bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of intrauterine tubo-peritoneal insemination and intrauterine insemination in the treatment of infertility
Authors: Gupta Disha , Verma Asha , Gupta Richa , Saini Soniya , Salvi Anuradha , Meena B. S.
Published: April 2017

Background: Infertility management has become more substantial and relevant with an increase in the number of infertile patients as well as advances in the science of reproduction. The objective of our study was to assess the role of intrauterine tuboperitoneal insemination (IUTPI) and intrauterine insemination (IUI) in the treatment of infertile patients.Methods: 236 infertile patients, 118 in each group attending the infertility clinic, after applying both inclusion and exclusion criteria were enrolled in the present study. Patients in each study group were given clomiphene citrate for ovarian stimulation followed by injection hCG for triggering ovulation. Insemination with washed husband’s sperm was performed about 36-40 hours after hCG administration, using 10ml of  inseminate in IUTPI and 0.5ml inseminate in IUI. The patient was then called after 2 weeks for urine pregnancy test (UPT) which, if positive was considered as clinical pregnancy.Results: Out of the total 236 cases, 42 cases had a positive outcome. Out of these 42 positive cases, 27 were from IUTPI group whereas 15 from IUI group. The pregnancy rate was 22.88% in IUTPI and 12.71% in IUI (p=0.039), which was a statistically significant difference. Endometrial thickness, preovulatory follicle number and prewash sperm motility significantly affected positive outcome in IUTPI. Factors like patient’s age, BMI<25, bilateral patent tubes and decreased duration of infertility also positively affected the treatment outcome.Conclusions: Our study found IUTPI to have better pregnancy rate compared to IUI. IUTPI may become a first line option for treatment of infertile patients.
Pattern of mortality in sickle cell disease: an autopsy study
Authors: Shah Pinkal , Bhagat V. M. , Patel Komal , Patel Chandani
Published: April 2017

Background: Sickle haemoglobin is highly prevalent in western India. Sickle cell disease (SCD) is the generic term for the group of haemoglobinopathies caused by the occurrence of haemoglobin S (Hbs) in the homozygous form –sickle cell anaemia (Hbss) or as the heterozygous combination of Hbs with another abnormal haemoglobin such as Hbsc or beta –thalassaemias (Hbs b-thal). While doing autopsy in case of death with no apparent cause, the possibility of death may be due to vaso-occlusive crisis in sickle cell disease should be kept in mind. The findings at autopsy are variation of features which may or may not be directly connected to death. The goal is to draw awareness among physicians and relatives on need of autopsy as to minimize future unexpected death from complication or crisis and to enhance knowledge on both parties.Methods: This was a study of autopsy specimens received between January 2015 to December 2015 at tertiary care hospital.Results: Total of 679 autopsy cases were received, out of which sickled erythrocytes were detected in 25 cases. The mean age at death was 30 years, a male/female ratio of 1.5:1 and peak mortality was in the 2nd to 4th decades of life. The commonest presentation was sudden death. The cause of death in middle aged patients were vaso occlusive crisis, in paediatric patients were infection and in older patients were chronic organ damage.Conclusions: Early diagnosis, prompt treatment and extended screening programme are necessary in prevalent tribal belt of western India to reduce morbidity and mortality. we should also introduce awareness programmes in tribal belt of western India.
Assessment of knowledge, attitude and practice of diabetic people in Najran, Kingdom of Saudi Arabia
Authors: Babikr Walid G. , Aedh Abdullah I. , Ahmed Awad Mohamed , Abdelraheem Ahmed , Alasmary Mohammed , Elhussein Amar B. , Alijla Anas R. , Ahmed Mutaz M. , Assiri Ali M. , Al-Qahtani Awad M. , Younis Abubaker A. , Alshehri Hamdan , Mohamed Hatem
Published: April 2017

Background: This cross-sectional hospital based study aimed at determining the level of knowledge, attitude and practice of diabetes among local people of Najran, Saudi Arabia.Methods: We aimed to investigate the levels of knowledge, attitude and practice among diabetic people in Najran area.Results: 10% of the participants scored >7, 28% scored >5 and 62% scored 5 and less in Knowledge questionnaire. None [0.00%] of the participants scored 7 or more out of the attitude questionnaire. 100% of the participants scored 5 and less out of 12. 100% of the participants scored >6 and 0% scored 12 or more in the practice questionnaire.Conclusions: Our study revealed that the level of knowledge, attitude and practice of diabetes in the area of Najran is very poor. We suggest that a structured educational program to be adopted by the health authorities in Saudi Arabia.
Distribution of different occupations in multiple myeloma patients- a hospital based study at a tertiary care hospital, Guwahati, Assam, India
Authors: Kalita Lohit Kumar , Mondol Mansi , Gogoi Pabitra Kamar , Sarma Umesh Ch.
Published: April 2017

