bluuebunny/crossref_metadata_2025 huggingface dataset:
Antenatal Care And Severe Pre-Eclampsia In Kathmandu Valley
Authors: Manandhar Bekha Laxmi , Chongstuvivatwong V , Geater A
Published: January 2014

Severe preeclampsia/eclampsia is one of the common cause of maternal and perinatal morbidity and mortality. So the prevention of this severe preeclampsia may prevent these complications. This study was undertaken to assess the associa­tion between antenatal care and severe pre-eclampsia/eclampsia, also to examine the role of other risk factors for severe preeclampsia/eclampsia. A case study was conducted during May to Oct 1994 in Kathmandu valley. This study failed to demonstrate that ANC could reduce the risk of severe pre-eclampsia/eclampsia. The incidence rate of ANC visits in third trimester was significantly lower among cases than among controls. Risk independently increased in women with a history of previous PET (OR 6.9, 95% CI 1.0-48.9), history of abortion (OR 4.5, 95% CI 1.1-19.3), late menarche (OR 3.7, 95% CI 1.6-8.4) and primigravidity (OR 2.9, 95% CI 1.2-7.4). Use of modern contraceptive methods decreased the risk (OR 0.21, 95% CI 0.05-0.83). Risk was also higher among the middle-income group (OR 3.6, 95% CI 1.2-10.7), manual workers (OR 13.4, 95% CI 4.5-40.3) and non-Hindu women (OR 9.9, 95% CI 3.0-32.3). This study did not demonstrate that ANC could reduce the risk of severe pre-eclampsia/eclampsia. The history of previous PET, abortion, late menarche and primigravidity status each independently increased risk. Use of modern contraceptive methods decreased the risk. Risk was higher among the middle-income group manual workers and non-Hindu women. Journal of Chitwan Medical College 2013; 3(4); 43-47 DOI: http://dx.doi.org/10.3126/jcmc.v3i4.9554
A Descriptive Study On Morbidities Of Patients Attending Free Health Camp In Sankhejung Vdc Of Ilam District, Nepal
Authors: Rayamajhi Rajan Bikram , Yadav DK , Ghimire A , Khanal VK , Tamrakar D , Shrestha A , Shrestha G , Sharma M , Manandhar N , Bhattachan M , Gautam R , Pokharel PK
Published: January 2014

Free health camp is an important means to cater health services to the needy people in an underdeveloped country like Nepal with difficult geographical terrain. The objective of this study was to assess the morbidities of patients attending the free health camp in Sankhejung, Ilam. A total of 399 patients visited the health camp and 35.1% of them were males. It was observed that diseases with musculoskeletal system and gastrointestinal system were reported among 24.3% and 25.1% of the attendees respectively. Based on the findings, it was concluded that the free health camp services was utilized more by the females and more burden of disease was found among musculoskeletal and digestive system. Journal of Chitwan Medical College 2013; 3(4); 48-51 DOI: http://dx.doi.org/10.3126/jcmc.v3i4.9555
Erythromycin Induced Carbamazepine Toxicity- A Preventable Drug Interaction
Authors: Shrestha Devendra , Dhakal AK , Singh KK
Published: January 2014

A drug interaction between Erythromycin and Carbamazepine is well established and harmful effects of Carbamazepine toxicity can be avoided. We report a patient who developed features of Carbamazepine toxicity namely ataxia, vomiting and nystagmus within 24 hours of oral Erythromycin with high serum Carbamazepine level and improved after discontinuation of Erythromycin with returning of serum Carbamazepine level to therapeutic range. Awareness among health professionals, patient education, proper record keeping and strengthening pharmacy services are essential to prevent such drug interactions. Journal of Chitwan Medical College 2013; 3(4); 52-53 DOI: http://dx.doi.org/10.3126/jcmc.v3i4.9556
Addisonian Crisis Precipitated By Thyroxine Therapy In A Patient With Type 2 Autoimmune Polyglandular Syndrome
Authors: Pokharel Sunil , Shrestha A , Maksey D , Shrestha B , Paudel P , Shrestha B , Dhital BM
Published: January 2014

Primary hypoadrenalism(Addison’s disease) refers to glucocorticoid deficiency occurring in the setting of adre­nal disease(mostly due to autoimmune adrenalitis), whereas secondary hypoadrenalism arises because of deficiency of ACTH(mostly due to pituitary disease) . A major distinction between these two is that mineralocorticoid deficiency invari­ably accompanies primary hypoadrenalism, but this does not occur in secondary hypoadrenalism because only ACTH is de­ficient; the renin-angiotensin-aldosterone axis is intact and in primary hypoadrenalism skin pigmentation is always present due to increased ACTH secretion(unless of short duration) but it is absent in secondary hypoadrenalism. Addison’s disease or primary adrenocortical failure was first described by English physician Thomas Addison, who found it in six patients with adrenal tuberculosis in 1855(1). Addisonian crisis is a potentially fatal condition associated mainly with an acute defi­ciency of the glucocorticoid cortisol and, to a lesser extent, the mineralocorticoid aldosterone. This is a rare condition with an estimated incidence in the developed world of 0.8 cases per 100,000 and prevalence of 4 to 11 cases/100,000 population. Despite optimised life-saving glucocorticoid replacement and mineralocorticoid-replacement therapy, it is life threatening if overlooked(2-3). Hypothyroidism may mask the addison’s disease so in patients with panhypopituitarism and autoim­mune polyglandular syndrome type 2 thyroxine replacement without adequate steroid replacement may precipitate acute addisonian crisis. Journal of Chitwan Medical College 2013; 3(4); 54-56 DOI: http://dx.doi.org/10.3126/jcmc.v3i4.9557
Editorial Vol.1(4)
Authors: Pahwa VK , Chaudhary Shatdal
Published: January 2014

