bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of mini-bestest and dynamic gait index for prediction of fall susceptibility in old individuals
Authors: Miqdad . , Pawar Sushil Kumar
Published: June 2017

Background: Emphasis on early identification, prevention, and intervention of fall risk in elderly people is becoming increasingly important in the fields of physical therapy and rehabilitation.Methods: Various scales are currently used for assessment of balance and fall risk. We have selected, MiniBESTest and DGI for our present study. We compared scores of Mini-BESTest and DGI in 30 elderly subjects with mean age of 62.23±4.38yrs. These subjects included 17 completely normal individuals, whereas 13 subjects were having early clinical features of fall-related disorders. Example: Parkinsonism, vertigo and paresis.Results: The data indicated that Mini-BESTest is more superior than DGI to indicate the fall risk in normal elderly population. Similarly, in cases of paresis and Parkinsonism, results are indicating that Mini-BESTest is better suited than the DGI. But in cases of vertigo, the results indicate that DGI is more superior than Mini-BESTest.Conclusions: An interesting finding is that the DGI scale seems to be more superior in subjects having vertigo (Refer Table-4), which is to be verified by further studies in a larger sample. The point which justifies the above conclusion is that the DGI scale includes many items which test the vestibular apparatus.
Status of soluble vascular cell adhesion molecule-1 in knee osteoarthritis among type 2-diabetic postmenopausal women
Authors: Shrivastava Reetika , Singh Neelima , Chandel Y. S. , Dhakad R. K. S. , Rathore Vedika , Shrivastava Swati
Published: June 2017

Background: Knee osteoarthritis is the most common form of joint disorder and a leading cause of pain and functional disability among elderly female population.  Type 2-diabetes is frequently reported comorbidity in elderly female patients with knee osteoarthritis. VCAM-1 is emerging as a strong and independent predictor for severe osteoarthritis. VCAM-1 is an inducible cell surface sialo glycoprotein and mediates heterotypic cellular aggregation. Therefore, the aim of this study is to assess the role of soluble vascular cell adhesion molecule-1 at the onset of knee osteoarthritis among type 2 diabetic postmenopausal women.Methods: The present study includes 100 type 2-diabetic female subjects of age above 50 years as cases and 100 normal healthy female age matched individuals as controls. Osteoarthritis of knee was ascertained using the American college of rheumatology classification criteria. Serum soluble VCAM-1 concentration was measured by ELISA method in all 200 subjects. Biochemical parameters-Fasting blood sugar and lipid profile were measured using Mind ray BS-400 and HbA1c was measured by turbidimetric immunoassay method. Statistical analysis was made by student independent sample t-test. Correlation was determined by using spearman’s rank correlation coefficient.Results: Serum level of soluble VCAM-1 was found statistically highly significant (p<0.001) in type 2 diabetic postmenopausal women having early stage of knee osteoarthritis as compared to control healthy subjects. The mean levels of fasting blood sugar, HbA1c, total cholesterol, TG, LDL-C and VLDL-C were also found significantly increased while HDL-C was found significantly decreased in cases as compared to controls.Conclusions: The increased level of soluble VCAM-1 in type 2 diabetic subjects shows active inflammation or cartilage damage. Therefore, it can be used as an early biomarker for osteoarthritis among type 2 diabetic postmenopausal women.
Self-assessment: how do third year medical students rate their performance during problem-based learning?
Authors: Vuma Sehlule , Sa Bidyadhar
Published: June 2017

Background: Problem-based learning (PBL) emphasizes students’ self-directed learning. This requires students to monitor their own learning.  When students enter medical school however, they do not seem to have self-monitoring skills and these need to be developed. Self-assessment exercises are useful in developing these skills. This paper emphasizes the importance of training in self-assessment during PBL. Objective was to describe third-year medical students’ self-assessment of their performance during PBL and correlate their scores with tutors’ scores, and their scores in a written progressive disclosure questions (PDQ) examinationMethods: Using the same rubric used for students’ evaluation by tutors, students scored their activities during PBL sessions. Their scores were compared with the tutor’s scores. Their scores for cognitive skills were further compared with their scores in a PDQ examination.Results: There was no statistically significant difference between the tutor and students’ scores. Low-achieving students (in the PDQ) scored themselves higher than high-achieving students. Self-assessment scores did not predict performance in the PDQ.Conclusions: Perhaps the high-achievers are more critical of themselves which drives them to work harder. Low-achieving students could be awarding themselves scores they wish to obtain and not what they deserve. They may also not understand the assessment criteria. This paper emphasizes the importance of self-assessment exercises, and the need to guide students in learning to assess themselves accurately so they may be better able to monitor their learning.
Attitude towards mental illness among doctors and nurses in a tertiary care centre, Pondicherry, India
Authors: Sujaritha V. , Partheeban M. , Thiviya T. , Sowmiya M.
Published: June 2017

