bluuebunny/crossref_metadata_2025 huggingface dataset:
Territorial Stigmatisation and Poor Housing at a London ‘Sink Estate’
Authors: Watt Paul
Published: February 2020

This article offers a critical assessment of Loic Wacquant’s influential advanced marginality framework with reference to research undertaken on a London public/social housing estate. Following Wacquant, it has become the orthodoxy that one of the major vectors of advanced marginality is territorial stigmatisation and that this particularly affects social housing estates, for example via mass media deployment of the ‘sink estate’ label in the UK. This article is based upon a multi-method case study of the Aylesbury estate in south London—an archetypal stigmatised ‘sink estate.’ The article brings together three aspects of residents’ experiences of the Aylesbury estate: territorial stigmatisation and dissolution of place, both of which Wacquant focuses on, and housing conditions which he neglects. The article acknowledges the deprivation and various social problems the Aylesbury residents have faced. It argues, however, that rather than internalising the extensive and intensive media-fuelled territorial stigmatisation of their ‘notorious’ estate, as Wacquant’s analysis implies, residents have largely disregarded, rejected, or actively resisted the notion that they are living in an ‘estate from hell,’ while their sense of place belonging has not dissolved. By contrast, poor housing—in the form of heating breakdowns, leaks, infestation, inadequate repairs and maintenance—caused major distress and frustration and was a more important facet of their everyday lives than territorial stigmatisation. The article concludes by arguing that housing should be foregrounded, rather than neglected, in the analysis of the dynamics of urban advanced marginality.
Hazai tulajdonú középvállalatok a magyar feldolgozóiparban
Authors: Lux Gábor , Páger Balázs , Kovács Szilárd
Published: February 2020

Tanulmányunk a magyar feldolgozóipar kiválasztott részét, a hazai tulajdonú középvállalkozások csoportját vizsgálja. A feldolgozóipar erős dualitása, a válság óta tovább növekvő külföldi működőtőke (KMT)-függősége indokolttá teszi a növekedési alternatívák feltárását. Tanulmányunkban a német középvállalati szektor (Mittelstand) nemzetközi szakirodalomban bevett, részben általánosítható koncepciója alapján tekintjük át a magyar középvállalkozások vállalatdemográfiai jellemzőit, növekedését, környezeti beágyazottságát és fejlődési kihívásait. Kutatásunkat országos adatbázisra támaszkodó kvantitatív felmérésre, valamint elsősorban vállalati interjúkon alapuló kvalitatív vizsgálatokra alapoztuk. Megállapításaink szerint a középvállalati szektort hosszas zsugorodás és a válság okozta sokk után a konszolidáció és lassú növekedés jellemzi, s egyes fejlődési jegyei alapján felállítható a párhuzam hosszabb múltú német megfelelőjével. Bár a középvállalatok nem képesek a külföldi tőke helyettesítésére, a jövőben növekvő szerepet játszhatnak a minőségi termelési tényezőkön alapuló növekedés megalapozásában. A jelenleg működő középvállalkozások mellett beazonosítható a kisvállalkozások közötti „potenciális középvállalkozások” köre is, amelyek megfelelő körülmények között maguk is középvállalatokká növekedhetnek. A hazai tőkeakkumulációt elősegítő, erősödő stratégiai orientációval rendelkező, kedvező lokális és regionális beágyazódást mutató, népességarányos elhelyezkedésű (a KMT-alapú iparnál kevésbé koncentrált) középvállalkozói réteg megerősítése a hazai gazdaságpolitika érdeke is.
Accuracy of visual inspection with acetic acid for cervical pathology screening in low cost setup
Authors: Sisodia Aditya
Published: February 2020

Background: Cancer cervix, a preventable disease continues to be a cause of great concern to women’s health, being associated with agonizing morbidity and high mortality. Approximately 493,100 new cases and more than 273,000 deaths occur each year, among women worldwide.IN India the screening is largely based on pap smear, which is cumbersome procedure due to transportation of samples and follow up of patients are not usually feasible. Visual inspection with Acetic acid (VIA) is simple and easy to teach procedure. Follow-up of patients usually doesn’t require.Methods: This study includes a total of 1000 patients who attended OPD of gynecology. Each patient is subjected to VIA examination. Biopsy is taken from women with abnormal findings on VIA. The objectives of this study were to evaluate the sensitivity and specificity and positive predictive value of inspection of cervix with acetic acid in precancerous lesions of cervix.Results: When biopsy is taken as reference standard, VIA has sensitivity of 97.7%, specificity of 76.6%, PPV of 62.9% and NPV of 98.5%. The accuracy rate for VIA is 84.8%.Conclusions: VIA is highly sensitive for diagnosis and treatment of cervical pathology at the same sitting. It can be done cost effectively in low resource set up.
A study to assess predictive value of yolk sac diameter by transvaginal sonography with the pregnancy outcome
Authors: Sheik Saniya , B. Anjana
Published: February 2020

