bluuebunny/crossref_metadata_2025 huggingface dataset:
Estimation of serum cortisol levels and its correlation with salivary cortisol levels in coronary artery disease patients with and without periodontitis: a cross sectional study
Authors: George Ria Susan , Manjunath Nandini , V. Manjunath B. , Bhat Kishore
Published: April 2017

Background: Atherosclerosis refers to combination of changes in the intima of arteries, consisting of focal accumulation of lipids, complex carbohydrates, blood and blood products, fibrous tissue, calcium deposits and associated medical changes. Ischemic heart disease (IHD) refers to a group of closely related syndromes that is caused by an imbalance between myocardial oxygen demand and blood supply.Methods: A cross-sectional study was conducted on 63 patients, aged 30-65 years, with known coronary artery disease. Estimation of serum and salivary cortisol levels were assessed with specific ELISA kit for cortisol (R&D Systems) and their comparison was performed in patients with and without periodontitis. Statistical analysis was done using Mann-Whitney U test and Pearson Correlation test.Results: The clinical parameters showed statistically significant association (p<0.001) between coronary artery disease and periodontitis and comparative levels of serum and salivary cortisol displayed varying degrees of positive correlation.Conclusions:Saliva along with serum has great potential as a diagnostic fluid and it showed good correlation with cortisol levels in coronary artery disease patients with and without periodontitis.
Myths and taboos in dentistry
Authors: Raina Sadhana A. , Jain Poorvi S. , Warhadpande Manjusha M.
Published: April 2017

Background: India, a developing country, faces many challenges in rendering health needs to its countrymen. The influence of culture is seen in every discipline of health and medical practices, and dentistry is no exception. This study was performed to investigate the existence of myths and taboos in dentistry, to assess the variation of these myths across various demographic aspects and socio-economic status, to co-relate the existence of myths with the oral health of the subject and to impart education to the people regarding abolishing the myth as that will be a hindrance towards a healthy life in patients.  Methods: The study had a cross-sectional design, used a structured questionnaire and was conducted to assess the existence of dental myths and taboos and to determine its correlation with the OHIS index of the patients. Statistical analysis software SPSS V 16.0 was used. Descriptive & inferential statistical analysis was performed on categorical and continuous data. Chi-square, independent sample T tests and ANOVA test were used to compare the distribution of caries and OHI-S between different groups. P value less than 0.05 (p<0.05) was considered to be significant. Socioeconomic status was also calculated.Results: In the present study it was found that the there was almost an equal distribution of prevalence of myths in the educated as well as uneducated patients .Also the ratio of existence of myths was found higher in females as compared to males.Conclusions: Existence of myths and taboos regarding dental health has started decreasing among the urban population due to the widespread of awareness regarding dentistry.But still there is prevalence of some myths in the patients having primary education as compared to patients having secondary and tertiary education. If community is educated about proper prevention and cure, the myths relating dental concepts will vanish from the society and over all dental health status of the community will improve.
Prevalence and patterns of psychiatric morbidity in people living with HIV
Authors: Balasubramaniam Senthilsayinathan , Pauldurai Kasikrishnaraja , Eswaran Madhushanthini , Vethanayagam Mohankumar , Rajagopalan Rajesh
Published: April 2017

Background: Diagnosis of HIV infection creates an overwhelming stress and leads to symptoms like guilt, fear, anxiety, sad mood, grief and suicidal ideation. Though the rate of suicide has decreased after the introduction of highly active anti-retroviral therapy (HAART), it still remains high. Indian studies assessing suicidal ideation in people living with HIV (PLHIV) are scarce. Psychiatric evaluation and treatment improves the quality of life in PLHIV. Aim of the study was to assess the prevalence and patterns of psychiatric morbidity including suicidal ideation in PLHIV attending Integrated Counselling and Testing Centre (ICTC), prior to initiation of ART.Methods: A cross sectional study design was used. 11476 persons attending ICTC of IRT Perundurai Medical College, Erode, Tamil Nadu, India were tested for their HIV status over a period of two years. 211 persons were found to be positive, 143 persons gave consent and met inclusion criteria. Every patient underwent a semi-structured clinical interview and their psychiatric morbidity was assessed based on ICD 10. Current suicidal behavior, hopelessness and depression were measured by appropriate rating scales. Data was analyzed by using the SPSS 16.Results: Psychiatric diagnosis was present in 36.4% of the sample. Depression was the commonest diagnosis followed by adjustment disorder, alcohol related problems and anxiety disorder. 26 persons (18.2%) had current suicidal ideation. 3 out of 143 persons had attempted suicide within 6 months following notification of their HIV status.Conclusions: Nearly 1/3rd of PLHIV require psychiatric referral and 1/5th of PLHIV have suicidal ideation. It will be highly beneficial to integrate psychiatric services into daily care of PLHIV.
Prevalence of migraine and tension headaches and related factors, 2014
Authors: Fattahzadeh-Ardalani Ghasem , Ahari Saeid Sadeghieh , Amani Firouz , Moghaddamnia Vahid
Published: April 2017