Background: Stigma can prevent care and treatment of mentally ill. About 54% of diagnosable mental disorders are seen in primary care settings. There is a gross underestimation of psychiatric morbidity among patients by substantial proportion of non-psychiatric clinicians. Hence there is a need to assess the attitude towards mental illness among doctors and staff nurses. The objectives of the study were to assess the attitude towards mental illness among doctors and nurses, to compare the attitude between doctors and nurses, to find if there is any correlation between duration of training or posting and attitude, to find if educational status had any influence on attitude, to find if there is any gender influence on attitude. Methods: It is a cross sectional descriptive study conducted in a private medical college, Pondicherry among doctors and nurses who had completed their under graduation with a sample size of 221 (Doctors-120, Nurses-101). The instruments used were a semi-structured demographic profile and 34 items of OMICC (Opinion About Mental Illness in Chinese Community). The data was entered in Microsoft Excel 2013 analyzed using descriptive statistics, unpaired t-test, pearson’s correlation coefficient.Results: Only 25% of doctors and 4.9% of nurses positive attitude when overall score was considered. Doctors group had higher positive attitudes compared to nurses in domains separatism, stereotyping, benevolence and stigmatisation.Conclusions: There was no correlation between duration of psychiatry posting and attitude.
Antibiotic profiling of Pseudomonas aeruginosa isolates from pus sample of rural tertiary care hospital of Western Maharashtra, Loni, India
Authors: Raytekar, Namita A., , Choudhari Meghna R. , Das Sonali
Published: June 2017

Background: Pseudomonas aeruginosa (P. aeruginosa) considered as an opportunistic pathogen which can be isolated from various kinds of infection. The risk of emergence of antibiotic resistance is based on different antibiotic treatments. Antibiotic resistance and flexibility to adapt changing environment renders the pathogens a matter of concern in hospital acquired infections. Changing pattern of antimicrobial resistance pose challenge in treating pyogenic infections, hence periodical monitoring of bacterial profile and their antibiotic susceptibility pattern is important. This study deals with the infectious and drug resistance nature of P. aeruginosa with effectiveness of antimicrobial agents against it.Methods: Present study was conducted in Centre for Biotechnology, Pravara Institute of Medical Sciences, Loni, Maharashtra, India. A total of 763 pus samples were received in the bacteriology section of department of microbiology, rural medical college, Loni from the various wards of Pravara Rural Hospital. The colonial morphology and identification was done as per standard microbiology procedures. Antibiogram testing was done as per Kirby Bauer disc diffusion method.Results: Out of 763 pus samples 154 were Pseudomonas aeruginosa thus showing 20.19% prevalence. In this study, it was observed that isolates were sensitive to Ciprofloxacin (76.63%) followed by Amikacin. However, showed 90.90 % resistant to Cefazolin followed by Co-trimoxazole 75.97% was observed. Multi drug resistance (MDR) strain 68.83% (N=106) was detected from 154 isolates strains of Pseudomonas aeruginosa. Prevalent resistance pattern was found to be GENr, AKr, CAZr, CZr, COTr for 10 (9.43%) isolates followed by GENr, CAZr, CZr, MRPr, COTr, CIPr for 9 (8.49%) isolates.Conclusions: Present study focused on antibiotic resistance pattern of P. aeruginosa from pus sample. This study contributes in understanding the emergence of MDR strains which can be considered for judicial usage of antibiotics in hospital settings.
Study of pulmonary function tests in response to localized cold stimuli in age group between 19-30 years of Guwahati city
Authors: Dutta Bijit , Bora Bonti
Published: June 2017

Background: The aim of the study was to observe any variation in the pulmonary functions in response to localized cold stimuli in an externally controlled environment.Methods: The baseline pulmonary function parameters were obtained before the introduction of localized cold stimuli. Now the stimuli were introduced by immersing both feet up to ankle in a bucket full of cold water maintained at temperature between 8-10degree Celsius in 30 male healthy subjects (age group 19-30 years) and the parameters were noted after 2 minutes and 5 minutes respectively using a Medspiror (HELIOS) Electronic spirometer and keeping room temperature at 24ocelsius in the Department of Physiology, Gauhati Medical College, Guwahati, Assam, India. For statistical analysis, the value of the pulmonary function parameters were presented as Mean±standard deviation. Analysis of variance (ANOVA) using Statistical Package for Social Sciences (SPSS) version 20 was employed for comparing the parameters and p<0.05 was considered as significant.Results: It was observed that the tidal volume and Inspiratory capacity showed a significant increase (p<0.05) whereas the Inspiratory reserve volume, expiratory reserve volume and forced vital capacity showed a significant decrease (p<0.05) in response to the cold stimuli.Conclusions: A significant effect was obtained in the pulmonary function tests exposed to cold stimuli showing the multidimensional response of the respiratory mechanics to cold, making a base for further information into the cold climatic effect in an individual.
Clinical benefits of preemptive oral clonidine versus oral tramadol for abdominal hysterectomy conducted under subarachnoid block with 0.5% hyperbaric bupivacaine: a comparative evaluation
Authors: Gupta Kumkum , Sharma Swati , Gupta Prashant K. , Kaur Guljeet , Tyagi Vasundra , Makroo Bilal Ahmad
Published: June 2017