Background: Ultrasonography is one of the most important and useful diagnostic tools in the field of modern medicine. Being non-invasive, safe and without hazards of radiation, it has gained wide acceptability, as an integral part of basic investigative procedures. A yolk sac can be detected easily by transvaginal sonography when the mean gestational sac diameter is 5 to 6 mm. Generally, the yolk sac should be observed when a gestational sac measures greater than 8. The yolk sac is situated between the amnion and the chorion.Methods: The present Prospective study was conducted in the department of obstetrics and gynecology, K. L. E. S. Dr. Prabhakar Kore charitable Hospital and Medical Research Centre, Belagavi during the period of January 2015 to February 2016. Records of pregnant women registering between 6 to 10-week 6 days’ period of gestation in OPD at KLES Dr. Prabhakar Kore Charitable Hospital and Medical Research Centre, Belagavi and who were fulfilling eligible selection criteria were studied prospectively.Results: A total of 254 study participants were included in the study and analysed. In this study, 49 cases were from age group of 20 years or less than 20 years i.e. around 19.29% of total study population. Majority of the cases were with normal yolk sac diameter (YSD) i.e. around 201 cases which accounts for 79.13% of total study population and total number of cases with abnormal yolk sac diameter (YSD) were 53 which accounts for 20.87% of total study population.Conclusions: Measurement of the secondary yolk sac diameter between 6th to 10th weeks 6 days of gestation can be used as a valuable tool in predicting outcome of the pregnancy.
Correlation of lateral placental location with development of preeclampsia
Authors: Gupta Anjali , Bansal Priyanka , Sen Jyotsna , Singhal Savita Rani
Published: February 2020

Background: Preeclampsia is a complex clinical syndrome which involves multiple organ systems and remains the principle cause of maternal and perinatal morbidity and mortality. Preeclampsia is a disease of trophoblastic tissue. Placental abnormality is one of the initial events in patients who are destined to develop pregnancy induced hypertension subsequently. Objective of this study was to evaluate the association of laterally located placenta on ultrasound with development of preeclampsia.Methods: This prospective observational study was conducted on 200 antenatal women with singleton pregnancy at 18-24 weeks of gestation who attended antenatal clinic of obstetrics and gynaecology, PGIMS Rohtak from October 2017 to October 2018. Detailed antenatal transabdominal ultrasound along with placental location was done between 18-24 weeks of gestation in women who fitted into inclusion criteria. All the antenatal women belonged to 18-24 weeks of gestation were included in the study except those women with chronic hypertension, diabetes mellitus, renal disease, severe anaemia, thyrotoxicosis, low lying placenta, previous history of preeclampsia or eclampsia.Results: Out of 200 antenatal women, 84 had lateral placenta while 116 had central placenta. Out of these 84 women who had lateral placenta, 55 women (65.5%) developed preeclampsia and out of 116 (58%) women who had central placenta, 28 women (24.1%) developed preeclampsia.Conclusions: From the above study, we concluded that women with laterally located placenta by ultrasound at 18-24 weeks of gestation have greater risk of developing preeclampsia.
Evaluation of factor VIII value in normal women and whom encountered recurrent pregnancy loss: is there any significant difference?
Authors: Rez Douaa Al , Eldine Hasan Naser , Alhalabi Marwan
Published: February 2020

Background: Recurrent pregnancy loss (RPL) is a serious problem on the women, it defined as two or more consecutive pregnancy losses before the fetus has reached birth. The aim of this study is to evaluate the association between the elevation in the factor VIII and RPL. Because women who have thrombophilia have increased risk of fetal loss in most studies.Methods: A total 72 women were recruited in this case control study. They divided into two groups: the RPL group included 41 women with a history of recurrent pregnancy loss and the control group included 31 healthy women, who had at least one successful pregnancy and none of them had a history of fetal loss or complicated pregnancy.Results: A majority of the patients of this study didn't have a high level of factor VIII, 9 of 41 (22%) patients of RPL group in comparison with 21 of 32 (65,6%) of control group, that suffer from the increase rate of FVIII, this means that factor VIII doesn't effect on RPL.Conclusions: The present study showed that the serum elevation in the factor VIII is not significantly associated with RPL.
Maternal body mass index: how much it affects mother and baby
Authors: Shembekar Chaitanya A. , Shembekar Shantanu C. , Shembekar Manisha C. , Saoji Parul Sharma , Upadhye Jayshree J.
Published: February 2020

Background: Overweight, obesity, and morbid obesity in the mother are associated with adverse obstetrics well as neonatal outcome. Aim of this study was to assess the prevalence of overweight and obesity, and the impact of body mass index (BMI) on maternal and neonatal outcome.Methods: This is a retrospective study from January 2018 to September 2018 on 180 women with singleton term pregnancies. Maternal and neonatal outcomes at delivery were noted.Results: In present study, 3 (1.66%) pregnant women were underweight, 57 (31.66%) pregnant women had normal BMI, 71 (39.44%) pregnant women were overweight while 49 (27.22%) pregnant women were obese. Gestational weight gain was less than 8 kgs in 40 (22.22%) pregnant women, weight gain was 8-15.9 kgs in 132 (73.33%) pregnant women while weight gain was more than 16 kgs in 8 (4.44%) pregnant women. Out of 3 underweight women, 1 delivered by cesarean section and 2 had normal delivery, out of 57 women with normal BMI, 21 delivered by cesarean section and 36 had normal delivery, out of 71 overweight women, 47 delivered by cesarean section and 34 had normal delivery while out of 49 obese women, 38 delivered by cesarean section and 11 had normal delivery. PET and GDM was seen in 9 (7.5%) women each while macrosomia were seen in 5 (4.16%) women.Conclusions: Increased association was seen with maternal obesity and adverse outcome of pregnancy like PIH, GDM, cesarean section.
A study of thrombocytopenia in pregnancy
Authors: Modi Komal , Chaudhari Jaydeep , Vaja Disha
Published: February 2020