DOI: http://dx.doi.org/10.3126/jucms.v1i4.9562 Journal of Universal College of Medical Sciences (2013) Vol.1 No.04
Non-psychiatry consultant's attitude towards psychiatry: a study from Universal College of Medical Sciences, Nepal
Authors: Subedi S , Aich TK , Shah S , Thapa DK
Published: January 2014

INTRODUCTION: Mental Health has been hidden behind the curtain of stigma and discrimination for a long time. Not only the mentally ill, even the mental health professionals are stigmatized. The medical professional's attitude to psychiatry appear to be negative, although the data are dated. Attitude of non-psychiatry consultants towards psychiatry may affect their ability to promote psychiatry as a discipline. The main aim of this study is to study the non-psychiatry consultants' attitude towards psychiatry. METHODS: It is a hospital based cross-sectional descriptive study of 30 non-psychiatry consultants working in Universal College of Medical Sciences Teaching Hospital, Bhairahawa, Nepal. ATP-30 self report questionnaire was used to collect the data. RESULTS: Majority of the subjects were male. About 69% of the consultants didn't have any exposure in the psychiatry. However, majority of the consultants had positive attitude towards psychiatry. The mean score for ATP-30 was 110.03. CONCLUSION: Majority of the consultants had positive attitude towards psychiatry. However some erroneous beliefs are still prevalent among the consultants. The attitude of non-psychiatry consultants directly/indirectly affects the development of psychiatry as a discipline. Further studies of such kind can help to determine whether changes in attitudes towards psychiatry are needed among the non-psychiatry consultants. DOI: http://dx.doi.org/10.3126/jucms.v1i4.9563 Journal of Universal College of Medical Sciences (2013) Vol.1 No.04: 2-6
Maternal and perinatal outcome in patients with severe pre eclampsia/ eclampsia with and without HELLP syndrome
Authors: Gupta T , Gupta N , Jain J , Gupta S , Bhatia P , Bagla J
Published: January 2014

OBJECTIVE: To evaluate the occurrence of HELLP syndrome inpatients with severe pre eclampsia & eclampsia and to compare the maternal & perinatal outcome in patients with and without HELLP syndrome (partial and true). METHOD: This was a prospective longitudinal study conducted in the Department of Obstetrics & Gynaecology, E.S.I. PGIMSR,NewDelhi from August 2011-April 2013. 50 pregnant women with singleton pregnancy with severe pre eclampsia detected at 28 or more weeks of gestation were enrolled. Patients were divided into three groups: group 1 with severe pre eclampsia, group 2 with severe pre eclampsia with partial HELLP syndrome and group 3 with severe pre eclampsia with true HELLP syndrome. Patients in three groups were compared in regard to maternal complications, gestational age atdelivery, mode ofdelivery, hospital stay andperinatal outcome. RESULTS: Prevalence of HELLP syndrome in severe pre eclampsia was 40% (partial HELLP= 28% and true= 12%). Antenatal and maternal complications were more in true HELLP syndrome patients as compared to other groups. PPH was observed in 40% of entire study group. DIC was found more in true HELLP syndrome patient with high statistically significant p value<0.001 Blood and its product transfusion was more in true HELLP syndrome. There was 100% ICU admission in group 3. In severe pre eclampsia, 11 neonates had birth weight >2.5kg. Where as in partial and true HELLP syndrome, no neonate had birth weight more than 2.5kg.This difference was statistically significant. There was 100% NICU admission in HELLP syndrome, 91.66% in partial HELLP syndrome and 42.3% in severe preeclampsia. The perinatal morbidity and mortality was higher in HELLP syndrome patients than in patient with severe pre eclampsia without HELLP syndrome. CONCLUSION: The study concludes that both maternal and perinatal outcome were adverse in HELLP syndrome than in severe pre eclampsia without HELLP syndrome. DOI: http://dx.doi.org/10.3126/jucms.v1i4.9564 Journal of Universal College of Medical Sciences (2013) Vol.1 No.04: 7-12
Clinical correlation between Anti-CCP antibody, rheumatoid factor and clinical parameters of patients with rheumatoid arthritis
Authors: Vaidya B , Nakarmi S , Rajbhandari N , Bataju P
Published: January 2014

BACKGROUND: The main clinically useful serological markers in patients with Rheumatoid Arthritis are Rheumatoid Factor and Anti-citrullinated Protein Antibodies (ACPA) for both diagnosis and prediction of functional and radiographic outcomes. We do not have data from Nepalese patients about gender differences and association of these antibodies with disease nature. OBJECTIVE: To identify the difference in nature of disease in relation to ACPA and gender. METHODS: A cross sectional open labeled study including consecutive patients who were diagnosed as RA according to ACR/EULAR 2010 attending the rheumatology OPD from October 2010 to October 2012 at Alka Hospital, Nepal. Data collection was done by direct patient interview and all data were recorded electronically in a predesigned performa. ACPA and RF were tested in the serum samples of 184 patients. RESULTS: Out of 184 patients, 114 of them were ACPA positive and 54 were Rheumatoid factor positive. The median duration of symptoms was 30.3±7.0 months lesser in ACPA positive patients as compared to negative ones. Mean age of females was 10.7 years less than male patients. No other significant differences were noted between male and female patients. Also, 52.3%ofRF negative patients were found to have ACPA positivity. CONCLUSION: Anti cyclic citrullinated peptide antibodies are excellent serological markers of rheumatoid arthritis, which shows good diagnostic value. This can increase the diagnostic value in addition to rheumatoid factor and its use in clinical practice may contribute to increased ability of rheumatologists to make judicious treatment decisions. DOI: http://dx.doi.org/10.3126/jucms.v1i4.9566 Journal of Universal College of Medical Sciences (2013) Vol.1 No.04: 13-16
Non invasive trans-cutaneous bilirubin as a screening test to identify the need for serum bilirubin assessment in healthy term neonates
Authors: Gupta BK , Chaudhary N , Bhatia BD , Gupta Binod
Published: January 2014