Background: Migraine and tension type headache (TTH) due to their effect on life and reducing efficacy are two major problems in human life. This study aimed to investigate the prevalence of migraine and tension headaches and factors affecting their occurrence in Ardabil, Iran.Methods: In this cross sectional descriptive study, 900 cases were selected randomly from referral outpatients to neurology clinic of Ardabil, Iran during 2014. Diagnosis of headache type was confirmed by a neurologist and required information was obtained by general and neurological examinations of patients and recorded in a checklist and then analyzed by statistical methods in SPSS.19.Results: Of all referral cases, 767 (85.2%) have headache which from them 27.9% have migraine and 48.2% have TTH. Among migraine patients, 15.4% was male and 84.6% was female, and among TH patients 38.1% were male and 61.9% were female. Most location of headache in migraine and TH patients was frontal and temporal with 37.8% and 28.9%, respectively. Frequency of headache attacks in migraine patients was often weekly or monthly (74.3%) and in TH patients was often daily or weekly (85.7%). The prevalence of headache history among migraine patients was significantly more than TH patients (43.5% versus 34.1%).Conclusions: Results showed that the prevalence of migraine and TH was high in our society and most of headache attacks were weekly or daily. Because of headache causes to private and social dysfunctions, doing studies to determine risk factors in incidence of migraine and tension headaches for early detection of them is essential.
Correlation of endothelial cell proliferation with vascular endothelial growth factor in endometrium of women with menorrhagia
Authors: Mehra Kiran B. , Gangane Nitin M. , Joshi Deepti R.
Published: April 2017

Background: Approximately 30% of women of reproductive age experience excessive blood loss during menstruation. In 50% of cases, menorrhagia has no underlying pathology. However, until recently, the only permanent cure for menorrhagia was hysterectomy. In this study we aim to determine the correlation of vascular endothelial growth factor (VEGF) expression with markers of endometrial endothelial cell proliferation like proliferating cell nuclear antigen (PCNA) and Cluster Determination (CD34).Methods: A total of 100 patients with history of menorrhagia were selected for study. Double Immunohistochemistry was performed on these endometrial biopsy sections. Proliferating endothelial cells were identified by an immunohistochemical double staining technique with PCNA and CD34. VEGF expression was also seen in endometrial biopsy.Results: In general, expression of both VEGF and PCNA was more in functional layer than basal layer in both menorrhagic patients as well as non menorrhagic patients.  When glandular cytoplasmic VEGF expression was compared with PCNA the association was statistically significant whereas completely opposite findings was seen with glandular luminal surface VEGF positivity but the association was statistically significant. In secretory phase (p-value<0.001) there was highly statistically significant association in PCNA grading with glandular luminal surface VEGF positivity whereas when we correlated PCNA with  cytoplasmic  glandular VEGF in secretory phase it was statistically significant (p-value<0.001).Conclusions: The endothelial proliferation was significantly higher in menorrhagia patients during late secretory phase of cycle than controls. We were able to demonstrate increased endothelial proliferation in patients in the premenstrual part of cycle.
Dynamic condylar screws versus 95º angle blade plate fixation of subtrochantric fractures of femur
Authors: Vashisht Deepak , Sreen Sanjeev , Daroch Manjit S. , Alawadhi Karan
Published: April 2017

Background: The purpose of this prospective randomized study was to evaluate the results of dynamic condylar screw (DCS) system and 95º angle blade plate fixation in the management of sub-trochanteric femoral fractures, regarding stability, union time, complication rate and functional out come.Methods: Total 30 consecutive patients with sub-trochanteric fracture were studied. The inclusion criteria were closed sub-trochanteric fractures in adults of both gender aged 18 years or above. Pathological fractures and open fractures were excluded from the study. After fixation of fractures with dynamic condylar screw system and 950 angle blade plate patients were followed up in OPD at an interval of 2 weeks till full weight bearing was started and then after at an interval of 4 weeks. Results of treatment were assessed by the Harris hip score for clinical and radiological assessment at the end of 6 months.Results: Among 30 studied cases, males were 22 (73.30%) and female 8 (26.70%). Most common mode of injury was road traffic accidents that occurred in 17 patients (56.70%) and the rest 13 patients had a history of fall. Patients were divided into two random groups (A &B) of 15 cases each. Group A was treated with DCS and Group B was treated with Angle Blade Plate 95º implants. Radiological union in most of the patients (13 out of 15 cases) treated with 95°angle blade plate occurred between 14-18 weeks, while in cases treated with dynamic condylar screw radiological union in most of the patients (14 out of 15) occurred between 12-16 weeks. According to Harris hip score, good to excellent results were achieved in 10 cases (66.66%) of 95°angle blade plate group and 14 cases (93.33%) of dynamic condylar screw group.Conclusions: Patients with sub-trochanteric fractures treated with dynamic condylar screw had earlier radiological union, better functional outcome, less complications and earlier weight bearing.
Clinical outcome of proximal left anterior descending revascularization with everolimus eluting stents via transradial route: a single centre experience in Western Rajasthan, India
Authors: Mathur Rohit , Kumar Goutam , Gupta Deepak , Sanghvi Sanjeev , Baroopal Anil
Published: April 2017