Background: Thrombocytopenia is defined as low platelet count and if it is present during pregnancy can jeopardize the maternal and fetal outcome. Thrombocytopenia occurs in 6-15% of pregnancies. Causes of thrombocytopenia include gestational, idiopathic thrombocytopenia, preeclampsia, HELLP, DIC, malignancy and marrow failure. Aim of this study was to find out the common causes of thrombocytopenia in this hospital and management being used.Methods: Data was collected form those women who came to the antenatal clinic (booked) and labour room (unbooked) in the department of obstetrics and gynecology, GMERS Medical College and Hospital, Sola, Ahmedabad. Data of a total of 75 pregnant women were collected during the period of July 2018 to June 2019.Results: There were 66.67% cases of gestational thrombocytopenia, 13.33% related to preeclampsia, 8% in Eclamptic patients, 2.67% in HELLP and DIC, 6.67 in ITP, and lastly 2.67% in dengue cases. There were number of associated complication whether directly related (PPH) or part of the disorder. PPH was observed in 22.67% which is maximum among all complications. Other complications were part of major associated illness i.e. liver failure (6.67%), renal failure (5.3%), DIC (5.3%) and HELLP (8%).Conclusions: Mode of delivery was not influenced by platelet count, but for obstetric indications. Management of patients was as per the diagnosis. Single donor plasma is preferable to random donor plasma. PPH was the commonest complication and we should be wary of that.
Placental cord drainage during third stage of labour: a randomized control trial at a tertiary care centre
Authors: Chaudhary Megha , Shah Maitri , Makwana Nitin
Published: February 2020

Background: Labour is a physiological process, but it is often associated with morbidity and mortality, with the most common cause being blood loss. Primary postpartum hemorrhage is commonly defined as a blood loss of 500 ml or more within 24 hours after normal vaginal birth. A prolonged third stage of labour (more than 20 min) is associated with postpartum hemorrhage. The present study was undertaken with the objective of assessing efficacy of placental cord drainage (PCD) during active management of third stage of labour.Methods: This is a randomized control trial in which full term primi gravida who were expected to have normal vaginal delivery, admitted in labour room of a tertiary care centre were evaluated for inclusion in the study. Total 126 participants were enrolled after having normal vaginal delivery. In study group (n = 63), placental cord drainage was used for management of third stage of labour while in control group (n = 63), third stage was managed without PCD.Results: The mean difference in duration of third stage of labour in study and control group was 1.79 minute and the mean difference in blood loss during third stage of labour in both groups was 57.86 ml which was statistically significant.Conclusions: The results of this study show small positive effects from cord drainage in reducing the length of the third stage of labour and in reducing the amount of blood loss when compared with those without cord drainage. The observed changes may be of clinical significance in reducing third stage related complications.
Clinical presentation of tubal ectopic pregnancy
Authors: Garikapati Kavitha , Devi M. Parvathi , Goud N. Alekya
Published: February 2020

Background: When the fertilized ovum gets implanted at site other than normal position of uterine cavity, it is known as ectopic pregnancy. Incidence of ectopic pregnancy is 1-2% of all reported pregnancies. It is an unmitigated disaster of human production and the most important cause of morbidity and mortality in first trimester with major cause of reduced child bearing potential. It is notorious in its clinical presentation, challenging the attending physician.Methods: women with risk factors, signs and symptoms and with confirmed diagnosis. Women discharged against medical advice. Study population is 50. Retrospective analysis for 3 years (2016-2019). Objectives of this study were to study the incidence, risk factors, clinical presentation, diagnosis and changing trends of modern management. Results analysed after entering the information in the excel sheets using descriptive analysisResults: Out of 4940 deliveries, 50 were tubal ectopic pregnancies 1.012%. Women aged 20-25 years were 52%. In our study, multiparous were 68%. Common symptoms were abdominal pain 80.2%, amenorrhea 72%, urine gravindex test positive 92.8%. Etiology was PID 20%, previous ectopic pregnancy 4%, IUCD 4%, LSCS with tubectomy 16%, most common site is ampulla 82%. About 78% were ruptured. Tubal abortions 4%, salpingectomy done in 82%. Laparotomy in 2.43% in hemodynamically unstable. Medical management 8%. Salpingostomy in 4% and expectant management 2%. Morbidity in the form of blood transfusion 23.48%, DIC with ICU admission 2%. No mortality.Conclusions: A high index of clinical suspicion with underlying risk factors may get us early diagnosis for timely intervention.
A study to evaluate the efficacy of combined prostaglandins and vaginal estradiol compared to prostaglandin alone in labor induction
Authors: B. Anjana , Sheikh Saniya
Published: February 2020