Background: Several studies have shown that people who have been exposed to radiation or to asbestos, benzene, pesticides, and other chemicals used in rubber manufacturing may be at higher risk for developing multiple myeloma (MM). Those exposed to wood products, such as carpenters, furniture makers, and paper makers, are also at higher risk of developing this disease. Most occupational cohort studies lack statistical power for rare outcomes such as MM and many case–control studies suffer from small numbers of exposed subjects in specific occupation, job title or chemical exposure categories. This study aimed to investigate the distribution of MM among different occupational groups.Methods: A total of 100 cases were studied in the out patient department (OPD) of the Clinical Haematology Department, Gauhati Medical College and Hospital, and Guwahati, Assam, India.  It was a hospital based cross-sectional descriptive study. The proforma was prepared based on universal standard protocols for evaluation of MM which contains separate history, examination and investigation parts. The International Myeloma Working Group (IMWK) criteria for classification of monoclonal gammopathy, multiple myeloma and related disorders were used for diagnosis of the disease. Data were analyzed using statistical package and results and observations were presented in tabular form. Statistical tests were applied wherever required.Results: Statistical analysis suggested that farmers and housewives were more vulnerable to MM and the prevalence was significantly high (p>0.00001) among farmers followed by housewives; prevalence of MM was significantly high (p>0.00001) among the farmers working in agriculture as compared to those in farms; there was some difference (p<0.00001) in relation to risk of pesticide exposure between cultivation of crops and vegetable. Pesticide exposure was relatively high with cultivation of crops than vegetable; among the farmers working in farms, those who work in farm with furred animals are more vulnerable (p<0.00001) to the prevalence of MM than the others; frequency of pesticide exposure had no effect (p=0.354) on the prevalence of MM; prevalence of MM was significantly high (p=0.0005) among farmers who expose to pesticides for more than 5 years as compared to those exposing for less time and prevalence of multiple myeloma is very insignificant (p<0.00001) among the fruit and pesticide sellers.Conclusions: Prevalence of MM was significantly high (p=0.0005) among farmers who expose to pesticides for more than 5 years and carpenters who worked for more than 4 years.
To Study the correlation between fundus fluorescein angiography and optical coherence tomography patterns in clinically significant macular oedema
Authors: Sheth Neeti R. , Chaudhari Sushilkumar G. , Matai Hiren D.
Published: April 2017

Background: To Study the correlation between Fundus Fluorescein Angiography and Optical Coherence Tomography  patterns in Clinically Significant Macular Oedema.Methods: This is a retrospective study which compares patterns in FFA and OCT in patients with CSME.Results: A total of 54 eyes were examined. Participants included 64.81 % males and 34.85% females. On Fundus Fluorescein Angiography (FFA) 37.03% eyes showed diffuse leak, 27.77% eyes showed focal leak, 35.18 % eyes showed CME, 53.7% eyes showed macular ischemia. Maximum pattern is macular ischemia type in FFA. On OCT 42.6 % eyes showed spongy oedema, 68.51% eyes showed combined pattern, 48.15 % eyes showed ERM/Traction, 46.3 % eyes showed CME, 40.7 % eyes showed hard exudates 14.8 % eyes showed serous detachment.Conclusions: Both FFA and OCT are indispensable tools for diagnosis and management of Diabetic macular oedema. Measurement of central foveal thickness, tractional, ERM was possible with OCT but large number of patients showed macular ischemia on FFA which was not possible to diagnose with OCT. So, both FFA and OCT are necessary for management of Diabetic macular oedema.
Morbidity profile of 2 months-5years children according to IMNCI classification in paediatrics outpatient department of tertiary care hospital, Joka, Kolkata, India
Authors: Chaudhuri Susmita , Dutt Rekha , Goswami Shweta , Benerjee Pritam , Lahiri Mahuya
Published: April 2017