INTRODUCTION: Hyperbilirubinemia is a common problem in the neonates. It can progress to develop kernicterus unless intervention is initiated. Severity of jaundice and decision for management are usually based on total serum bilirubin (TsB) estimation which technique and results closely correlates with total serum bilirubin levels. OBJECTIVES: To compare the accuracy of visual assessment of jaundice by single trained observer based on Kramer's index with total serum bilirubin levels in healthy term neonates. To compare accuracy of non invasive bilirubin assessment with serum bilirubin levels, to compare trans-cutaneous bilirubin assessment on different sites (forehead and sternum) and to develop a cutoff point oftrans-cutaneous bilirubin level for serum bilirubin assessment. METHODS: This prospective study was conducted in the Neonatal unit of the department of Paediatrics at Kasturba Hospital ,Manipal. Study period was from October 2007 to June 2008. Clinical assessment of jaundice was done in healthy term neonates by observer (Trained Paediatric Post Graduate Resident) based on Kramer's index. Transcutaneous bilirubin assessment was done on the forhead and sternum of each baby using JM-103 Minolta. Air shields bilirubino meter. Serum bilirubin level was measured within 30 minutes of the clinical assessment for each baby. RESULTS: This study included 187 healthy term neonates. The mean birth weight was 2856.83gm ± 493.89gm and mean gestation was 38.25+ 1.030 SD. Clinical assessment and Transcutaneous bilirubin(TcB) significantly correlated with total serum bilirubin (TsB), with correlation co-efficient of 0.757 and 0.801 respectively (p 0.0001). Transcutaneous bilirubin assessment over forehead showed a tendency to under estimate total serum bilirubin, with mean difference of-0.31 mg/dl, SD 1.75 mg/dl with 95% confidence interval ofthe mean -0.60 and -0.02 mg/dl (p value 0.05).Transcutaneous bilirubin assessments between 10 mg/dl to 15 mg/dl correlated accurately with total serum bilirubin levels avoiding blood sampling. CONCLUSION: Trained observer clinical assessment of jaundice can be used for screening neonatal jaundice. Non invasive transcutaneous bilirubin assessment has demonstrated significant accuracy with serum bilirubin level estimates between 48 hours to 7 days on two different sites forehead and sternum. DOI: http://dx.doi.org/10.3126/jucms.v1i4.9567 Journal of Universal College of Medical Sciences (2013) Vol.1 No.04: 17-21
PG E2 gel supplemented with oral PG E2 for induction of labour in high risk pregnancy
Authors: Doshi NR , Sah D , Das CR
Published: January 2014

INTRODUCTION: The risks to the fetus-infant increase substantively in high risk pregnancies. The efforts are always to ensure a vaginal rather than a caesarian delivery. The present study aims to assess the safety and efficacy of Prostaglandin E2( PGE2) intracervical gel and oral PGE2 in inducing and augmenting labour in such patients. METHODS: PGE2 intracervical gel was used for induction oflabour in 100 high risk pregnancies. PGE2 gel was supplemented by oral PGE2 afterARM. RESULTS: PGE2 successfully induced labour in 60% of women while it improved the Bishop's score in the rest of the cases. L.S.C.S. was needed in only 7% of women. CONCLUSION: Intracervical PGE2 gel application is a safe and efficacious method of inducing labour, which can be augmented with oral PGE2 when needed. DOI: http://dx.doi.org/10.3126/jucms.v1i4.9568 Journal of Universal College of Medical Sciences (2013) Vol.1 No.04: 22-25
In vitro antifungal susceptibility of griseofulvin, fluconazole, itraconazole and terbinafine against clinical isolates of Trichophyton rubrum and Trichophyton mentagrophytes
Authors: Reddy KR , Reddy SR
Published: January 2014

Investigations on antifungal drug susceptibility were carried out on 90 clinical isolates of Trichophyton rubrum, and Trichophyton mentagrophytes with four antifungal drugs, namely griseofulvin, fluconazole, itraconazole and terbinafine as suggested by National Committee for Clinical Laboratory Standards (NCCLS) M27A (1997) document by broth macrodilution method to standardize in vitro antifungal susceptibility testing and to find out the Minimum Inhibitory Concentration (MIC) of the drugs. In this study, terbinafine was found to be the most efficient drug for all isolates. Terbinafine had the lowest MIC range of 0.001 g/mlto 0.09 g/ml and MIC50 was low at 0.005 g/ml and MIC90 was also low at 0.04 g/ml against T. rubrum; and MIC range of 0.001pg/ml to 0.19pg/ml with a MIC50 of 0.01pg/ml and MIC90 at 0.09 pg/ml against T. mentagrophytes. Itraconazole showed antifungal activity superior to that of fluconazole, with a MIC range of 0.04g/ml to l.56g/ml, with MIC50 at 0.19pg/m land MIC90 at l.56g/ml against T. rubrum; and MIC range of 0.04.g/ml to 1.56pg/ml, with MIC50 at 0.19pg/ml and MIC90 at 0.78pg/ml against T. mentagrophytes. Griseofulvin appears to be still a potent drug for management of dermatophytoses. Griseofulvin had a MIC range of 0.15g/ml to 5.07 g/ml with MIC50 at l.26 g/ml and MIC90 at 2.53 g/ml against T. rubrum; and MIC range of 0.31pg/ml to 5.07pg/ml with MIC50 at 1.26pg/ml and MIC90 at 2.53pg/ml against T. mentagrophytes. Fluconazole showed a high MIC range of 0.19 g/ml to 50 g/ml and MIC50 was high at 1.56g/ml and MIC90 was also high at 12.5 g/ml against T. rubrum; and a high MIC range of 0.09pg/ml to 25.0pg/ml, with MIC50 at 1.56pg/ml and MIC90 at 12.5pg/ml towards T. mentagrophytes. The technique was found to be easy to perform and reliable with consistent results.DOI: http://dx.doi.org/10.3126/jucms.v1i4.9569 Journal of Universal College of Medical Sciences (2013) Vol.1 No.04: 26-28
Prevalence of low backache in practicing dentists of Eastern region of Nepal
Authors: Shubham S , Yadav RP
Published: January 2014