Background: Induction of labor (IOL) is a process where labor is initiated artificially before its spontaneous onset for the delivery of feto placental unit by mechanical or pharmacologic methods.Methods: The present Hospital based prospective randomized comparative study was conducted in the department of obstetrics and gynecology, KLES Dr. Prabhakar Kore Charitable Hospital, Belagavi during the period of January 2015 to December 2015.The selected women were randomized into two groups by simple randomization using an opaque sealed envelope, into either without vaginal estradiol Group A: Group PGE2 - Prostaglandin E2 gel intracervical alone group or Group B: PGE2 + E (Estradiol) - combined Prostaglandin E2 gel intracervical and 50 µg of estradiol tablet intravaginal group.Results: In the present study 65% of the women in group PGE2 required three doses of prostaglandins compared to 23.33% in group PGE2 and estradiol for the cervix to become favorable. In this study there is significantly longer mean interval time noted for induction to cervical ripening (12.88±4.91 versus 8.92±5.07; p <0.001), induction to active labor (16.97±4.93 versus 11.02±4.72; p <0.001) and induction to delivery time (21.97±3.83 versus 13.14±4.98; p <0.001) in group PGE2 compared to combined PGE2 and estradiol group.Conclusions: Thus, vaginal estradiol along with prostaglandins has the potential in cervical ripening and induce labor and in an efficacious way. There is beneficial fetal outcome when combined vaginal estradiol along with intracervical prostaglandin E2 was used.
Advanced maternal age and obstetric outcome
Authors: . Ritu , . Mini
Published: February 2020

Background: The objective of this study was to compare the adverse obstetric and perinatal outcome of pregnancies in women with advanced maternal age > 35 years with that of younger women in age group 20-34 years.Methods: A retrospective comparative study was carried out in department of obstetrics and gynecology at Adesh Medical College over the period of one year from June 2017 to June 2018. The obstetric and perinatal outcome of 100 women with advanced maternal age (study group) was compared with those of 100 younger women aged 20-34 years (control group).Results: Among antenatal complications, women of advanced maternal age had increased incidence of hypertensive disorder of pregnancy (26.6% versus 4.4%; p = 0.00009) and breech presentation (8.8% versus 1.1%; p = 0.04).  The rate of caesarean delivery was significantly higher in advanced maternal age (28.8% versus 17.7%; p = 0.05). In perinatal outcome, older women had significantly higher incidence of perinatal death (7.7% versus 0%; p = 0.01).Conclusions: Thus, from this study, it can be concluded that advanced age women had higher incidence of hypertensive disorder of pregnancies and mal presentation, were more likely to deliver by caesarean section and had increased incidence of perinatal death.
Prevalence of sub clinical hypothyroidism and pregnancy outcome: a prospective comparative study
Authors: Rehman Bilal Ur , Gull Hiba
Published: February 2020

Background: In pregnancy, subclinical hypothyroidism is more common than overt hypothyroidism, ranging from 15% to 28% in Iodine sufficient region. Evidence suggests that subclinical hypothyroidism is associated with adverse pregnancy outcome. The aim of this study was to find the prevalence of subclinical hypothyroidism in pregnant women and adverse pregnancy outcome.Methods: This hospital based prospective comparative study was conducted over a period of 6 months from 1st July 2018 to 31st December 2018 in department of obstetrics and gynecology SKIMS Soura Kashmir. All the subjects who fulfilled the inclusion criteria and who consented to participate were screened for subclinical hypothyroidism.Results: A total of 175 pregnant women participated in the study and subclinical hypothyroidism was diagnosed in 25 pregnant women (14.2%). Most of our patients were in age group 21 to 30 years (69.1%). Pregnant women with subclinical hypothyroidism had significant risk of preeclampsia (35%) and higher cesarean section rate (29.6%). Neonate of women with subclinical hypothyroidism had higher incidence poor Apgar score, NICU admission.Conclusions: The prevalence of subclinical hypothyroidism is high in pregnant women and the gravity of the complications like pre-eclampsia, neonate with low Apgar score, increased NICU admission, overweight the cost of screening. In this view, we propose screening of all pregnant women in the first trimester for diagnosis.
Study of intrauterine fetal death cases in a tertiary care center
Authors: Meena Lalita , Gupta Ritu
Published: February 2020

Background: The death of a fetus is a tragic event not only for the parents but also a great cause of stress for the caregiver. It is thus vital to identify specific probable causes of fetal death to determine the risk of recurrence, prevention or corrective action.Methods: This retrospective observational study was carried out in department of obstetrics and gynaecology, Jhalawar Medical College, Jhalawar, from July 2019 to October 2019. Intrauterine fetal death was confirmed either with ultrasound or on clinical examination. The details of complaints, obstetrics history, examination findings, mode of delivery, fetal outcomes and investigation reports were recorded.Results: A total of 114 intrauterine fetal deaths were reported amongst 2982 deliveries conducted during the study period. The incidence rate of IUFD was 38.22/1000 live births. 85.96% deliveries were unbooked. 59.64% belonged to rural population. 59.64% fetal deaths occurred in women between 20 to 25 years of age. 45.61% women were primigravida. 41.2% IUFD occurred between 26 to 31 weeks of gestation. Among the identifiable cause’s hypertensive disorders (23.68) and placental causes (19.29%) were most common.Conclusions: Unexplained causes, PIH and abruptio placentae were major causes of IUFD. Majority of fetal wastage can be prevented with universal and improved antenatal care.
Absence of Wharton’s jelly: an association with feto-maternal morbidity
Authors: Trivedi Swati , Ratanoo Lata , Purohit Shivani , Rastogi Prasoon
Published: February 2020

Umbilical cord contains two arteries and one vein connecting fetus to the placenta and is responsible for blood flow between the two. It is surrounded by Wharton’s jelly which is a gelatinous substance and functions as adventitia layer of umbilical vessels, thereby providing insulation and protection to the umbilical cord. Umbilical cord abnormalities are associated with poor perinatal outcomes. Very few cases of absent Wharton’s jelly are reported in literature. Ours might be the 8th one in which we did a lower segment caesarean section for meconium stained liquor but the baby died after 12 hours.
Study of renal functions in metabolic syndrome and its correlation with various parameters
Authors: N. Anand , A. Vidya T.
Published: February 2020

