. highly unreliable methods like coitus interruptus, calendar method etc. found high number of users. The reasons for non use were apprehension of complication/side effects in 39%) and inconvenience or the difficulties with modern contraceptive methods or lack of knowledge by 7.67% and 6.95% respectively, 16% were relied on traditional methods, such as periodic abstinence, withdrawal and herbal mixtures from traditional healers as well as LAM 8% for a FP method, all of which have high failure rate. Only 24.8% Women were decision maker regarding the time and type of contraceptive to be used. The unmet need was 29.7% out of which the unmet needs for spacing and limiting were 9.6 per cent and 20.1 per cent, respectivelyConclusions: The unmet need is high and can be addressed by removing the constraints such as poor accessibility to the knowledge thus removing apprehension for side effects, improve accessibility to resources and low decision-making autonomy.