AIM: To analyze the prevalence of low backache among practicing dentists of Eastern Region of Nepal. METHODS: A descriptive cross-sectional, questionnaire based study was conducted among the practicing dentists of Eastern region of Nepal from April 2012 July 2012. A pre-tested, pre-calibrated self-administered verbal rating questionnaire "The Oswestry Low Back Pain Disability Questionnaire" was distributed to a random sample of 85 dentists from different parts of eastern region of Nepal through direct contact and e-mails. RESULTS: A total of 85 dentists were identified among which 76 dentists participated in the research. Research finding showed that the prevalence of back pain among practicing dentists in Eastern region of Nepal was 90.79% among which 50% (minimal), 36.84% (moderate) and3.95% (severe). Among 45 males 4.44% had no back pain, 53.33% had minimal, 37.77% had moderate and 4.44% had severe back pain. On contrary females (31 participants) showed lesser prevalence of low back pain with 16.12% no back pain, 45.16% minimal, 35.48% moderate and3.22% severe back pain. The participants were divided into 3 different age group intervals in which dentists between 25-30 years were 50 in which 8% had no back pain, 58% had minimal, 28% moderate and 6% had severe back pain. Between 31-35 years were 22 participants in which 50% had minimal, 50% moderate and 0% had severe low back pain. More than 35 years were 4 participants in which 75% had no back pain, 25 % had moderate. Similarly the participants were divided into 5 different groups according the years of clinical practice in dentists having 1- 2 years of clinical practice (37 participants) had 2.70% no back pain, 56.75% minimal, 35.13% moderate and 5.40% severe back pain. 16 participants had 3-4 years of clinical practice out of which 12.50% had no low back pain, 62.50% had minimal, 18.75% had moderate and 6.25% had severe back pain. 10 participants had 5-6 years of clinical practice out of which 10% had no low back pain, 50% had minimal and 40% had moderate. 9 participants had 7-8 years of clinical practice out of which 11.11% had no low back pain, 33.33% had minimal and 55.55% had moderate. 5 participants had >9 years of clinical practice out of which 75% had no low back pain, 25% had minimal and 25% had moderate. CONCLUSION: The prevalence of back pain among dental personnel in Eastern region of Nepal was relatively high. The significant risk factors associated with it might be poor posture. Innovations for preventive and, ergonomic strategies should be undertaken to reduce the low back pain. DOI: http://dx.doi.org/10.3126/jucms.v1i4.9570 Journal of Universal College of Medical Sciences (2013) Vol.1 No.04: 29-32
Prevalence of hepatitis B and C virus seropositivity among tribal and non-tribal voluntary blood donors of Rangamati, Bangladesh
Authors: Dewan G
Published: January 2014

INTRODUCTION: Prevalence of hepatitis B and C virus seropositivity is not defined among blood donors of Rangamati district of Bangladesh. This region is mainly inhabited by tribal population of multiethnic stocks. Government policy formulation for tribal health is lacking data on this issue among tribal population of Bangladesh. MATERIALS AND METHODS: A retrospective study on eight years data from 2005 to 2013 carried out to define hepatitis B and C virus related seropositivity among tribal and non-tribal voluntary blood donors in Rangamati General Hospital. RESULTS: A total of 4974 unit of blood were screened during this period. Of them 2760 unit were from tribal and 2214 unit from non-tribal donors. Result shows there is higher prevalence of hepatitis B seropositivity among tribal donors («=100) compared to non-tribal (n =26). The prevalence rate for hepatitis B virus was 3.62% for tribal population and 1.17% for non-tribal population. This difference was statistically significant (p< 0.0001). Hepatitis C seropositivity was low in both groups. CONCLUSION: In Rangamati tribal population bear significantly higher burden of hepatitis B infection than non-tribal population. DOI: http://dx.doi.org/10.3126/jucms.v1i4.9571 Journal of Universal College of Medical Sciences (2013) Vol.1 No.04: 33-36
Congenital anatomical malformation at birth in Western Regional Hospital, Pokhara, Nepal
Authors: Sharma I , Rijal BT , Thapa SB , Poudel I
Published: January 2014