Background: Neuraxial techniques possess many benefits for elective abdominal hysterectomy due to profound surgical anesthesia and muscle relaxation. The present study was aimed to compare the clinical benefits of pre-emptive oral clonidine with oral tramadol for abdominal hysterectomy conducted under subarachnoid block with 0.5% hyperbaric bupivacaine.Methods: Sixty adult female patients of American Society of Anaesthesiologists (ASA) physical status I and II, aged 42 to 65 years, were randomized into two groups of 30 patients each to receive either oral clonidine, 100 µg (Group C) or oral tramadol 50 mg tramadol (Group T), 90 min before initiation of subarachnoid block with 3.5 mL of 0.5% hyperbaric bupivacaine. Intraoperative hemodynamic changes, duration of analgesia and incidence of shivering were recorded as primary end points. Drug related effects of pruritus, sedation, nausea, vomiting, and respiratory depression were recorded as secondary outcomes.Results: The onset of sensory and motor block was comparable between the groups but the time to two dermatome regression were prolonged in patients of Group C with statistical significant difference (p=0.05). Duration of analgesia was also enhanced in patients of Group C (268.27±12.18 min versus 223.15±14.31 min in Group T) with statistically highly significant difference (p=0.000). The incidence of shivering was lower in the patients of clonidine group. The heart rate was lower in patients of clonidine throughout intraoperative period and no incidence of bradycardia, hypotension or sedation occurred in any patient.Conclusions: Both drugs showed clinical benefits as pre-emptive oral medication for abdominal hysterectomy conducted under subarachnoid block but oral clonidine (100 µg) proved to be more beneficial.
Serum adenosine deaminase levels and other laboratory parameters in the diagnosis of extrapulmonary tuberculosis: a clinicopathological study
Authors: Mugulkod Prabhavati , S. Sateesh Chavan
Published: June 2017

Background: Diagnosis of extra pulmonary tuberculosis (EPTB) is difficult due to its nonspecific signs and symptoms and paucibacillary nature. Early diagnosis and institution of appropriate therapy is essential to reduce the morbidity. The aim of the study was to study correlation between clinical findings, cytological/histological findings of EPTB with other laboratory parameters such as erythrocyte sedimentation rate (ESR), acid fast bacilli (AFB) status on Ziehl Neelson (ZN) stained sections /smears and serum adenosine de aminase (ADA) levels.Methods: All histologically and cytologically diagnosed cases of EPTB were included in the study and were examined for AFB on ZN stained smears and correlated with clinical findings and laboratory parameters such as ESR and serum ADA levels.Results: A total number of 230 cases of extrapulmonary tuberculosis were studied. Most common site of EPTB was lymph nodes. The most common age group affected was 3rd and 4th decade. Over half of the patients were females with male to female ratio 1:1.03. Majority had elevated ESR and caseating granuloma and only minority showed AFB positivity. Serum adenosine de aminase levels were raised in 83.3% (45 out of 54 cases). Majority of cases of EPTB with raised serum ADA levels had elevated ESR but negative for acid fast bacilli.Conclusions: Both histopathology (including cytology smears) as well as Ziehl Neelsen smears for acid fast bacilli are an “independent” diagnostic parameter and still be considered as “gold standard” while serum ADA levels are most valuable surrogate parameter.
HIV and hepatitis B co-infection - prevalence and clinical spectrum in a rural tertiary care centre of Northern India
Authors: Nim Ranjit Kumar , Verma Vivek Kumar , Kumar Manoj , Kela Dheeraj , Singh Brijesh , Singh Neetu , Singh Anand Kumar , Kumar Sushil
Published: June 2017

Background: HBV and HIV are both endemic in India. Currently, it is not well established what proportion of HIV-positive patients harbours HBV infection in India. No study was done to know the epidemiology of HBV HIV Co infection in rural population of Northern India. So, this study was done to explore the impact of HBV in HIV patients.Methods: Prospective cohort study was conducted on HIV-HBV co infected patients who attended the ART Clinic at ART centre, Department of Medicine, UPUMS, Saifai, Etawah, after obtaining informed consent.Results: Out of these 1751 HIV patients 919 were eligible for start on ART and the remaining were treatment naïve patients. Out of these 1751 HIV positive patients 79 patients were HBS Ag positive. Thus, the prevalence of HBV-HIV co infection at our ART centre was found to be around 4.5%. 68 patients were found to be eligible for start of ART drugs. Out of these 68 patients on ART, 46 (67.6%) patients were alive, 9 (13.2%) were transferred out, 5 (7.4%) patients were lost to follow up (LFU) and 8 (11.8%) expired till the end of the study.Conclusions: HBV co infection is common in HIV serology positive and can cause significant morbidity and mortality especially in the presence of other concurrent cause of liver injury. HBV co infection might associate with severe hepatotoxicity during intake of HAART regimen. For these reasons, prevention and treatment of HBV infection is mandatory in HIV serology positive.
Study of microalbuminuria as early risk marker of nephropathy in type 2 diabetic subjects
Authors: Verma Manish K. , Kumar Pradeep , Sharma Preeti , Singh V. K. , Singh Shashi Prabha
Published: June 2017

Background: Diabetic nephropathy (DN) is a common complication of diabetes mellitus that lead to end-stage of kidney disease (ESKD). Detection of early-stage can slow loss of kidney function and improve patient outcomes with use of diagnostic biomarker detection of DN. Aims and objectives of this study is to evaluate the possible association between glycated hemoglobin and urinary microalbumin as a predictor of diabetic nephropathy in type 2 diabetic patients.Methods: Total 162 subjects were included in this study comprises uncontrolled diabetes 54 cases, controlled diabetes 54 cases and healthy controlled 54 controls. Micro albumin was measured by urinary microalbumin (turbidimetric immunoassay), glycated hemoglobin (HbA1c) measured by ion exchange resin method and fasting blood glucose estimated by GOD-POD method. The inclusion of age group was between 35 to 74 years. Statistical analysis was done by using SPSS, version 16.0. p values were calculated by ANOVA unpaired t-test. The p<0.05 was considered a statistically significant.Results: Urinary microalbumin levels were statistically significant increase in type 2 diabetes mellitus with nephropathy in comparison to uncontrolled diabetes mellitus and controlled diabetes mellitus (138.9±13.7 mg/l vs 67.7±14.1 mg/l and p<0.005**).  HbA1c, which acts as a biomarker of diabetes was significant higher diabetic nephropathy, in comparison to uncontrolled diabetes mellitus, controlled diabetes mellitus and healthy control (8.0±1.1% vs 7.1±0.9% and 5.7±0.4%).Conclusions: The present study was demonstrated impaired glycaemic control is associated with elevations in urinary micro albumin levels and it may be considered as risk marker of diabetic nephropathy.
Comparative study of endonasal dacryocystorhinostomy with and without adjunctive topical use of Mitomycin C
Authors: Kulkarni Ganesh P. , Handal Ashwini S.
Published: June 2017