Background: The proximal left anterior descending (LAD) artery stenosis represents the most important proximal site for obstructive coronary artery, as it supplies 40%–50% of the total left ventricular myocardium and could result in ischemia to a large area of myocardium. This study assesses the clinical outcome of patients with coronary artery diseases undergoing percutaneous revascularization with everolimus eluting stent implantation in the proximal left anterior descending coronary artery via trans radial route.Methods: 150 patients with significant angiographic lesion of proximal LAD artery stenosis treated with PTCA and stenting to proximal LAD via TRA were selected for study and were followed for one year.Results: Total 15 events were recorded 4 (2.6%) deaths and 11 (7%) MI and TLR was noted in 4% of patients. One (0.6%) case of acute stent thrombosis was recorded.Conclusions: Total MACE of this record (10% at 12 months of clinical follow-up) is consistent with those observed in the large randomized and multi-center studies with drug-eluting stents implanted in the proximal left anterior descending artery.
Cord blood parameters change in pregnancy induced hypertension
Authors: Meher Purnima , Meher Sitanshu Kumar , Jena Sunil Kumar
Published: April 2017

Background: Pregnancy induced hypertension (PIH) is a multisystem disease of unknown etiology which affects only human beings. It poses several problems to both mother and child. Complications in newborns like intrauterine death (IUD), intrauterine growth retardation (IUGR), perinatal asphyxia, neonatal sepsis and bleeding disorders are associated with toxaemia of pregnancy. To decrease the perinatal morbidity and mortality, babies of hypertensive mothers should be carefully monitored and managed. Aim of this study was to establish the changes in total platelet count, reticulocyte count and absolute neutrophil count of umbilical cord blood in pregnancy induced hypertension as compared to normotensive mothers.Methods: This case-control study was conducted among 60 subjects including 30 case (diagnosed cases of pregnancy induced hypertension) and 30 control (normotensive pregnant women). The case group was again categorized into three subgroups – gestational hypertension (06), pre-eclampsia (16) and eclampsia (08). In all the subjects, 2 ml of umbilical cord blood anticoagulated with EDTA was collected and haematological tests for reticulocyte count, total platelet count (TPC) and absolute neutrophil count was done.Results: There was significant decrease in TPC (p<0.01) and absolute neutrophil count (p<0.01), but significant rise in reticulocyte count (p<0.05) in umbilical cord blood of babies born to hypertensive mothers compared to normotensive mothersConclusions: From this study, it can be concluded that newborns of hypertensive mothers carry risks for infection and bleeding complications. So, these simple haematological tests can be done at early stage in neonates to reduce possible perinatal morbidities and mortality.
Prevalence of metabolic syndrome in a rural population- a cross sectional study from Western Uttar Pradesh, India
Authors: Zafar Khwaja S. , Pious Tony , Singh Prem S. , Gautam Rajesh K. , Yadav Sudhir K. , Singh Prafulla , Sharma Himanshu
Published: April 2017

Background: Prevalence of non-communicable diseases like hypertension, diabetes mellitus and coronary artery disease is on the rise due to the change in lifestyle, unfavourable dietary habits and obesity. Metabolic syndrome is a simple tool by which we can predict the future risk of diabetes mellitus and cardiovascular disease. Studies showed that prevalence of metabolic syndrome is rising in Indian population, but majority of them were done in urban population. This study was conducted to look into the current status of the metabolic syndrome in rural population.Methods: The study was conducted among a population of 2982. Each participant was subjected to clinical examination, anthropometric measurements and necessary laboratory investigations. Metabolic syndrome was diagnosed based on modified NCEP: ATP III criteria.Results: The prevalence of metabolic syndrome was found to be 11.7% and was higher among female population (13.8%) as compared to males (9.6%). The prevalence of metabolic syndrome increased with increasing age. 28.3% of the participants over the age of 50 years had metabolic syndrome whereas it was only 0.4% below the age of 20 years. Nearly half (47.1%) of the obese individuals were suffering from metabolic syndrome implicating obesity as one of the most important risk factors in the etiopathogenesis of metabolic syndrome. The prevalence was only 1.1% among the underweight group.Conclusions: Present study has shown moderate prevalence of metabolic syndrome among the rural population of Western Uttar Pradesh, India with a more female predisposition.
Mucormycosis- in a case of diabetes mellitus
Authors: Francis Felin Ann , Shetty Varun , Khomne Amit , Ansari Imran
Published: April 2017

Mucormycosis is a rare fungal infection seen in immunocompromised people especially with uncontrolled diabetes mellitus – in this case causing orbital cellulitis. Patient of diabetic ketoacidosis was investigated with CT PNS, MRI Brain and Final diagnosis was made after clinical examination, discussion with ENT specialist, ophthalmologist about the best diagnostic technique and an endoscopic nasal biopsy was done - which showed fungal hyphae.
Non-convulsive status epilepticus: an often-overlooked etiology of syndrome of inappropriate antidiuretic hormone secretion
Authors: Davis Elizabeth , Chakraborty Rima
Published: April 2017