Background: Every year, more than 10 million children die in developing countries before they reach their fifth birthday. Seven in 10 of these deaths are due to acute respiratory infections mostly pneumonia, diarrhoea, measles, malnutrition & combination of these illnesses. The rationale of our study is to assess the profile of childhood illness in the paediatrics out- patient department at ESI-PGIMSR and MC, Joka, Kolkata, India so that the same burden can be minimised & to promote healthy upbringing of children below five years of age.Methods: This was an observational study of cross-sectional design conducted among the mother-child pair (child belonging to the age group of 2 months-5 years) visiting Pediatrics OPD during the study period i.e. 4 weeks. Convenience sampling method was used. The participants whose guardians did not give consent for the study & were seriously ill were excluded from this study.  A pre-designed and pre-tested interview schedule was used. After giving a brief introduction about the topic, verbal consent was taken & face to face interview was conducted in local language. Data was compiled & computed in SPSS software version 20.Results: According to the IMNCI classification, 15.9% of the study subjects had severe pneumonia, 17.8% had pneumonia. 1.9% of the study subjects had severe dehydration. None of the respondents presented with some dehydration. Only 1% of the respondents presented with anemia. 4.9% of the respondents presented with severe malnutrition, 13.8% of them had malnutrition according to IMNCI classification.31.7% of the respondents had primary immunisation.67.3% of them had been breastfed. Among them 41.2% of them were breastfed 8 times & more a day.92% of them had supplementary feeding as rice, 33.3% of them had supplementary feeding as baby food. 69.3% of them had complained of change in food habit during illness.Conclusions: Proper counselling to parents regarding prevention of common morbidities like pneumonia, diarrhoea, malnutrition etc. should be provided at each and every possible hospital contact. Awareness about danger signs & symptoms of urgent hospitalisation should be imparted using pamphlets or other health educational materials. Health workers also should undergo proper training so that proper classification of the conditions as well as efficient management could be provided.
Unilateral duplex collecting system with incomplete duplication of ureter - a case report
Authors: Nagpal Hema , Chauhan Renu
Published: April 2017

Duplex collecting system is presence of two pelvicalyceal system which is associated with single or double ureter. Bifid ureter is one of the variations related to congenital anomalies of urinary system which are many times an incidental finding. A bifid ureter may be found in association with other congenital anomalies and defects. In the present case report, we present a case of bifid ureter with duplex collecting system and with no other associated congenital anomaly. The embryological and clinical correlations of duplex collecting system are discussed in present paper.
Strategies to enhance recruitment methods in phantom limb pain clinical trials
Authors: Pinto Camila Bonin , Saleh Vélez Faddi Ghassan , French Melanie N. , Zeng Dian , Crandell David , Bolognini Nadia , Merabet Lotfi B. , Fregni Felipe
Published: April 2017

Phantom limp pain (PLP) was first described in 1551. To date, its mechanisms and novel interventions remain mostly untested. Only limited conclusions can be drawn from few and small sized randomized clinical trials (RCTs) on PLP. In this scenario, enhanced recruitment strategies are crucial in order to overcome inherent challenges to recruit and enroll PLP subjects for clinical trials. Although there are many general methods to enhance recruitment and also retention, in this article we discuss these methods based on a common topic; dissemination. We summarize and discuss ten strategies of recruitment related to the dissemination of information based on the notion that increased trial awareness may lead to both improved recruitment and also external generalizability. In addition, we include insights based on our experience recruiting PLP patients for the purposes of a large-scale and on-going NIH-sponsored clinical trial. Although specific regulatory considerations need to be considered when choosing the methods of recruitment (which may vary across different countries and Institutional Review Boards (IRBs)), these strategies may be applicable to most research settings.
Feasibility study protocol to examine the role of mantra meditation at reducing psychological distress in emergency department staff
Authors: Dunne Padraic J. , O'Leary Caoimhe , Prihodova Lucia , Breen Rachel , Walsh Cathal , Freeman Laurence , Carroll Aine , McMahon Geraldine , White Barry
Published: April 2017

Background: Work in a healthcare setting can affect the psychological wellbeing of healthcare professionals (HCPs). Emotional exhaustion among HCPs can have a significant negative impact on the quality of healthcare provided to patients in terms of increased medical errors and decreased patient satisfaction. There is a need for an effective stress-reducing intervention, such as mantra meditation. This feasibility study will examine the suitability of random controlled trial (RCT) methodology to assess the efficacy of mantra meditation at reducing emotional exhaustion among emergency department (ED) staff.

Methods: This is a mixed methods, stratified feasibility study with intent-to-treat protocol, using two study arms (passive control and intervention), the purpose of which is to examine (1) recruitment, retention, and adherence; (2) outcome measures (psychological wellbeing and stress-related biological parameters such as blood pressure, heart rate variability and salivary cortisol); and (3) data management, control, and dissemination prior to conducting a full RCT.

Results Eligible ED staff allocated to the intervention group (n = 30) will be taught mantra meditation and discuss prescribed texts (4 x 4 hour session over 6 weeks), as well as engage in 20 minutes of twice-daily mantra meditation practice. Participants in the passive control group (n = 30) will work as usual. Data will be collected pre (T1), post (week 11; T2) and at follow-up (week 19; T3).  