Background: Metabolic syndrome includes a constellation of various metabolic abnormalities that have been associated with cardiovascular disease, stroke and all-cause mortality in the general population. It has now been established that it is also associated with renal dysfunction. This study was done to assess renal function in metabolic syndrome in Indian population as well as its correlation with different parameters of the metabolic syndrome.Methods: A cross-sectional study was conducted in a university hospital from 2014 - 2015. Renal functions were studied in 100 obese individuals, 50 with and 50 without metabolic syndrome after informed consent and the results were analysed.Results: 100 obese individuals, 50 with and 50 without metabolic syndrome were compared. All underwent a physical examination and relevant investigations. All parameters of renal function showed significant derangement in cases as compared to controls. 38 patients (76%) among the cases (N=50) of metabolic syndrome had altered renal functions versus 9 patients (18%) among controls (n=50). Individually, there was a significant correlation of altered renal function (reduced estimated glomerular filtration rate eGFR and presence of microalbuminuria) with fasting blood glucose and systolic blood pressure (p=0.001), diastolic pressure (p=0.003) and triglyceride levels (p=0.036). High density lipoprotein-cholesterol levels did not show a significant correlation.Conclusions: Obese individuals with metabolic syndrome have significant derangement of renal functions as compared to those without metabolic syndrome. Most parameters of the syndrome are also independently associated with alteration of renal functions.
Adverse drug reaction risk assessment with prescribed renal risk drugs among hospitalized patients attending a teaching hospital in South India
Authors: Sharma Sadhna , Ramineni Hari Babu , Shahitha K. Poornima , Mounika K. , Ramyachandra P. , Girija B.
Published: February 2020

Background: Renal impairment is the primary cause of mortality and morbid conditions in patients. Inappropriate drug use in patients who are with risk of renal damage causes harmful and deleterious effects. Adjusting doses based on renal function is necessary for renal risk drugs, primarily to avoid adverse reactions of medications. Aim of the present study was to assess the risk of incidence on ADRs with drugs lowering the renal function.Methods: This is a cross-sectional observational study conducted in General Medicine department. 230 Patients constituted the sample in the study. The study was conducted for a period of one year and prescriptions with renal risk drugs were evaluated. Changes in the renal functional tests were compared to the normal range and adverse drug responses were monitored.Results: A total of 230 patients who fulfilled the inclusion criteria were included in the study. The meanage of the study subjects were 50.9±15.2 respectively. 56.39% patients were men and 43.6% were women. Renal risk drugs included in the study are anti-hypertensive, antibiotics, and analgesics. Paracetamol (24.77%) followed by telmisartan (20.85%) are the predominantly prescribed renal risk drugs with high incidence of adverse drug reactions. Causality assessment by Naranjo ADR probability scale showed out of 211 ADRs, 51.6% were possible, 25.59% were doubtful, 21.8% were probable and 0.94% was definite.Conclusions: The current study signifies that patients under high risk of renal damage require continuous monitoring and optimized therapy for better disease management.
Importance of carotid intimal medial thickness measurement in patients with coronary artery disease
Authors: Margekar Venugopal , Thakur Shweta , Jatav O. P. , Yadav Pankaj
Published: February 2020

Background: Prevalence of CAD in urban India is about double that of rural India and about 4-fold higher than in United States. Mortality related to CAD is high in Indian Population. Early diagnosis can prevent the CAD related morbidity and mortality. Aims and objectives is to study and compare the CIMT among the patients with CAD and asymptomatic control group.Methods: Hundred patients with CAD were studied for the CIMT and compared with age and sex matched asymptomatic control subjects in Department of Medicine of G. R. Medical College, Gwalior for one year from 2012 to 2013. Details on history, risk factors and presenting symptoms were recorded for all. High resolution B mode ultrasonography was performed to assess CIMT of carotid arteries.Results: CAD was more prevalent among males (78%) having mean age of 56.82±8.91 years. Majority of CAD patients had dyslipidemia (42%) followed by hypertension (21%), diabetes (13%) and smoking (17%). Majority of the CAD patients had chest pain (98%) followed by breathlessness (54%) and sweating (12%) as the most common presenting symptom. Mean CIMT was significantly more among the CAD patients (0.76±0.34) as compared to those without it (0.63±0.22) (p<0.001).Conclusions: CIMT was found to be more in CAD as compared to asymptomatic control subjects. CIMT can be an important tool for assessing CAD and atherosclerosis.
Factors influencing addiction in female population of an urban slum area
Authors: Sapkal Ashwini Baburao , Deshpande Swati Rajesh
Published: February 2020