Altered mental status is a common presenting complaint in adult medicine with a broad differential diagnosis. When found in the context of chronic medical conditions, less common etiologies can be overlooked. We present a case of acute altered mental status thought to be secondary to acute on chronic hyponatremia in the context of syndrome of inappropriate antidiuretic hormone secretion (SIADH), eventually diagnosed as non-convulsive status epilepticus, partial type. We report the case of a 67-year-old patient with known SIADH of unknown etiology, hypertension, chronic pancreatitis and chronic obstructive pulmonary disease (COPD) who presented with fatigue, myalgia, decreased urine output. On presentation patient also had profound acute on chronic hyponatremia. During sodium correction, the patient developed an acute, progressive decline in mental status. Vital signs remained stable and workup including LP and MRI were negative. Initial electroencephalographic (EEG) showed no definitive seizure activity, but did show bifrontal focal continuous slowing. The patient’s mental status continued to decline and upon further evaluation it was suggested that the EEG findings and the patient’s progressive AMS could be compatible with non-convulsive status epilepticus. The patient received loading doses of IV lorazepam and levetiracetam and within 48 hours after initial treatment was back to baseline. Non-convulsive status epilepticus is a common, but heterogeneous subclass of status epilepticus that is difficult to diagnose. This case demonstrates the difficulty of diagnosing normalized corrected Shannon entropy (NCSE) in the context of other chronic medical conditions and the importance of including it on any differential diagnosis for acute change in mental status.
Synovial hemangioma: a pictorial essay of two cases
Authors: Raj Gaurav , Deodhar Manish S. , Chauhan Abhishek , Avasthi Sachin , Rawat Anil , Verma Chandrashekhar
Published: April 2017

Synovial hemangiomas are uncommon benign tumours of vascular origin arising in relation to the synovium of joints or bursae. Usually, a long-standing history of pain and joint swelling is present affecting children and adolescents especially in the knee or elbow joint. We present two cases of knee swelling diagnosed as synovial hemangioma.
Randomised controlled trial of the effects of a self-management patient education program on overall quality of life and knee pain of older people with mild to moderate knee(s) osteoarthritis
Authors: Jahan Alhadi M.
Published: April 2017

Background: Knee osteoarthritis (OA) is the most important chronic rheumatic disease affecting human beings. It is more common among the older population. The objective of OA treatment is to control the symptoms, such as pain, mobility problems and consequently, to improve overall quality of life. Although, self-management patient education programs, such as educational workshops and other learning activities are effective approaches in some chronic diseases, the evidence for arthritis is still inconclusive. The aim of this trial is to compare the effectiveness of an OA of the knee self-management education program with a control group, as determined by improvements in pain and quality of life.

Methods: In this study, we will perform a two-group, randomized (1:1 ratio), controlled study with repeated-measures to examine the differences between the two groups over time. The research sample will be selected from the patients who are referred to a physiotherapy department with a diagnosed mild to moderate knee(s) OA, aging from 45 to 65 years.

Conclusions: Positive findings of this trial will pave the road for new methods of cooperation between patients and healthcare providers. Also, patient education ensures that patients are well-informed about their own health and they could avoid any deterioration and disability due to bad practices. Finally, an increased understanding helps patients to make informed decisions about their healthcare avenues.
Specific learning disability: a 5 year study from India
Authors: Singh Shipra , Sawani Vishal , Deokate Mahesh , Panchal Saminder , Subramanyam Alka A. , Shah Henal R. , Kamath Ravindra M.
Published: April 2017

Background: Specific learning disability (SLD) is an important cause of academic underachievement among children, which often goes unrecognized, due to lack of awareness and resources in the community. Not much identifiable data is available such children, more so in Indian context. The objectives of the study were to study the demographic profile, risk factors, co-morbidities and referral patterns in children with specific learning disability.Methods: The study has a descriptive design. Children diagnosed with SLD over a 5 years’ period were included, total being 2015. The data was collected using a semi-structured proforma, (based on the aspects covered during child’s comprehensive assessment at the time of visit), which included socio-demographic aspects, perinatal and childhood details, scholastic and referral details, and comorbid psychiatric disorders.Results: Majority of the children were from English medium schools, in 8-12 years’ age group, with a considerable delay in seeking medical help, were referred mostly by the teachers for academic issues. Most of them had all the three disabilities-dyslexia, dysgraphia and dyscalculia. 38.56% of children had ADHD. Psychological maternal stress, developmental issues and various co-morbidities were accompanying in many cases, of which speech delay and fine motor issues were more in children having comorbid ADHD.Conclusions: Awareness, early identification and referral to appropriate services is crucial to deal with the challenge of learning disability. Health professionals should look for early signs in routine visits of children and co-morbidities, particularly ADHD, should be adequately taken care of. Role of media and education system is crucial for its destigmatization in community.
Clinical profile of children (0-5 years) with rota virus diarrhea
Authors: Bhatnagar Shrish , Srivastva Geetika
Published: April 2017