BACKGROUND: Congenital anomalies are any abnormality present at birth, either structural or functional, which may have been inherited genetically, acquired during gestation, or inflicted during parturition. There has not been much studies related to the congenital anomalies in Nepal. METHODOLOGY: One year hospital based review study was conducted to find out the incidence, magnitude of congenital malformation and to know the specific involvement of anatomical structures among babies born at Western Regional Hospital, Pokhara, Nepal. RESULTS: Of 10013 deliveries during the period of 1 year, total number of live birth was 98.82% (9895). Out of 9895 of total live births with any form of conginital anomolies was found amongst 0.42% (42) children, congenital anomalies were ranging from minor to major, single to multiple systems. Musculoskeletal anomalies accounted for the maximum of 57.1% followed by genitourinary anomaly 14.3%. Nervous system anomaly was seen in 11.9% and few cases of gastrointestinal system anomaly and anomalies of the sense organs. CONCLUSION: Incidence of congenital anatomical malformations at birth at Western Regional Hospital, Pokhara was found to be 0.42%. DOI: http://dx.doi.org/10.3126/jucms.v1i4.9572 Journal of Universal College of Medical Sciences (2013) Vol.1 No.04: 37-40
Clinical profile of toxic keratoconjunctivitis after ocular trauma with insect
Authors: Patel S , Dhakhwa K , Rai SKC , Bhattarai B , Pandey A , Badhu BP
Published: January 2014

INTRODUCTION: Toxic keratoconjunctivitis is a frequently encountered problem in the subspecialty of cornea. Toxic keratoconjunctivitis can occur as a complication of exposure to various substances. Toxic keratoconjunctivitis due to exposure to many chemicals and medications have been well described in the literature. The present study was carried out to explore the clinical profile of toxic keratoconjunctivitis caused by insect an unknown cause in a tertiary care center in Lumbini zone of western region of Nepal. METHODS: It was a prospective observational study conducted in cornea clinic of Lumbini Eye Institute, Bhairahawa, Nepal from 1 October 2012 to 30 September 2013. Institutional approval and informed consent was taken. All the patients presented with toxic keratoconjunctivitis caused by insect or unknown causes were included in the study. Patients with other known causes of toxic keratoconjunctivitis like drugs, chemicals were excluded from the study. Detail clinical history, general physical examination and meticulous ophthalmological examination were carried out in all the subjects as per predesigned pro-forma. Patients were followed up after 3 days, 1 week and 2 weeks after initial presentation. RESULTS: Total 39 patients with toxic keratoconjunctivitis presented in cornea clinic of Lumbini Eye Institute during the study period were enrolled and analyzed. The mean age of the patients was 38.20±15.44 year ranging from 16-75 years. Male were affected more than female. In our study 33 (84.62%) patients were male and only 6 (15.38%) patients were female. Most of patients presented during the month of April and May. Twenty one (53.85%) of our patients noticed some small insects lodged in the eye. Eighteen (56.15%) patients had history of exposure of foreign body but could not identify it as insect. Most of patients noticed exposure of insect or an unknown object in Night (36, 92.31%) and only 3 (7.69%) patients during day time. Mean duration of illness was 2.13±1.19 days ranging from 1 to 5 days. Right eye and left eye were involved equally. Complete healing of lesions occurred in all the patients CONCLUSION: Toxic keratoconjunctivitis caused by insect or unknown foreign body is a frequently encountered problem seen in summer months in a tertiary care center in Lumbini zone of western region of Nepal. With treatment all the patient had good out come in form of complete healing of ocular lesions. DOI: http://dx.doi.org/10.3126/jucms.v1i4.9573 Journal of Universal College of Medical Sciences (2013) Vol.1 No.04: 41-44
Isolated cysticercosis of anterior abdominal wall mimicking clinically as acute appendicitis: an unusual presentation
Authors: Gupta MK , Ahmad K , Ansari S , Rauniyar RK , Chaudhary S
Published: January 2014

Cysticercosis, a parasitic disease caused by Taenia solium larva, is a major public health problem in developing countries. The encysted larval stage can affect any part of the body, but are most frequently detected in brain, eye, skeletal muscle and subcutaneous tissues. Isolated cysticercosis of the abdominal wall can rarely mimic acute abdomen due to its nonspecific clinical presentation. We report a case of isolated cysticercosis of the right lower abdominal wall in a 25-year-old female who presented with acute abdominal pain mimicking clinically as acute appendicitis. High resolution ultrasonography showed typical features of cysticercosis in the abdominal wall and the patient had excellent clinical response to albendazole. DOI: http://dx.doi.org/10.3126/jucms.v1i4.9574 Journal of Universal College of Medical Sciences (2013) Vol.1 No.04: 45-47
A case report of a self-reproduced case of Paederus dermatitis
Authors: Panta YR , Poudyal Y
Published: January 2014

Many cases of irritant contact dermatitis are noted every year in the students residing at the Universal College of Medical Science (UCMS) Hostel, Bhairahawa. The exact etiology of the disease was not confirmed but the suspect was an insect Paederus', commonly referred to as 'acid fly' in UCMS. However, none of the patients ever gives the clear cut history about the time of contact with the insect after noticing the lesion. So, an experiment was performed by crushing the suspected insect on the skin of the flexor aspect of the forearm and the reactions produced on the skin and the symptoms were noted every 12 hourly till the primary lesion was formed. Erythematous papules were formed initially that passed through different stages to form an erythematous plaque with many vesicles that suppurated to form sterile pustules. This resembled the common lesions observed in the students. It was confirmed that the irritant contact dermatitis observed in the students residing at the UCMS hostel is Paederus dermatitis. The clinical course of this dermatitis was also revealed experimentally. DOI: http://dx.doi.org/10.3126/jucms.v1i4.9575 Journal of Universal College of Medical Sciences (2013) Vol.1 No.04: 48-52
HIV encephalopathy in a child: a rare presentation
Authors: Prasad R , Madeshwaran M , Mishra OP
Published: January 2014