Background: Endoscopic dacryocystorhinostomy has now established itself in the treatment of lacrimal obstruction. Failures in endoscopic dacryocystorhinostomy are mainly due to reclosure of the stoma in the lateral nasal wall. Mitomycin-C is an alkylating agent used in the chemotherapy of various cancers. Mitomycin-C when topically applied to mucosal tissues has been reported to inhibit excessive scar tissue and granulation tissue formation, resulting in greater success rates.Methods: To evaluate the efficacy of Mitomycin-C in preventing reclosure of the dacryocystorhinostomy stoma, we performed a prospective, randomized case control study between November 2013 and October 2015. The study was conducted at tertiary care centre. The study sample consisted of 50 patients, who were randomly assigned to two groups, Group A which received the application of Mitomycin-C topically to the dacryocystorhinostomy stomal site and Group B which did not receive this intervention. The patients were regularly followed up for 6 months.Results: 24 patients (96%) out of 25 in the Group A, had a successful surgical outcome. In Group B 23 patients (92%) out of 25 were symptom free after surgery. These results indicated no statistically significant difference between the two groups (p>0.05). Hence the results of this study did not show any significant benefit for the use of Mitomycin-C as an adjunct during primary endoscopic dacryocystorhinostomy.Conclusions: An atraumatic and meticulous surgical technique along with a good follow up care post-operatively establishes endoscopic dacryocystorhinostomy as an effective treatment modality for chronic dacryocystitis.
Department of Pathology, Government Medical College and Cancer Hospital, Aurangabad, Maharashtra, India
Authors: Dhawle Manjusha S. , Tangde Ashwini R. , Mundhe Bhagyashree P. , Rathod Santosh G. , Bindu Rajan S.
Published: June 2017

Background: The intrauterine existence of fetus is dependent on one vital organ 'the placenta’. The placenta reflects the status of maternal hypertension as it is the mirror of maternal and fetal health. The hypertensive disorders complicate 5-10% of all pregnancies and form a dangerous triad with haemorrhage and infection that contributes greatly to maternal morbidity and mortality. The fetus is dependent on placenta for growth and development. Many disorders of pregnancy like hypertension are accompanied by gross and histological changes in placenta. Aim of the study was to study the various morphological lesions of placenta in pregnancy induced hypertension and compare them with normal pregnanciesMethods: Gross and microscopic examination was conducted on 70 placentas. These included 15 normal placentas and 55 placentas from pregnancy induced hypertension.Results: In PIH, on gross the placenta showed areas of infarction, perivillous fibrin deposition and basal decidual haematoma, while microscopically showed increased syncytial knotting, cytotrophoblasitc proliferation, basement membrane thickening, vasculosyncytial membrane deficiency, infarction and fibrinoid necrosis.Conclusions: Maternal disorders affect the placental histology and can be detected by morphological examination of such placentae. The placenta from hypertensive pregnant women show significant morphological changes as compared to control, which may alter the perinatal outcome.
Role of technetium scan in diagnosis of congenital hypothyroidism
Authors: N. Prasad Nayak , Maben Roshan , Chako Nisha , Soans Santosh T.
Published: June 2017

Background: With advent of screening new born population the incidence of congenital hypothyroidism dropped to 1:3000 to 1:4000. We have aimed to show the importance of doing technetium scan to find out exact etiology of congenital hypothyroidism. It helps in proper treatment and explaining the long-term prognosis. However, many centres in India do not have facilities for nuclear study.Methods: Study comprised of 30 children, the results of thyroid function test (TFT) were analysed, ultrasound neck was done to detect the presence or absence of thyroid gland in the neck and technetium scan was done in the department of nuclear medicine. Based on the images its classified as agenesis, ectopic or decreased uptake. The results of TFT, Ultrasound neck, technetium scan was analysed using statistical software.Results: Correlation of thyroid profile with technetium scans, T3 was decreased in 61.5% cases of ectopic thyroid, 100% cases of thyroid agenesis and 83.3% cases of decreased uptake. T4 was decreased in 92.3% cases of ectopic thyroid, 80% cases of thyroid agenesis and 75% of decreased uptake. Whereas TSH increased in all the cases with abnormal Technetium scan results. Correlation of ultrasound neck with technetium scans revealed, of the nonvisualised thyroid gland by ultrasound, 13 were ectopic, 5 agenesis and 5decreased uptake. of the visualized thyroid gland, all the 07 showed decreased uptake.Conclusions: Congenital hypothyroidism is one of the most serious condition needs to be diagnosed as early as in the newborn period.
Balloon cavoplasty in membranous obstruction of vena cava
Authors: Abhisek B. Sunil , B. Kumar
Published: June 2017