Background: The use of certain licit substances like alcohol, tobacco and illicit substances like cocaine, amphetamine, cannabis, etc is termed as substance abuse. Globally, the most prevalent form of tobacco use in women is cigarette smoking. But, in low- and middle-income countries use of smokeless forms is quite common. Aim of the study was to study the factors influencing drug and tobacco addiction in the female population of an urban slum area.Methods: Community-based cross-sectional study conducted on 577 female participants in urban slums of a metropolitan city. A pre-validated semi-structured questionnaire was used. Data analysis was done in SPSS version 22.0 (IBM). Descriptive statistics and chi-square tests for associations were used.Results: The mean age of participants was 44.84±14.99 years and the mean age of onset of addiction was 21.51±6.47 years. Around 70.7% of women were tobacco chewers, 9.4% were smoking bidis and 15.8%were addicted to alcohol. Addiction is the subject of conflict in families of 70(12.1%) women. A most common source of information about the harmful effects of addiction was television and tobacco packets. Almost all women i.e. 555(96.2%) knew that oral cancer was a harmful effect of addiction. Willingness to quit an addiction was seen in 45.8%of women.Conclusions: Addiction in females is a major public health problem which is compounded by their lack of knowledge.
Multidrug resistant clinical strains isolated from tracheal aspirates of patients in Dhaka, Bangladesh
Authors: Afroz Jinia , Jubyda Fatema T. , Sharmin Sanzida , Faruq Md. J. , Dey Amit K. , Ibrahim Md. , Farzana Tasmia , Sarkar Murshed H.
Published: February 2020

Background: Antimicrobial resistance poses a major threat in the treatment of respiratory disease especially in developing countries like Bangladesh. Multidrug-resistant (MDR) bacteria along with extremely drug resistant (XDR) bacteria have emerged as major clinical and therapeutic dilemma in the treatment of tracheal infections here. Thus, the aim of this study is to assess multidrug resistance among clinical strains isolated from tracheal aspirates of patients in Dhaka, Bangladesh.Methods: Total 200 clinical isolates from tracheal aspirates were identified and their antibiotic susceptibility profiles were evaluated by using the VITEK 2 system following the Clinical and Laboratory Standards Institute guidelines. Patient information on diagnosis, sex, age was obtained from hospital data.Results: Of 200 clinical isolates obtained, Pseudomonas aeruginosa was the most frequent pathogens (30.5%) followed by Acinetobacter baumannii (29%), Klebsiella pneumoniae (22.5%), Streptococcus pneumoniae (7.5%), Escherichia coli (5%), Staphylococcus aureus (2%), Proteus spp (1.5%), Enterobacter spp (1%), Citrobacter spp (0.5%), Providencia spp (0.5%). Of 20 different antibiotics tested, highest number of isolates (86%) showed resistance to third generation cephalosporin cefixime, however least number of isolates showed resistance to polymixin antibiotics- colistin (12.5%) and polymixin B (6%). Tracheal infection was found to be more prevalent in males rather than in females although this difference was not statistically significant. The prevalence of infections was highest among the patients of age-group (old adults) ≥60 years (61.5%). Of 200 clinical isolates, 43 (21.5%) were XDR and 125 (62.5%) were MDR bacteria. Of 200 clinical isolates, the synthesis of extended spectrum β-lactamases (ESBL) and carbepenemase were detected in 59 (29.5%) and 98 (49%) strains respectively.Conclusions: Tracheal infections caused by β-lactamase producing MDR and XDR pathogens among patients are high in Dhaka, Bangladesh. Therefore, there is an urgent need for constant surveillance and interventions in Bangladesh in order to prevent further spreading of those resistant organisms.
Stable ankle after modified brostrom technique using one anchor with double suture at Sanglah Hospital: a case report
Authors: Subawa I. Wayan , . Dwiwahyonokusuma , Mahardika Putra I. Gede
Published: February 2020

Ankle sprains are commonly seen injuries among athletic and young population, and it is necessary to stabilize the patient ankle as soon as possible. Authors report the cost-effective option of using a modified Brostrom technique with one suture anchor in a limited resource setting. Case a 24- year-old male came to the orthopaedic clinic with chief complaint of left ankle pain for the past 2 weeks after jumping and landing in a twisted position. Patient also complained of unstable ankle after the fall. On physical examination, the ankle showed tenderness and instability when anterior drawer test was performed. The patient was diagnosed with lateral ankle instability. This case report describes a modification to the original Brostrom procedure using one suture anchor to anatomically reconstruct the lateral ankle ligaments in treating high demand patient who have lateral ankle instability. After six months follow up, the patient has shown significant improvement on his left ankle. Despite of all the modifications of Brostrom procedure, the use of more suture anchors or sophisticated technique such as arthroscopy might result in increasing cost. Reasonably good outcome can still be achieved with modified Brostrom procedure that utilizes minimal incision, simple steps, and single suture anchor. Due to its cost-effectiveness, authors believe that modified Brostrom technique with one suture anchor is an effective and practical treatment option for lateral ankle instability. Brostrom technique using suture anchors as shown here can provide similarly good outcomes compared with other more complex techniques.
A case of pigmented fungiform papillae of tongue in a young female with iron deficiency anaemia
Authors: Patto Shoiab M. , Keena Nazish M. , Keena Beenish M.
Published: February 2020

Fungiform papillae are red/pink, mushroom shaped projections located on the tip and dorsolateral part of tongue. It harbours several taste buds. Pigmented fungiform papillae is a not so common benign condition which involves pigment deposition in fungiform papillae. Authors report a case of 35 years female who presented with history of blackish spots over tongue for past 10 years with no other associated symptom. Patient had conjunctival pallor (moderate) and rest of the examination was normal. Investigations showed iron deficiency anaemia with Hb. of 9.5 mg/dl. A clinical diagnosis of Pigmented Fungiform Papillae (PFP) with associated Iron Deficiency Anaemia (IDA) was made. Patient was explained in detail about the benign nature of disease and was put on oral iron therapy. Follow up after 2 months was advised.
Therapeutic and medicinal uses of lycopene: a systematic review
Authors: Joshi Bishal , Kar Sanjit Kumar , Yadav Prem Kumar , Yadav Shankar , Shrestha Laxmi , Bera Tushar Kanti
Published: February 2020