Human Immunodeficiency virus encephalopathy is a rare presenting feature in children. We had a 7 year female child of HIV positive parent, who presented with fever, progressive decline in neurological function and altered sensorium for 15 days. On examination, she was febrile, unconscious (GCS 4/15) with decerebrate posturing, symmetrical exaggerated deep tendonreflexes,and bilateral extensor plantar. Her ELISAfor HIV was positive and CD4+ count was 89 cells/pl. CSF cytochemical analyses was normalwith negativelndia ink study for cryptococcus. Cranial CT showed brain atrophy in serial scans. A diagnosis of progressive HIV encephalopathy was made and antibacterials, antifungals and HAART regimen was started but child succumbed to illness. Progressive encephalopathy in childhood may be due to HIV infection. DOI: http://dx.doi.org/10.3126/jucms.v1i4.9576 Journal of Universal College of Medical Sciences (2013) Vol.1 No.04: 53-55
Psychiatric disorders among medical students: how aware are we?
Authors: Ranjan S , Shah S , Aryal S , Aich TK
Published: January 2014

Studying medicine is a physically and emotionally demanding course. Several studies have documented that medical students are at high risk for developing psychiatric disorders. Also the risk increases because these students who are the future health care providers may misunderstand and stigmatize psychiatric disorders. This can be potentially tragic. This article reviews the data on prevalence of psychiatric disorders among medical students. PubMed and Medline were searched to identify latest peer-reviewed English-language studies reporting on depression, anxiety, suicide and other psychiatric disorders among medical students from different parts of the world. Searches were done using the key words medical students, psychiatric disorders, depression, burnout and suicide. References of the retrieved articles were inspected to identify relevant additional articles. The studies suggest a high prevalence of burnout, depression, suicide and other psychiatric disorders among medical students, higher than in the general population. Medical students are reluctant to seek psychiatric treatment more than the general population. The environment where they study may make them behave in the unprofessional way rather than the mental illness itself. Medical school is a time of significant psychological distress. Large, prospective, multicenter studies are needed to identify personal and training-related features that influence depression, anxiety, and burnout among students and explore relationships between distress and competency. DOI: http://dx.doi.org/10.3126/jucms.v1i4.9578 Journal of Universal College of Medical Sciences (2013) Vol.1 No.04: 56-60
Systemic fungal infections emerging infection in newborn
Authors: Thakre R
Published: January 2014

DOI: http://dx.doi.org/10.3126/jucms.v1i4.9579 Journal of Universal College of Medical Sciences (2013) Vol.1 No.04: 61-65
Human specimen plastination by using synthetic plastic polymer
Authors: Chaudhary J , Supriya K , Singh S , Shah SK
Published: January 2014

Plastination is a preservation technique which keeps human specimen in natural, dry, hard and odour less state. This is introduced by Dr. Gunther Van Hagen. Recently, anatomists are doing research in plastination to give durable and better human specimen for demonstration tool, museum specimen without formalin irritation. In the department of anatomy, plastic polymer and chloroform is used in plastination. The formalin fixed specimens are dehydrated in acetone. Then transferred to polythene polymer mixer for impregnation and harden in natural drying process. At the end dry, hard and odour less specimens are obtained. In our experience plastination shows the plastinates are natural, dry, hard and odour less state can be an excellent medical educational tool. DOI: http://dx.doi.org/10.3126/jucms.v1i4.9580 Journal of Universal College of Medical Sciences (2013) Vol.1 No.04: 66-68
Consent
Authors: Srivastava CP
Published: January 2014

DOI: http://dx.doi.org/10.3126/jucms.v1i4.9581 Journal of Universal College of Medical Sciences (2013) Vol.1 No.04: 69-70
Competitiveness in the export demand for Nigerian rubber
Authors: Nwachukwu IN , Onyenweaku CE , Nwaru JC , Mbanasor JA , Daramola A
Published: January 2014

The study examined the degree of competitiveness in the export demand for Nigerian rubber with focus on the Spanish Market. The study covered the periods of 1961 – 2010 and data comprised national aggregates. Two Stage Least Squares (2SLS) approach was used in the estimation after instrumenting for simultaneity and establishing stationarity cum cointegration relationship. The outcome of the analysis showed that the demand for Nigerian rubber by Spain was affected negatively by export price of the commodity and income of the importing country. The coefficients of export price of the substitute crop and world production excluding participating countries traced out a positive relationship. The result further showed that there is relative competitiveness in the Spanish market on the strength of the Lerner index of 0.015. The study recommends the allocation of more resources to the export crop through deliberate budgetary allocation to the producing states and exchange rate stabilization policies are strongly advocated among others. DOI: http://dx.doi.org/10.4038/jas.v9i1.6348 The Journal of Agricultural Sciences, 2014, vol.9, no1: p.1-11
Firms’ realization on the intended benefits of adoption of food quality metasystems: case of adoption of HACCP in the agri-food processing sector in Sri Lanka
Authors: Jayasinghe-Mudalige UK , Ikram SMM , Udugama JMM , Edirisinghe JC , Herath HMTK
Published: January 2014