Background: Rotavirus is a common cause of acute watery diarrhea in under 5 years’ children and it may cause severely dehydrating disease in an unvaccinated child. Methods: A Cross sectional study including children aged 0-5 years presenting with complaints of acute watery diarrhea with or without fever at Department of Paediatrics, Eras Lucknow Medical College and Hospital, Lucknow (Uttar Pradesh).Results: Among 399 patients of acute diarrhea, 385 were discharged and 14 took leave against medical advice. No mortality was reported in this study. Out of 399 patients enrolled 161 (40.4%) were rota virus positive on ELISA assay with mean age 18.65 months. (p=0.028). Rotavirus positivity rate was higher among those having decreased urine (p <0.001), severe dehydration (p <0.001), those with mix/formula feed (89.3%) as compared to those having exclusive breastfeeding (33.3%) in <6 month infants (p <0.001), Only 17.5% of the patients had rotavirus immunization however, the positivity rate among those with rotavirus immunization was only slightly lower (40.0%) as compared to those having incomplete rotavirus immunization (40.4%) (p=0.947). Dehydration rate was significantly higher among cases with incomplete immunization (p <0.001).Conclusions: Severe malnutrition, mix/formula feed and improper hygiene makes the children prone for developing acute rotavirus diarrhea. Children with acute rotavirus diarrhea should be monitored for the development of severe dehydration, decreased urine output and electrolyte derangement especially hypokalemia.
Congenital femoral deficiency: a rare case report
Authors: Ukkali Sadashiva B , Mahvish Khodaija , Jeergal Nazeer
Published: April 2017

Proximal femoral focal deficiency (PFFD) is a rare congenital anomaly. We present a case of an isolated unilateral congenital femoral deficiency that was born locally. A full-term male baby was brought to us with a complaint of short left lower limb. Examination revealed short left lower limb with absence of thigh. Detailed history was obtained and he was examined clinically as well as radiologically. He was diagnosed as a case of PFFD of type C. Proper evaluation and its management accordingly can help the patient to lead a socially and economically productive life.
Control of epidemics in the Roman army: 27 B.C. - A.D. 476
Authors: Belfiglio Valentine J.
Published: April 2017

During the Roman Empire thousands of soldiers were exposed to communicable diseases. The Romans forged a military medical system that surpassed the medical systems of most of their enemies. Under the principles of immediacy and expectancy, the Roman medical staff salvaged and returned to duty many sick and wounded soldiers as rapidly as possible. The selection of and training of healthy legionnaires, hygiene and sanitation and immediate medical care emphasized that the timing of care after diagnosis is as important as the quality of care. The Romans were the first army in history to employ medical corpsmen, field hospitals and triage. The Roman efficacy in combat medicine may be one of the least appreciated aspects of the ability of the Roman army to help create and maintain an empire.
Analogous assay between green tea mouthwash, listerine mouthwash and chlorhexidine mouthwash in plaque reduction, on orthodontic patients: a randomized cross-over study
Authors: Raju Ramyathilagam , Divya Angeline , Rajendran Ganesh , John James Rufus
Published: April 2017

Background: The aim of the study was to compare the efficiency of green tea mouthwash, Listerine mouthwash and Chlorhexidine mouthwash in plaque reduction among orthodontic patients. Methods: The study employed a double blinded, simple randomized, cross over design with a control group consisting of 30 orthodontic patients undergoing fixed appliance therapy. All the subjects were divided into group 1 (Green tea), group 2 (Listerine) and group 3 (Chlorhexidine) as 10 subjects per group. Gingival status was assessed using Sulcus Bleeding Index and plaque accumulation was assessed using Turesky-Gilmore-Glickman modification of Quigley Hein Index. After a relapse period of 15 days, group 1 and 2 were crossed over, however, group 3 remained the same. Indices were again recorded at baseline and 15th day. Results: The mean gingival and plaque score was reduced in all the three groups. However, green tea mouthwash was estimated to have the highest mean difference from 2.17 ± 0.610 at baseline to 1.48 ± 0.474 on the 15th day. Conclusions: Effective use of mouthwashes as supplements for tooth brushing has proved to be beneficial in oral hygiene and maintenance. The findings of this study provide useful insights on the effectiveness of different compositions of mouthwashes.
An epidemiological study to find out the seroprevalence of Hepatitis B in a rural population of Kashmir valley
Authors: Fazili Anjum Bashir , Shah Rohul Jabeen , Shah Zaffar Amin , Iqbal Qazi Mohammad , Mushtaq Beenish , Ahmad Feroz , Parray Javed Ahmad
Published: April 2017

Background: Hepatitis B continues to pose a tremendous burden of disease with approximately 240 million people having chronic hepatitis B virus (HBV) infection globally. The prevalence of HBV infection varies widely, with rates ranging from 0.1% to 20% in different parts of the world.Methods: This Community based Cross sectional study was carried out for a period of one year (2015-2016) in bock Hajin of Kashmir to find out the seroprevalence of Hepatitis B and various risk factors associated with it.1861 subjects consented and participated in the study. A semi structured, pre tested, self-designed questionnaire was used to gather requisite information. Both screening as well as confirmatory tests were used to find out the seroprevalence of HBsAg in the study population.Results: Out of 1861 participants, 65.1% were females and 34.9% were males. All study participants were Muslims with 64.4% belonging to Sunni sec. 67.3% belonged to age group 10-40 years. Prevalence of hepatitis B infection in the study population was 0.9%. Gender, occupation, education and treatment by quacks were significantly associated with seropositivity. Only 76 (4.1%) of the participants had some knowledge about hepatitis B.Conclusions: The study reveals that the seroprevalence of hepatitis B is very low in the study population. It also reflects a low awareness level of population regarding hepatitis B infection thus demanding timely intervention in the form of awareness campaigns to keep transmission under check.
Evaluation of primary immunization coverage among children in a rural block of district Rohtak, Haryana, India
Authors: Goyal Sahil , Kumar Vijay , Garg Ritika
Published: April 2017