A hepatic venous outflow tract obstruction at any level is considered as Budd Chiari syndrome (BCS). Primary BCS is usually due to a congenital membrane causing the obstruction; referred to as membranous obstruction of vena Cava (MOVC). In the past MOVC was predominantly treated through surgery, percutaneous transluminal balloon angioplasty (PTBA) is an alternative and effective form of treatment. Case scenario of a 32-year-old gentleman presented himself with complaints of hematemesis for one year and hematochezia for three months. Hepatomegaly was noted. An ultrasonogram revealed a dilated IVC, till its hepatic portion, and also the Hepatic Veins. There was a fibrous membrane like structure of about 5 mm thickness that was obstructing the IVC flow. Patient was taken up for venogram for conformation of diagnosis and intervention. 6F NIH catheter was introduced from Femoral vein, an injection into the IVC showed contrast not flowing into right atrium and there was a membranous obstruction for the forward flow. A Brockenbrough’s trans-septal needle with Mullins Sheath was used to puncture the membrane and right atrium was entered. A 22 mm Inouye mitral valvuloplasty balloon (Single Balloon, Toray Medical, Tokyo) was taken and positioned at the membrane and inflated and deflated several times with incremental pressures till the waist of the balloon disappeared. Conclusion membranous obstruction of vena cava (MOVC) is a common cause of primary Budd Chiari syndrome. Percutaneous transluminal angioplasty using Inoue or mansfield balloon with or without stenting is a safe and effective treatment option.
Esophageal lung associated with VACTERL anomaly: a case report
Authors: Deshpande Aditi , Patil Shalil , Gupta Abhaya , Kothari Paras
Published: June 2017

Esophageal lung is an extremely rare type of bronchopulmonary foregut malformation in which the main stem bronchus is anomalously connected to the esophagus instead of the trachea and is supplied by branches of pulmonary artery. Less than 25 cases have been reported so far in literature. We hereby report first case of esophageal lung associated with VACTREL anomaly. An 8-month-old female child with weight of 4.7 kg presented with recurrent lower respiratory infections. She was diagnosed to have esophageal lung on basis of clinical examination, chest X-ray f/b computed tomogram of chest and esophagobronchoscopy. There was a bifid vertebra at D9 level with scoliosis, an ectopic left kidney and dextrocardia with patent foramen ovale. Thus, this case was classified as having VACTREL association. Patient was successfully operated for excision of the hypoplastic lung via thoracotomy. She recovered well and gaining weight at 3 months f/u without any respiratory infection since surgery. High index of suspicion is necessary for the diagnosis of esophageal lung when common causes of recurrent respiratory infections are ruled out.
Tuberculous cervical lymphadenitis (scrofula): USG, doppler and elastographic evaluation: report of two cases
Authors: Phatak Suresh V. , Gupta Nipun , Phatak Pallavi
Published: June 2017

Lymphadenitis is the most generic form of extra pulmonary manifestation of tuberculosis. It is both diagnostic and therapeutic challenge because it mimics various other pathologic processes and yields inconsistent physical laboratory findings. Diagnosis is quite difficult often requiring biopsy. It is also important to differentiate tuberculous from non-tuberculous mycobacterial cervical lymphadenitis as their treatment protocols are different. We are presenting a case report of two patients who presented with neck swelling. Elastography is a recent advance in the field of sonography helping in identifying nature of pathology. Sonography, doppler and elastographic findings are discussed.
A CT and DNE study of osteomeatal complex variations and their correlation in chronic rhinosinusitis patients
Authors: Sachdeva Parul , Sachdeva Kuldeep S. , Singh Baldev , Singh Manjit , Kaur Manpreet , Goyal Isha , Kataria Gaurav
Published: June 2017

Background: CRS is a global burden reducing the productivity at work. This study was done to evaluate the occurrence of anatomical variations of osteomeatal complex (OMC) and to assess its relation in causation of chronic rhinosinusitis in the study population.

Methods: A 100 patients diagnosed with CRS in the outdoor of Dept. Of ENT between November 2012 – November 2015 were subjected to CT Imaging and DNE and the frequency of anatomical variations and involvement of paranasal sinuses were evaluated. The correlation between them was established using chi-square test.  

Results: Agger nasi cells were the most common variant seen in 73 (73%) patients with 12% being unilateral and 61% bilateral. Other variants seen were: deviated nasal septum in 68%, uncinate process variations in 58%, concha bullosa in 30%, enlarged bulla ethmoidalis in 25%, paradoxical middle turbinate in 18%, haller’s cells in 6% and accessory maxillary ostia in 2%. We could establish a correlation between a few of these variants and the affected sinuses.

Conclusions: The importance of CT and nasal endoscopy is emphasized in patients with persistent symptoms to identify the anatomical variations that may contribute to the development of chronic sinus mucosal disease.
Clinical correlation between palpability of styloid process with its length on CT scan
Authors: Anchan Shibani V. , J. S. Arunkumar , Shanbag Raghunath , Garag Santosh S.
Published: June 2017

Background: The aim of the study is to correlate the clinical palpability of the styloid process with its length which is determined by CT scan.