Lycopene is a carotenoid present in fruits and vegetables. The richest sources of lycopene are tomatoes and tomato products. The beneficial effects of lycopene in human health and disease are mainly associated with its antioxidant properties. Lycopene is a carotenoid with strongest antioxidant property because of its capability of quenching the singlet oxygen. Eleven conjugated double bonds of lycopene give it a deep red color and are responsible for its antioxidant activity which is major functional feature of lycopene. Dietary intakes of tomatoes and tomato products containing lycopene have been shown to be associated with decreased risk of chronic diseases such as cancer and cardiovascular diseases in numerous studies. Although there are evidences from many epidemiological and cell culture and animal studies explaining the inverse relationship between lycopene and cancer or cardiovascular disease risk, more clinical trial data is needed to support this hypothesis. In this article we outline the possible mechanisms of action of lycopene and review the current understanding of its role in human health and disease prevention.
Association of foot length and gestational maturity in neonates: a single centre study
Authors: Resu Hareesh , Kumar Vinod , Goel Atul , Praveen Uppu
Published: February 2020

Background: As the prematurity is one of the important causes of neonatal mortality/ morbidity in a developing country like India. It is important to differentiate between preterm and term babies and timely refer them to higher centre. But it's difficult to assess the Gestation age (GA) in rural areas by existing methods like New Ballard score, and Antenatal ultrasound (due to lack of equipment and experienced person). So that shows the importance of the alternative, reliable, and easy to use method for identification of term, preterm and post-term babies. The present study carried out to find out the importance of Foot length in the assessment of GA.Methods: It is a hospital-based prospective observational study, 253 newborns were included in the study. The GA assessment was done by using New Ballard score. Foot length measured by using Digital sliding calliper and birth weight were recorded. Correlation of Fetal foot length with GA and birth weight was made by using appropriate statistical tests.Results: Among 253 neonates distribution of term, preterm, male and female were 65%, 35 %, 55%, 45% respectively. In this study positive Correlation between foot length and gestational age was found with the “r” value of 0.77. The study also showed a correlation between foot length and weight with the “r” value of 0.74.Conclusions: To conclude most of the newborn in our study have a good correlation of Foot length with gestational maturity and Birthweight. Derived equation from this study can be used as an alternative to New Ballard score in the estimation of gestational age in poor sources situations like in rural areas and also in emergencies by ASHAs (Accredited Social Health Activist) & Anganwadi workers.
Impact of public health lecture intervention on consumption behaviour towards indigenous staple carbohydrate foods
Authors: Onodu Bonaventure , Culas Richard , Nwose Ezekiel U.
Published: February 2020

Background: The increase in non-communicable diseases (NCDs) experienced more in the developing countries can be attributed to changes in demography (rural to urban migration) and changes in pattern of food consumption. With the increasing incidences in diabetes globally, dietary restrictions and modifications in consumption behaviors still remains the bedrock in the prevention and management of the disease. Specific education to prevent or manage people’s lifestyle in order to combat NCDs such as diabetes are widely available, but assessment of knowledge about dietary fiber and its impact on staple foods consumption is largely unexplored.Methods: This study utilized nutritional education as an intervention strategy to bring about changes in consumers consumption behaviour, changing their perspective in consumption of root and tuber crops in relation to wheat in the study area. The intervention involved public health lecture on the nutrition values of staple carbohydrate root and tuber crop foods (cassava and yam) with focus on their dietary fibre content, relative to wheat.Results: The statistical analysis showed that there is a significant difference in the dietary habits in urban and in rural areas. Intervention resulted in shift in consumption behavior towards indigenous staple carbohydrate food crops. The changes in behavior were more obvious in urban dwellers, especially in favour of cassava consumption.Conclusions: Education or information targeted to correct the consumption behaviour of specific group of individuals stands a chance in impacting and improving their food choices and dietary behaviours.
Study of under nutrition among under six years children in Kasturwadi village of disrtict Jalna, Maharashtra
Authors: Kausar Hina M. , Muneshwar Sujata
Published: February 2020

Background: Malnutrition is a silent emergency. Malnutrition prevents children from reaching their full physical and mental potential. The health of children and youth is of fundamental importance. Without ensuring optimal child growth and development efforts to accelerate economic development significantly will be unsuccessful. Aim of the study was to study the prevalence of undernutrtion among the children under 6 years of age and to determine association of sociodemogrphic factors with undernutrition.  Methods: A community based cross-sectional study was conducted in children of under 6 years age living in the rural field practice area of Department of Community Medicine IIMSR, Warudi, Jalna, from January 2018 to December 2018. One ninety eight children were studied for nutritional status, socio-demographic measures were obtained from structured questionnaire and followed by anthropometric assessment using standards methods. Statistical analysis was done by using appropriate statistical test.Results: Study found that 44.79% children were underweight, 47.92% were stunted and 39.58% were wasted. Among sociodemographic factors age, maternal educational, working status and SES class had an impact on nutritional status of child.Conclusions: Prevalence of underweight, stunting and wasting was high in this study, this calls for educating mothers and other caretakers in the family regarding increased nutritional requirements with increasing age for attainment of best possible nutrition and growth in children, targeted short-term strategies addressing underlying risk factors and more long-term poverty alleviation strategies may be needed.
Comparison of internet addictions and its mental effects in medical and engineering students of a private university at Pune
Authors: Murarkar Sujata K. , Sava Shraddha N. , Gothankar Jayashree S.
Published: February 2020