Background: Vaccination is the most important preventive and cost-effective intervention to decrease morbidity and mortality rates in children. Every year, vaccination averts an estimated 2-3 million deaths from diphtheria, tetanus, pertussis and measles. These are all life threatening diseases that disproportionately affect children. An estimated 1.5 million children die annually from diseases that can be prevented by immunization. In the past 50 years, vaccination has saved more lives worldwide than any other medical products or procedures. The objectives of the study were to evaluate primary immunization coverage along with 1st dose of Vitamin-A supplementation coverage, age-appropriate immunization and also to know the reasons for partial or non-immunization among children.Methods: Community-based cross sectional study was conducted among 540 children in the rural area of Rohtak, Haryana during June 2015-May 2016. Information was collected from the mothers regarding immunization status of their children aged 12-23 months old and socio-demographic variables using a semi-structured interview schedule.Results: 395 (73.15%) of 12-23 months old children were fully immunized and the rest 145 (26.85%) were partially immunized. The major reason for drop-out rate was found to be unawareness regarding need for immunization. Immunization coverage was found to be significantly associated with the presence of immunization card and literacy level of mothers.Conclusions: Though the immunization coverage showed improvement through intensive immunization campaigns in recent years, still a lot needs to be done to increase awareness regarding importance of full immunization at the right time as mentioned in the National Immunization schedule (NIS).
Quality of work life of nurses working at tertiary health care institution: a cross sectional study
Authors: Thakre Subhash B. , Thakre Sushama S. , Thakre Sneha Nilesh
Published: April 2017

Background: Quality Work Life is the quality of relationship between employees and the total working environment. Nurses are the largest group of employees in health care organization. QWL of nurses is influenced by many factors. Objectives of the study were to know the perceptions about QWL and the factors contributing in QWL of nurses working in Government Medical College and Hospital, Yavatmal. Methods: A present cross sectional study was carried out in 100 randomly selected nurses working at tertiary heath care institution. A composite scale was used for assessment of QWL in nurses. Descriptive statistics were calculated and independent sample t-test and one-way ANOVA was used to determine the relationship between quality of work life and other demographic variables. Results: Mean age ± SD of study participants was 39 ± 9 years. The majority (>70%) of nurse respondents indicated that they were satisfied with items in the dimension of work environment life. Quality of work life in terms of organizational culture; 78% have received cooperation from respective department. However, 61% were unsatisfied due to gender discrimination. Significant differences (P<0.05) were found according to education, marital status, work experience, night shifts, per capita per month income, and support from family members. Conclusions: This research provides an initial step in understanding the work life of nurses in a tertiary health care setting. The present study showed that nurses' quality of work life is at the moderate level. This study also reveals significant association with socio-demographic characteristics of nurses and QWL.
Prevalence and factors associated with breastfeeding in a population with good literacy
Authors: Rajasekar Geetha
Published: April 2017

Background: Recent studies in the scientific world show that countries with high income levels and high maternal education have poorer breast feeding rates. This study was done in a population with good literacy with an objective to assess the knowledge, beliefs, practices, prevalence of breast feeding and factors associated with it among women with children less than two years of age.Methods: This was a cross sectional study done among 183 women at a tertiary hospital of south India in a population with female literacy 77% and male literacy 90%. Knowledge, beliefs and practices were assessed by validated questionnaire. Data entry and analysis were done with Epidata 3.1 and SPSS18 software.Results: The prevalence of early initiation of breast milk was 56.3% (95% CI: 48.98 to 63.62), colostrum to newborn 84.2 % (95% CI: 78.82 to 89.58),exclusive breast feeding (EBF)10.6% (95% CI: 6.02 to 15.18), predominant breast feeding 80.6% (95% CI: 74.72 to 86.48) and delayed complimentary feeding was 8.8% (95% CI: 4.58 to 13.02).Only 51% (95% CI: 42.92 to 57.68) had health professional guidance and among them only 29.34% (95% CI: 19.84 to 38.83) had received it after delivery. Lower segment caesarean section (LSCS) had 3.9 times (95% CI: 1.95 to 8.05) risk of late initiation of breast milk. Breast feeding information from relatives had protective effect from late initiation of breast milk with odds ratio 0.33 (95% CI: 0.16 to 0.66). Women who had not received health professional guidance had 3.5 times (95%CI: 1.13 to 11.00) risk of not practicing exclusive breast feeding.Conclusions: The knowledge and beliefs about breast feeding were encouraging. Inspite of good literacy women need guidance from health personnel for EBF. Mothers who had delivered by LSCS have to be given help to initiate breast feeding earlier.
A study on treatment adherence among patients with type 2 diabetes mellitus attending diabetic clinic
Authors: Imran Mohammed , Plathottam Joslin Jose
Published: April 2017