This study investigates extent to which the HACCP certified agri-food processing firms in Sri Lanka have “realized” (i.e. post-adoption experience) those “intended” (i.e. pre-adoption expectations) benefits upon having a food safety and quality metasystem in place. First, a series of in-depth interviews were undertaken with Quality Assurance/General Managers (n=15) of HACCP certified firms, University Academics specialized on this discipline (n=12) and Quality Management System Auditors/Executives (n=5) from the SLSI. The interviews were voice-recorded, transcribed, and analyzed though N-Vivo (version 7.0) qualitative data analysis software, which led to the categorization of firm’s level of expectation (E) and subsequent realization (R) with regard to 14 different incentives that can be attributed to four major types of economic incentives that motivate a firm to act on food quality management, including: (1) External market-based, (2) Internal market-based; (3) Increased efficiency, and (4) Regulatory. Next, these 14 incentives were incorporated into a structured questionnaire in the form of attitudinal statements on which the respondents (n=57) were asked to score on a two-way, four-point likert-scale to elicit their expectations and realizations. The Expectation – Realization diagram generated could differentiate those incentives on three criteria, i.e. R>E, R=E and R<E. The results show that the most realized incentives (i.e. R≥E) include external market-based incentives such as reduced customer complaints followed by improved internal efficiency. Further, it highlights that dairy, meat and fish processing firms realized more of those benefits than fruit/vegetable firms. The outcome of analysis provides insights for policy makers to recognize the importance of market-based incentives and the close interplay and interactions of which with regulatory incentives so as to develop a properly functioning incentive-based institutional set up for food safety. DOI: http://dx.doi.org/10.4038/jas.v9i1.6349 The Journal of Agricultural Sciences, 2014, vol.9, no1: 12-23
Study on preparation of rice-wheat bread using premix
Authors: Mahalingam P , Veluppillai S , Ekanayake S
Published: January 2014

In this study the formulation of rice-wheat bread premixes stored for 3, 4, 6 and 8 weeks were investigated aiming to find out the feasibility of preparing rice-wheat bread using premix (rice flour, wheat flour, yeast and bread improver). The breads produced with premixes (rice-wheat premix bread; RWPB) were compared with wheat bread (WB) and rice-wheat bread (RWB) taking into account physical, nutritional and sensorial parameters. Breads were prepared using a basic formula by straight dough method. Based on the determination of gluten percentage of different combinations of rice-wheat flour mixes, flour mix with 20% rice and 80% wheat was selected to prepare premixes. There were no significant differences (p>0-05) between the physical, nutritional and sensorial qualities of RWB and RWPB while the qualities of RWB and RWPB differed significantly (p<0.05) from the qualities of WB. Moisture content of RWB and RWPM was significantly higher (p<0.05) than that of WB. The total sugar contents of RWB and RWPM were significantly higher (p<0.05) than that of WB while total protein content of RWB and RWPM was significantly lower (p<0.05) than that of WB. Fat content of WB was significantly lower than that of RWB and RWPM. There were no significant differences (p>0.05) in ash and crude fiber content of all types of breads. The specific gravity of WB was higher than that of RWB and RWPM and there were no significant differences in the sensory qualities except crumb colour and crust colour. Even though RWB and RWPM differed in some qualities with WB, they did not differ in qualities among them. Therefore from this study it can be concluded that rice – wheat breads can be prepared using premixes stored up to 8 weeks with the qualities consistent with that of bread prepared using fresh rice-wheat flour mix. DOI: http://dx.doi.org/10.4038/jas.v9i1.6351 The Journal of Agricultural Sciences, 2014, vol.9, no1: 31-36
Genetic variability and path coefficient in maize (Zea mays L.) genotypes
Authors: Mustafa Hafiz Saad Bin , Aslam Muhammad , Hasan Ejaz-ul , Hussain Fida , Farooq Jehanzeb
Published: January 2014

Present investigations were aimed at estimating the genetic parameters and character’s association in forty maize genotypes. The PCV was higher in magnitude than GCV for almost all the traits except for root density which showed greater value of GCV than PCV. Heritability estimates were also higher in all the traits and highest hretability was shown for chlorophyll content. Path coefficient analysis revealed that the fresh shoot length had maximum direct effect on fresh root length followed by root density, dry shoot weight, leaf temperature and dry root weight. It may be concluded that fresh root length, dry shoot weight, root density, leaf temperature and dry root weight are the characters which contribute largely to the fresh shoot length of maize seedlings. These traits had reasonable heritability estimates, thus selection could be made for high yielding maize genotypes on the basis of these traits. DOI: http://dx.doi.org/10.4038/jas.v9i1.6352 The Journal of Agricultural Sciences, 2014, vol.9, no1: 37-43
Economic value of irrigation water: a case of major irrigation scheme in Sri Lanka
Authors: Aruna Shantha A , Asan Ali BGH
Published: January 2014

It is generally agreed that inefficient use of irrigation-water and poor performance of irrigation systems are critical issues; especially in the light of the apparent lack of water resources. This study attempts to determine the economic value of irrigation-water in a government properly managed irrigation project (GPMIP) by eliciting farmer’s willingness to pay (WTP) using contingent valuation method followed by single bounded dichotomous choices. A stepwise backward binary multivariate logistic regression model was used to measure WTP and to determine the factors that influence the variation in WTP. Primary data were obtained from 367 farmer households in Nagadeepa irrigation schemes in dry zone. The estimated value of irrigation water was Rs. 5,275 ($40) per hectare per season which is 8.6 percent of net income in paddy farming per hectare at present in selected irrigation scheme. Further, if farmers can increase further their household farming income by 5.9%, it is possible to cover additional cost which would be driven due to pricing irrigation water and it is not an unreachable challenge with proper irrigation services. One of the most important policy implications of this study is the possibility of restructuring the existing irrigation pricing system by taking into account the economic value of irrigation water. Such policy reform can encourage farmers to use irrigation resources efficiently by motivating improvement in water management practices and generating revenue for operation, maintenance and capital replacement and irrigation sustainability in the country. DOI: http://dx.doi.org/10.4038/jas.v9i1.6353 The Journal of Agricultural Sciences, 2014, vol.9, no1: 44-57
Ascites Drainage Leading to Intestinal Adhesions at the Mesentery of the Small Intestine with Fatal Outcome
Authors: Kettler B. , Schrem H. , Klempnauer J. , Grannas G.
Published: January 2014