Methods: A prospective study of 50 patients who presented to ENT OPD from January 2011 to January 2016 with cervicofacial pain and features of Eagle’s syndrome were clinically evaluated for elongated styloid process by palpating the tonsillar fossa. These patients were subjected to a detailed CT scan with coronal, axial and 3D cuts. The length of the styloid process in the CT scan was correlated with the clinical palpability of the styloid process.  

Results: It was noticed that only styloid process of length greater than 28 mm was clinically palpable. Correlation between the clinical palpability and the minimum length required was established in this study.

Conclusions: Patients with cervicofacial pain should be evaluated for styalgia by imaging and clinically by palpating the tonsillar fossa.
Vocal cord palsy and getting to know it better
Authors: Gee Varghese Irene , M. K. Goutham
Published: June 2017

Background: Vocal cord palsy is a challenging entity encountered by otolaryngologists in clinical practice. It is a sign of an underlying pathology. Vocal cord palsy requires thorough examination and needs to be investigated. We conducted a study to identify the various etiology of vocal cord palsy and the various modalities of treatment.

Methods: A prospective study was conducted to study the various etiologies and modalities of treatment of vocal cord palsy. A total of 55 patients with vocal cord palsy were included in our study based on the inclusion and exclusion criteria. Patients diagnosed with vocal cord paralysis were followed up and the various modalities of treatment were studied.  

Results: Males outnumbered females. Among patients of unilateral vocal cord paralysis left vocal cord was paralyzed in majority of the cases (30 patients). Vocal cord paralysis has a variable etiology. Neoplastic causes accounted for the largest number of patients followed by iatrogenic causes. The modality of treatment depends on the etiology. Patients with unilateral vocal cord palsy speech therapy were our modality of treatment. No surgical intervention was done for unilateral vocal cord palsy. Five patients with bilateral vocal cord palsy underwent Kashima’s operation.

Conclusions: Vocal cord palsy is a symptom of an underlying disorder and not a disease. In our study malignancy is the commonest etiology for vocal cord palsy.
Our experience of 200 cases of thyroid surgery under local anaesthesia versus general anaesthesia
Authors: Chintale Sambhaji G. , Kirdak Vilas R. , Jatale Sonali P. , Shaikh Kaleem
Published: June 2017

Background: Local Anaesthesia is now being accepted universally as a safe alternative to general anaesthesia for thyroid surgery. This study was carried out to compare the outcomes of patients undergoing thyroid surgery under local and general anaesthesia.

Methods: 200 patients who underwent thyroid surgery for benign and malignant diseases under local and general anaesthesia from March 2014 to march 2017 were analysed. Patient characteristics analysed were age, sex, pathology lesion size, operating time, length of stay, cost and post-operative complications.  

Results: Mean lesion sizes were 4.5 cms and 6.5 cms in local and general anaesthesia group respectively. Mean operating time was 50, 5 minutes and 75.5 minutes in local anaesthesia and general anaesthesia group respectively. Mean cost incurred was Rs. 2500 in local anaesthesia and Rs. 5500 in general anaesthesia group. Mean length of hospital stay was 40, 25 hours and 75.06 hours in local anaesthesia and general anaesthesia group respectively.

Conclusions: Local anaesthesia is a safe alternative to general anaesthesia for patients undergoing thyroid surgery. Use of local anaesthesiahas resulted in a decreased length of stay, cost and means operating time, hence useful in a setup with limited anaesthesia time and increased work load.
Comparison of efficacy of myringoplasty in dry and wet ears in chronic otitis media of tubotympanic type
Authors: Chandrashekar Yogeshwar , Chandrashekar Ravishankar
Published: June 2017

Background: The objective of the study was to compare the outcome of myringoplasty in dry and wet ears in tubotympanic type of chronic otitis media (COM) with respect to graft uptake and hearing improvement.

Methods: This is a prospective study done in department of ENT Bangalore Medical College and Research Institute during the study period of November 2014 to May 2016, wherein a total of 60 patients of tubotympanic type COM with 30 cases each of dry and wet ears, aged 15-60 years were included. The hearing impairment was assessed and recorded by pure tone audiometry (PTA). After obtaining informed written consent the patients underwent myringoplasty (temporalis fascia graft, underlay technique). Microbiological examination of discharge in wet ears was done and histopathology of the excised remnant TM analyzed in both groups. Both groups of patients were followed up for 3 months and assessed for graft uptake and hearing improvement. PTA was repeated at 3 months postoperatively.  

Results: Our study included 60 patients of tubotympanic type of COM with 30 cases each with dry and wet ears who underwent myringoplasty. Majority of our patients were in second decade in both the groups. There was slight female preponderance in our study with male to female ratio of 0.93:1. Discharge from ears in wet ears was mucoid in consistency and were culture negative. Histopathology of excised remnant TM in wet ears revealed evidence of inflammatory cells and vascularization within stroma of fibroblasts while these were absent in dry ear cases. The overall successful graft uptake following myringoplasty was 88.3% with 86.7% for wet ears and 90% for dry ears with no statistical significance (p value of 0.688>0.05) between the two groups. With respect to hearing improvement post-operatively there was significant hearing improvement in both the groups when compared to preoperative hearing with a mean hearing gain (dB) of 3.43±2.81 in wet ear cases to 3.85±3.05 in dry ear cases, but when compared between the two groups, there was no significant statistical difference (p value of 0.582>0.05).