Background: Diabetes is one among chronic diseases requiring long term medication and its prevalence is increasing globally. Adherence to prescribed treatment among diabetes patients is very important for good glycemic control. Poor glycemic control following poor adherence is associated with increasing risk of complications, disease progression, morbidity and mortality with increasing costs of care. Hence, the present study was undertaken to assess the adherence of diabetic patients with their prescribed medications.Methods: The study involved 200 diabetic patients on oral anti-diabetic medication visiting out-patient diabetic clinic in a teaching hospital, Bangalore, who met required criteria. Information was collected using predesigned questionnaires by personally interviewing selected patients.Results: A total of 122 patients (61 %) were non-adherent with medication; 36 (18%) and 42 (21%) of patients were moderately adherent and adherent to treatment respectively. Among non adherent patients, males were more (72%) compared to females (50%), which was statistically significant (P<0.05). Non adherence was more among employed (69%) patients compared to unemployed patients (54%), this was significant statistically (p >0.05). Non adherence level was very high among males with history of smoking (80%).Conclusions: It was observed that the proportion of diabetic patients who are non-adherent to their prescribed medications was high. It is recommended that patients should be counselled repeatedly by health care providers on the importance of complying with prescribed drug regimen for better compliance and treatment outcome.
Health-promoting lifestyle behaviours of nursing students of a tertiary care institute
Authors: Borle Pradip S. , Parande M. A. , Tapare V. S. , Kamble Vidya Sanjeev , Bulakh Pradymunaa C.
Published: April 2017

Background: In addition, Health promoting behaviours among the nursing students may affect the quality of patient education. Therefore, this study was undertaken to determine the health-promoting lifestyle behaviours of nursing students in a tertiary care institute, Maharashtra.Methods: This cross-sectional study was performed on 124 nursing students. Health Promotion Lifestyle Profile Proforma (HPLP)was prepared which consists of two parts, Part I deals with the sociodemographic characteristics of the participants  and Part II of the proforma deals with Health-promoting lifestyle information which was a modified version of Health Promoting Lifestyle Profile II (HPLP II). It consists of 46 items divided into 7 subscales (Health responsibility, Physical activity, Food practices, Spiritual growth, Self-concept, Inter personal relations and Stress management). Internal consistency (Cronbach’s alpha) of this tool was 0.8197. Permission of Institute Ethical Committee was taken. Descriptive statistics were used to describe HPLP. Data was analyzed by using analysis of variance (ANOVA) and Mann Whitney test. Results: Majority 89(71.77%) were have good HPLP score and 29(23.39%) were excellent category. The mean overall (Total) HPLP score was 62.27±9.66 (range 33-87). The highest mean score in the subscale were for self-concept and spiritual growth. The lowest scores were for food practices and physical activity. Highly significant difference (p<0.0001) was found between overall mean HPLP scores among the different age groups.Conclusions: These nursing students had reasonably good orientations towards health behaviours. Attention need to be paid for healthier food choices. Health promotion planning to motivate students for regular physical activity with the purpose of promoting health and preventing diseases is necessary.
Functional outcome of ligament reconstruction tendon interposition for basal joint arthritis of thumb
Authors: Jagdev Saranjeet Singh , Pathak Subodh Kumar , Dave Nisheet , Salunke Abhijeet
Published: April 2017

Background: Thumb carpometacarpal osteoarthritis is a common disease, affecting up to 11% and 53% of men and women in their 50s respectively, which leads to pain, stiffness, weakness of the CMC joint. Patients with advanced disease have multiple surgical options including ligament reconstruction with tendon interposition, resection arthroplasty, silicone implantation, or total joint arthroplasty. The aim of study was to evaluate results of LRTI for CMC joint arthritis.

Methods: This is a series of 29 patients operated in a tertiary care hospital. All patients included in the study were seen in the outpatient and identified to have basal joint arthritis according to their clinical presentation and classified on the basis of radiologic appearance. Trapeziectomy with ligament reconstruction with tendon interposition was done for patients with advanced disease. All the patients were followed up and assessed for function and disability using DASH score.

Results: Average duration of follow up was 36 months with average tip pinch strength gain was 75%, key pinch strength gain 80% , grip strength gain 80 % of other limb. Significant Improvement in active 1st web space angle was seen with average of 19.5 degree. Average DASH score was 4.14. Nobody had extreme pain, 3 had mild pain and 2 had moderate pain.

Conclusions: Based on our observation of DASH scores, the results have remained encouraging in most of the cases with restoration of normal anatomy to provide a stable and functional thumb. The success of LRTI in treating trapeziometacarpal arthritis has withstood the test of time.
Posteromedial fragment fixation through Lobenhoffer approach in tibial plateau fractures
Authors: Chandele Vijaysing S. , Bhalotia Abhishek P. , Ingle Milind V. , Koichade Maroti R.
Published: April 2017

Background: Management of tibial plateau fractures with coronal fractures especially posteromedial fragment is frequent and challenging. This study was conducted to evaluate the functional outcome of patients with tibial plateau fractures having posteromedial fragment treated with open reduction and internal fixation (ORIF) using Lobenhoffer approach.