A common problem in patients with chronic liver diseases and liver cirrhosis is the development of ascites. First line therapy for ascites is the restriction of sodium intake and a diuretic treatment. Paracentesis is indicated in patients with large compromising volumes of ascites. In selected cases, permanent drainage of ascites over prolonged periods of time may be indicated. In the case presented here, a 66-year-old male patient, who was hospitalized with liver cirrhosis caused by alcoholic abuse, required permanent drainage of ascites. After three weeks of continuous ascites drainage, he developed bacterial peritonitis. Conventional attempts to remove the catheter by transcutaneous pulling failed and we thus decided to perform a median laparotomy to remove the catheter surgically. Intraoperatively an adhesion of the ascites drain (a so called ‘basket catheter’) to the mesentery very close to the small intestine was found, approximately 50 mm distal of the ligament suspensorium duodeni (ligament of Treitz). The basket catheter used for this patient was especially designed to drain infections, not fluids. We solved the adhesion, removed the basket catheter, placed a new surgical drain and finished the operation. The patient developed a rupture of his abdominal fascia suture 12 days later, which was caused by massive ascites and complicated by hepatorenal syndrome type I. The patient was taken to the operating theater again. After the second operation, the chronic liver failure decompensated and the patient died. Ascites caused by liver cirrhosis is still a medical challenge. The indication for the use of the correct percutaneous catheter for permanent paracentesis should be carefully considered. Some catheters are obviously not suited to drain ascites and may lead to fatal outcomes.
Older Adults without Radiographic Knee Osteoarthritis: Knee Alignment and Knee Range of Motion
Authors: Fahlman Lissa , Sangeorzan Emmeline , Chheda Nimisha , Lambright Daphne
Published: January 2014

This study describes knee alignment and active knee range of motion (ROM) in a community-based group of 78-year old adults (n = 143) who did not have radiographic evidence of knee osteoarthritis in either knee (KL < 2). Although knee malalignment is a risk factor for knee osteoarthritis, most women and men had either valgus or varus alignments. Notably, no men were valgus in both knees. Women with both knees valgus had significantly greater body mass index ( P > 0.001) than women with varus or straight knees. Men and women with valgus or varus knee alignments had generally lower ROM than individuals with both knees straight. In summary, this study highlights the complex relationships among knee alignment, ROM, body mass index, and gender in elderly adults without radiographic knee osteoarthritis.
Bisphenol A (BPA) Found in Humans and Water in Three Geographic Regions with Distinctly Different Levels of Economic Development
Authors: Karalius Vytas P. , Harbison Justin E. , Plange-Rhule Jacob , Van Breemen Richard B. , Li Guannan , Huang Ke , Durazo-Arvizu Ramon A. , Mora Nallely , Dugas Lara R. , Vail Lane , Tuchman Nancy C. , Forrester Terrence , Luke Amy
Published: January 2014

The suspected endocrine disruptor bisphenol A (BPA) is associated with the manufacture, distribution, and use of epoxy resins and polycarbonate plastics; thus, studies of this compound have focused primarily on urban areas in developed countries. This small study investigating urinary BPA of 109 people was conducted in the urban United States, urban Jamaica, and rural Ghana. Additionally, local drinking and surface water samples were collected and analyzed from areas near study participants. Levels of BPA in both urine and water were comparable among all three sites. Thus, future studies of BPA should consider expanding investigations to rural areas not typically associated with the compound.
An operational model for Lithuania’s coastal zone
Authors: Zemlys Petras , Dailidienė Inga , Zaboras Jevgenijus
Published: January 2014

The results of testing (hindcast) an operational hydrodynamic model HIROMB_LT for Lithuania’s coastal zone are presented and analysed in this paper. A model is developed using the program code of an operational hydrodynamic model of the Baltic Sea HIROMB (Swedish Meteorological and Hydrological Institute). The model grid (horizontal resolution 300m, vertical resolution 25 layers) covers the Baltic Sea coastal area until the Gdansk Bay in the West and Latvian border in the North and the Curonian Lagoon. The model simulated water levels, surface water temperature surface water salinity and ice cover variables were tested against measurements for the year 2009. The model shows satisfactory performance on water level and temperature and rather weak performance on salinity at stations where good reproduction of the mixing of fresh and saline water is critical (Juodkrantė and Klaipėda seaside stations). The model performance on ice thickness is still problematic because of too coarse spatial resolution of westerly winds. Despite of these shortcomings, the model can be used for operational forecasts already; however, data assimilation may be necessary for salinity and ice thickness.
Modulation of equatorial electrojet irregularities by atmospheric gravity waves
Authors: Shume E. B. , Rodrigues F. S. , Mannucci A. J. , de Paula E. R.
Published: January 2014

On 9 January 2002 and 14 November 2001, the São Luís 30 MHz coherent backscatter radar observed unusual daytime echoes scattered from the equatorial electrojet. The electrojet echoing layers on these days, as seen in the range time intensity maps, exhibited quasiperiodic oscillations. Time‐frequency decomposition of the magnetic field perturbations ΔH, measured simultaneously by the ground‐based magnetometers, also showed evidence of short‐period waves. The ground‐based observations were aided by measurements of the brightness temperature in the water vapor and infrared bands made by the GOES 8 satellite. The GOES 8 satellite measurements indicated evidence of deep tropospheric convection activities, which are favorable for the launch of atmospheric gravity waves (AGW) near São Luís. Our multitechnique investigation, combined with an analysis of the equatorial electric field and current density, indicates that AGW forcing could have been responsible, via coupling with E region electric fields, for the short‐period electrojet oscillations observed over São Luís.