Conclusions: The outcome is equally good for myringoplasty in dry and wet ears in tubotympanic type of chronic otitis media with respect to graft uptake and hearing improvement. 
Non-Hodgkin lymphoma of sinuses and nasal cavity: case series of two
Authors: Dalmia Deepak , Behera Sanjaya Kumar , Bhatia Jas Simran Singh
Published: June 2017

Non-Hodgkin lymphoma is a type of hematologic malignancy derived from lymphocytes, which varies significantly in their severity, from slow growing to very aggressive types. Incidence increases with age. Up to 45 years of age Non-Hodgkin lymphoma is more common among males than females. Various etiological factors includes infectious agents like Epstein-barr virus, Human T-cell leukemia virus, Helicobacter pylori, Human herpes virus-8, Hepatitis c virus, HIV etc. Exposure to chemical like polychlorinated biphenyls, phenoxy herbicides and medical treatments like radiation therapy and chemotherapy also act as etiological factors. Genetic diseases like Klinefelter’s syndrome, ataxia telangiectasia and autoimmune diseases like celiac sprue, rheumatoid arthritis and systemic lupus erythematosus can also act as causal factors. NHL in nose and nasal cavity is a rare finding. Ours is a case series of two rare case of non-Hodgkin lymphoma presented with a nasal mass with nasal obstruction. The first case is a sixty years old female patient who presented with a right nasal mass with nasal obstruction. The second case is a fifty years old male who presented with left side nasal mass with left proptosis.  We diagnosed these cases by taking biopsy from the nasal masses. These cases highlighted the importance of good clinical history and examination along with management according to definite protocols in regarding to avoid missing a rare.
Endoscopic trans-sphenoid excision of solid petrous apex lesion: a case report
Authors: Nayak Sai Spoorthi R. , Shah Nishit J. , Deopujari Chandrashekhar E. , Gunawat Prashant V.
Published: June 2017

Petrous apex lesions are highly challenging for surgical access as they lie in the most medial portion of the temporal bone, surrounded by vital structures. These lesions are traditionally tackled by labyrinthine approaches. Endoscopic endonasal approach has been described to drain cystic lesions like cholesterol granulomas. Intraosseous schwannomas of the petrous apex are a rare occurrence with only 3 cases being reported so far. We are the first to describe a transphenoidal route to completely excise a solid petrous apex lesion like a schwannoma.
Nanobytes
Authors: Vaishnav Radhika A.
Published: June 2017

The US Food and Drug Administration (FDA) recently announced its decision to go ahead with approval of existing immunotherapeutic drug Keytruda to treat cancers based on the genetic profile of a tumor rather than the type of cancer. Such a decision to approve a drug in a “site agnostic” manner is a first, with drugs traditionally approved for specific types of cancer based on location or cell type. The drug has been given the green light for individuals – adults as well as children - who have solid tumors with microsatellite instability or mismatch repair deficiency and that do not respond to other treatment. Both of these genetic changes involve impairment of the cell’s gene repair system and lead to increased mutations. Such genetic changes, although rare overall among cancers, are fairly common in colorectal, endometrial, and gastrointestinal cancers. The FDA used accelerated approval based on five clinical trials that studied it in 15 different cancer types. Almost 40% individuals saw shrinkage of tumors after receiving Keytruda. The development is encouragement for other immunotherapies in the pipeline as well - with over 200 immunotherapeutics currently in various stages of clinical trial or approval.
Project Managers Perceptions about more Effective Leadership Styles
Authors: José Sousa Maria , Dias Ivo , Moço Isabel , Saldanha Ana , Caracol Carla
Published: June 2017

The main purpose of this study is to analyze the type of leadership that can be more effective in the perceptions of project managers. In this case, the research question answer could have a major meaning due to the fact that projects rarely fail due to the lack of professional skills and knowledge; they most often fail because of the type of leadership. The research question is “Which are the most effective leadership style for project managers?” The methodology used was quantitative through the application of a questionnaire to 78 project managers and the results shows that Transformational Leaders are the most effective according the specificities of the projects.
Subjectively Experienced Benefits and Harms of Antipsychotics According to Users’ Firsthand Accounts on the Internet
Authors: Hughes Shannon E. , Matheson Alicia
Published: June 2017

This study used an analytic framework emphasizing psychotropic drugs’ subjectively experienced psychoactive properties to reframe the helpfulness and burden of antipsychotics’ effects and impacts on users’ lives. Methods: User-reported effects of aripiprazole, lurasidone, and quetiapine within 819 user reviews on two popular websites (WebMD, Ask a Patient) were examined within the drug-centered model of drug action, cited in the literature as an alternative to the conventional disease-centered model. Independent coders used QDA Miner Version 4.1.22 to code 16 physical, mental, and emotional effects, layered with codes indicating the desirability and burden of effects from users’ perspectives. Results: Most (70%) users were female, 57.5% reported taking the reviewed antipsychotic for less than 6 months, most commonly (69.1%) for a mood disorder. Antipsychotics’ benefits included improved mood stability (14.4%) and depression (13.6%); worsened anxiety/agitation was the most frequent harm (15.3%). One quarter of undesirable effects were extremely burdensome. Aripiprazole and lurasidone demonstrated activating effects, with lurasidone users reporting the highest rates of akathisia (19.5%) and worsened anxiety (19.1%). Quetiapine’s sedating effects were often helpful (28.1%) but also produced excessive sleepiness (33.3%) and poor concentration/memory (13.9%). Users appear to subjectively experience antipsychotics’ overall activating or sedating effects as a mixture of interconnected desirable and undesirable changes occurring along a continuum of burden. Conclusions and Implications for Practice: Subjective experiences of users should be central to assessing the benefits and harms of antipsychotic drugs. Reconceptualizing the role of medications in recovery is likely needed in light of mixed and variable firsthand treatment experiences.
A comparative study of three different methods of shoot meristem excision for induction of embryogenic calli in coconut
Authors: U Bhavyashree , K Lakshmi Jayaraj , TP Fayas , KS Muralikrishna , KK Sajini , MK RAJESH , Karun Anitha
Published: June 2017