Methods: Thirty two patients with tibial plateau fractures having posteromedial fracture alone or part of bicondylar fracture was operated with ORIF using Lobenhoffer approach. Time to union, maintenance of alignment, rate of complications and functional outcome was assessed using Oxford knee score.

Results: The mean time to healing was 16.4 weeks, without any complication in the form of non-union and infection. Malunion with secondary loss of alignment was seen in only one case due to fracture comminution and early weight bearing. Oxford knee score was good to excellent in all the cases.

Conclusions: With recent development in understanding these fractures, ORIF gives excellent to good outcome in all patients operated through Lobenhoffer approach. Long term disability can be prevented by maintenance of adequate alignment and reduction through direct visualization of fracture.
A study of management of trochanteric fracture of femur treated with dynamic sliding hip screw-plate device vs. proximal femoral nail
Authors: Banerjee Upal , Chattopadhyay Abhishek , Dey Nirmal Kumar , Sinha Prashant Kumar , Chattaraj Writtika , Sen Sukanta
Published: April 2017

Background: The incidence of intertrochanteric fractures has been increasing significantly due to the rising age of modern human populations. Generally, intramedullary fixation [proximal femoral nail (PFN) and gamma nail] and extra-medullary fixation [dynamic hip screw (DHS)] are the 2 primary options for treatment of such fractures.  Objectives: The goal of this study is to compare the clinical and radiographical results of DHS and PFN for the treatment of trochanteric hip fractures. 

Methods: Patients with trochanteric fractures were treated either with DHS or  PFN in the Department of Orthopaedics, M.G.M. Medical College and L.S.K Hospital, Kishanganj, Bihar from October 2010 to October 2012 were included for this study.

Results: Forty three patients (24 male and 19 female, ratio of M:F 1.26:1) surgically treated for trochanteric fractures were divided into two groups. Group 1: 25 hips treated with DHS and group 2: 18 hips treated with PFN. The outcome for each group was analyzed, and total operative time, time to union, complications (early and late), and mortality were recorded. The results were statistically compared. Out of 25 cases of DHS, majority cases (13) took between 1 hour 36 minutes to 2 hours. Whereas, out of 18 cases of PFN, majority (8) took 1 hour to 1 hour 30 minutes. The mean time to union for group 1 was 2.09 months and 1.69 months for group 2. Early and late complication rates between treatment groups revealed no statistically significant differences. Total duration of surgery was significantly lower for PFN than it was for DHS. A comparison of time to union and overall mortality demonstrated no statistically significant differences.

Conclusions: We detected no differences between the two treatment groups in regard to early versus late complications, time to union, and overall mortality; however, with its shorter operative period, PFN is a good alternative to the DHS.
Localised melorheostosis
Authors: Agarwal Sunny , Khanna Vishesh , Varghese Mathew , B Suresh
Published: April 2017

Melorheostosis is a sclerosing bone dysplasia of unknown aetiology. Diagnosis is mainly based on a combination of clinical and imaging studies. The classical dripping candle wax picture on plain radiograph is diagnostic. We report a case of localized melorheostosis of a 14 year old boy on daily analgesics for two years for pain relief. Radiographs showed endosteal bone formation like dripping candle wax. Biopsy and decompression of the hyperostosis was done. However biopsy did not relieve his symptoms. Based on literature survey he was given a single infusion of zoledronic acid. This gave dramatic relief in pain.
“De amor echele un oxo, fablel’e y allegueme.” Parodia de algunos tópicos medievales y renacentistas en 'Navegación en Yoremito' de Abigael Bohórquez
Authors: Bustamante Bermúdez Gerardo
Published: April 2017

En este artículo se analiza el diálogo intertextual que hace el poeta Abigael Bohórquez con la tradición medieval y renacentista, particularmente en lengua española, en su libro Navegación en Yoremito, texto ganador del Premio Clemencia Isaura, 1993. Bohórquez desolemniza la tradición, subvierte los tópicos medievales del amor cortés y los lleva al terreno de la disidencia y los placeres sexuales, a veces desde el ambiente pastoril, otras desde la alcoba de lo homoerótico como posibilidades de defensa de un amor que realiza desde los márgenes de la confesión y la libertad absoluta.
Worksheets that Teach: Algebra 2, Volume IV
Authors:   Quantum Scientific Publishing
Published: April 2017

Worksheets That Teach are completely different than normal classroom worksheets because they actually teach the content!

Each content-based worksheet begins by actually teaching all of the content in the stated learning objective(s) before moving into the set of exercises that are normally found in a classroom worksheet.

Worksheets That Teach are ideal for:
1. Classroom use to reinforce a topic
2. Student test preparation
3. Homeschooling
4. Individual tutoring sessions
5. Successful students that would like the additional challenge of exploring a new topic on their own
6. Substitute teachers that need to teach a class in an unfamiliar discipline

Worksheets That Teach Series Areas of Study:
Foreign Languages
General Studies
History
Language Arts
Mathematics
Science