Background: There has been explosive growth in the use of the internet. Internet addiction is upcoming problem and less researched entity. Study is conducted to compare internet addiction in engineering and medical students.Methods: A self-administered pretested predesigned questionnaire was used for data collection. Total 303 medical and engineering students were participated in the study. Young’s internet addiction test and DASS scale is used to measure internet addiction and psychological variables.Results: 23% were normal users, 59.1% were mild internet addicts, 17.4% were moderate internet addicts and 0.3% were severe internet addicts. There was strong positive relation between internet addiction and depression anxiety and stress.Conclusions: Internet addiction is a growing problem so it is important to create awareness among students to have a healthy lifestyle.
Substance use and its determinants among students of industrial training institute in tribal area of Thane district, Maharashtra
Authors: Acharya Shrikala , Chandrachood Mandar V.
Published: February 2020

Background: Substance use is a major public health challenge because it is engulfing the younger generation with serious health, social and economic concern. Unhealthy behaviors such as smoking, drinking and illicit drug use often begin during adolescence. The study was undertaken with objectives of assessing the prevalence of substance use and its determinants among students of Industrial Training Institute (ITI).Methods: A cross sectional study was conducted in all students of the institute to find out prevalence of substance use and its determinants. Data was collected in a predesigned and pretested proforma by oral questionnaire method and was analyzed by SPSS software using descriptive statistics and appropriate statistical tests of significance.Results: Prevalence of substance use was 18%. There was no significant association of substance use with age, education, caste or residence of the student but it was significantly associated with type of family (p=0.02) and literacy of mother and father (p=0.04 and p=0.01). Tobacco was most commonly used substance and most common factor determining substance use was addiction in family members. All the participants were aware about cancer as a health hazard of substance use but awareness about other health hazards was low.Conclusions: Several factors can act as determinants of substance use including type of family, education of parents, peer pressure and addiction in family members. Role of family and society should be identified and practiced for prevention and control of this substance use.
Paradoxos do Turismo Sustentável no Brasil: obstáculos à inclusão socioprodutiva de pescadores artesanais e agricultores familiares
Authors: Tasso João Paulo Faria , Nascimento Elimar Pinheiro do , Costa Helena Araújo
Published: February 2020

O objetivo deste artigo é analisar os principais entraves na comercialização direta de pescados e de produtos agrícolas entre pequenos produtores locais e o trade turístico, objetivando a inclusão socioprodutiva. A metodologia consistiu em análise documental de projetos técnicos desenvolvidos em Jericoacoara, Lençóis Maranhenses, Delta do Parnaíba e Porto Seguro; observação direta; e realização de entrevistas semiestruturadas e oficinas participativas. Foram identificados 10 principais obstáculos: dificuldade de emissão de nota fiscal; insuficiência de capital de giro; precariedade da estrutura de beneficiamento; limitações quanto ao recebimento-pagamento; inadequação da produção à sazonalidade do turismo; instabilidade na qualidade e no volume de produtos fornecidos; dificuldades na obtenção de selos de inspeção sanitária; indisponibilidade logística; pouca capacitação profissional; e fragilidades na organização coletiva do trabalho. Serão necessárias ações que reconheçam a importância dos pequenos produtores locais no sistema turístico, que sejam capazes demitigar as barreiras impostas pela legislação e que facilitem o acesso dos produtores ao crédito e à assistência técnica e à formação continuada.
AVALIAÇÃO DE DESEMPENHO ECONÔMICO-FINANCEIRO DE UMA EMPRESA EM RECUPERAÇÃO JUDICIAL: ESTUDO DE CASO OI S.A.
Authors: Rodrigo Alves dos Santos Everton , Machado Corcetti Mauricio , Dias Ramos Murilo , Latarini Taís , Pellicani Aline
Published: February 2020

O presente estudo fundamenta-se nos balanços e demonstrativos dos resultados da Oi S.A. entre os anos de 2002 e 2016 para analisar os fatores que a levaram a declarar recuperação judicial. Os indicadores financeiros sugerem que a fragilidade da Oi S.A. é proveniente da captação de dívida de curto prazo. Em meados de 2016 houve uma tentativa de reestruturação da dívida da empresa, mas o fato de a companhia demonstrar insustentabilidade também pode ter influenciado na captação de recursos. Soma-se a isso, as constantes quedas de rentabilidade, instabilidade de governança corporativa, constantes multas aplicadas à empresa e os processos judiciais enfrentados, também agravaram a saúde financeira da empresa.
SOBRE AQUILO QUE (NÃO) SE FALA “EU NÃO SOU ESSE... GAY QUE LEVANTA A BANDEIRA PELO PRÓPRIO CORPO”
Authors: Silveira Biazus Paula Hosana , Brancher Vantoir Roberto
Published: February 2020

O presente texto busca discorrer, embebida nas leituras do Imaginário Social de Castoriadis (1992, 2004, 2006, 2007), um excerto de entrevista vinculada à pesquisa de mestrado da autora que investiga as significações imaginárias docência e os trajetos formativos de docentes LGBT. Problematizamos e direcionamos nossa atenção à relação que o professor entrevistado realiza com sua noção de corpo, discutindo as transformações do termo homossexualidade e o impacto que essas mudanças refletem no contexto escolar, tendo a sua fala como norteadora.