A protocol was standardized to maximize yields of embryogenic calli from shoot meristem culture of coconut. Three different shoot meristem excision methods were tested viz., excision of shoot meristem aseptically from in vitro germinated embryo after 10-12 days, excision of shoot meristem from in vitro germinated embryo subjected to GA3 treatment for five days and excision of shoot meristem from fresh embryo. The primary calli induction after 30 days of culture incubation for the three treatments were 21%, 27%  and 79% respectively.  Further, the primary calli formed from the shoot meristem excised from fresh embryo gave rise to 56% of embryogenic calli. The calli obtained from the shoot meristem which were excised from in vitro germinated embryo formed less percentage of embryogenic calli because of the presence of cotyledonary tissues which inhibited the multiplication of meristematic tissues. In the case of shoot meristem extracted from GA3-treated embryos, the percentage of non-embryogenic calli was more compared to the shoot meristem excised from fresh embryo. It was observed that the addition of GA3 in the initial stages of culture inhibited the formation of embryogenic calli and favored direct shoot development. Currently, the shoot meristem excised from fresh embryo is being employed for scaling up the planting material production from released varieties of coconut.
Effects of the bendazol fungicide on in vitro development of the nim (Azadirachta indica A. JUSS)
Authors: Dos Santos Elisabete Pacheco , De Souza Robson Antonio , Lacerda e Medeiros Maria Jaislanny , Alves Gilberto Dias , Houllou Laureen Michelle
Published: June 2017

Two experiments were conducted to evaluate Bendazol fungicidal effects in neem micropropagation. In these experiments, the nodal segment explants from in vitro plants were used. In the first experiment, the explants remained in DKW culture medium for a period of 30 days containing different concentrations of Bendazol (M1 -50, M2 - 100, M3 - 200, and M4 - 400 mg.L-1). The control treatment (M0) was prepared with DKW medium + BAP (0.225 mg.L-1). In the second experiment, the explants were maintained for only one week in media supplemented with Bendazol or BAP, and then they were transferred and kept in free Bendazol/BAP media for three weeks. In each experiment, the design was completely randomized with five treatments, 10 replicates per treatment, and one explant/cultivation flask.  The variables analyzed included the formation of calluses and roots, lateral bud development, shoot height, contamination and plant death. There was no significant difference in tree variables (shoot, callus formation and shoot height) between treatments in both experiments. There was no death, plant contamination and rooting during the experiment. The results indicate that Bendazol can be used at low doses for in vitro neem cloning thereby replacing BAP and ultimately reducing production costs.
Serum biochemical properties and liver morphology of broiler chicken as affected by feeding Misai kucing (Orthosiphon stamineus) as a supplementary diet
Authors: Malahubban Masnindah , Ab Aziz Zakry Fitri
Published: June 2017

To evaluate the effects of ground leaf of Misai kucing (Orthosiphon stamineus) as a dietary supplement on serum biochemical parameters and liver morphology. One hundred and sixty one-day old male broiler chickens (n=160) were distributed into four treatment groups, with five replicates of eight birds in each group: the control group (diet without additives); the group dietary treatments, Diet OS2 (Basal diet + 2g/kg O. stamineus); Diet OS4 (Basal diet + 4g/kg O. stamineus) and Diet OS8 (Basal diet + 8g/kg O. stamineus). After 42 days, 40 birds were randomly selected for serum biochemical profile analysis involving pancreatic, renal, and hepatic functions (urea, sodium, potassium, chlorine, aspartate transaminase (AST), alkaline transaminase (ALT), alkaline phosphatase (ALP), glucose, cholesterol, triglycerides, total protein, albumin, and globulins). Present study found that serum levels of cholesterol, triglycerides, urea, AST, ALT and ALP were significantly lower suggesting that the O. stamineus ground leaf possibly do not cause kidney and liver impairment, mainly, at the higher dosage (8g/kg). Present study concluded that the broiler chicken fed O. stamineus ground leaf at a rate 8 g/kg was the most promising dietary supplement to enhance health without deleterious effects on serum biochemical properties and morphological components of liver. In addition, it reduces abdominal fats and serum cholesterol. This study has provide evident that medicinal plant, O. stamineus can potentially substituted the use of additive synthetic.
Genetic Diversity Analysis of Couroupita guianensis Aubl.based on RAPD Marker
Authors: P Santosh , Arakera Suresh B.
Published: June 2017

 Couroupita guianensis Aubl. Commonly known as cannon ball tree, belongs to family Lecythidaceae and widely used in Chinese medicine. C. guianensis is being threatened due to habitat destruction in its native range for human settlement and other development related activities. Native populations of C. guianensis  were collected from different locations of  the India states and characterized through. To study the genetic diversity of C. guianensis  populations we performed RAPD – PCR with several primers. The results are revealed in this study.