Conclusions: This study will pave the way for a larger RCT that will investigate mantra meditation as a definitive intervention to reduce emotional exhaustion among ED staff.
Blood borne viral infections in adolescents of East Sikkim, Northeast India: serological prevalence and risk behaviour correlation
Authors: Pradhan Ashish , Khatri Dheeraj , Adhikari Luna
Published: April 2017

Background: There is a high prevalence of HIV infection in adolescents of India, especially the north eastern states but awareness on blood borne viral infections among them is poor.Methods: Four hundred and ninety students aged thirteen to nineteen from seven schools and seven colleges of East Sikkim were interviewed on behavior related to transmission of blood borne viral infections and their blood was tested for Hepatitis B surface antigen, anti-Human Immunodeficiency virus and Hepatitis C virus antibodies.Results: None of the students tested positive for anti-Human Immunodeficiency virus and Hepatitis C virus antibodies and only one tested positive for Hepatitis B surface antigen. 6.7% of students gave history of heterosexual relationship.Conclusions: Despite the presence of behaviors associated with risk of acquiring blood borne viral infections in our adolescents we found a low prevalence of these infections, hence there is a need to do similar studies involving more and different cohort of adolescents.
Study of aetiological profile, clinical presentation and outcome of hepatosplenomegaly in children between 1 month and 14 years of age
Authors: Champatiray Jyotiranjan , Panigrahi Debasish , Mondal Dipankar , Satpathy Saroj Kumar
Published: April 2017

Background: Hepatosplenomegaly is the simultaneous enlargement of liver and spleen. Hepatosplenomegaly is a sign seen in various disease processes in infants and children. So, an attempt was made in the present study to know the various etiological factors and clinical features and clinical outcome of hepatosplenomegaly in the cases admitted in SVPPGIP and SCB Medical College and Hospital, Cuttack.Methods: A tertiary care hospital based prospective study was carried out in 150 children between1 month to 14 year of age for a period of 2 years.Results: The most common presenting features was anemia (79.3%) followed by fever (78%) and jaundice (38.7%). Infectious (50%) causes are commonest aetiology of hepatosplenomegaly followed by haematological (36%) and congestive (6%) causes. Infectious etiology was commonly constituted by malaria (25.2%) due to high prevalence of malaria in rural Odisha. Mortality is significant in infectious and congestive aetiologies among younger age groups whereas haematological causes have favorable outcome.Conclusions: A detailed history and thorough physical examination should be carried out in every case of hepatosplenomegaly to reach a diagnosis and determine further management plans. Since clinical outcome of children with infectious and congestive aetiologies are overwhelmingly poor, it can be improved by intervention at earliest time possible and aggressive treatment.
Study of CSF C-reactive protein in meningitis to differentiate bacterial meningitis from aseptic meningitis in children between 1 month and 12 years of age
Authors: Natani Bhagwan S. , Goyal Pardeep , Agarwal Ankit , Bhatia Sumit , Kumar Malvika
Published: April 2017

Background: Meningitis is a serious illness of childhood. CSF Gram stain and culture is the gold standard for diagnosis which is a costly and time consuming. So, this study was conducted with the objective to measure the specificity, sensitivity, positive and negative predictive values and diagnostic accuracy of CSF-CRP in the diagnosis of bacterial meningitis.Methods: This prospective study was conducted in Department of Pediatrics, National Institute of Medical Sciences and Research, Jaipur. Children between 1 month to 12 years of age admitted with acute history of fever and seizure were included. CSF was sent for CRP estimation and other laboratory investigations. CSF CRP was determined qualitatively and value >6mcg/ml was considered positive. Patients were divided into three groups based on clinical and CSF findings. Group 1 (Bacterial meningitis), Group 2 (Aseptic Meningitis) and Group 3 (No meningitis/Control Group). Statistical analysis was done using software SPSS version 23.Results: 120 patients were enrolled in our study. 65% of our cases were males. The mean age of our cases was 74.9±39.8 months. 48 cases had bacterial meningitis, 42 cases had Aseptic Meningitis and 30 cases had no meningitis. CSF-CRP was positive in 35 cases of Bacterial meningitis, 6 cases of aseptic meningitis and negative in all cases of control group. Hence the Sensitivity, Specificity, Positive Predictive Value, Negative Predictive Value and Diagnostic Accuracy of CSF-CRP for diagnosis of bacterial meningitis were 72.92%, 85.71%, 85.71%, 73.47% and 78.89% respectively. CSF-CRP cases of bacterial meningitis were also found to have a poor outcome.Conclusions:CSF-CRP can be used as an initial test for the diagnosis of Bacterial Meningitis till other confirmatory test reports are awaited.
Morbidity profile of infants of mothers with gestational diabetes admitted to a tertiary care centre
Authors: K. Devi Meenakshi , R. Narayana Babu , Padmanaban Srinivasan
Published: April 2017

Background: Infants born to mothers with gestational diabetes are at increased risk of neonatal morbidities like birth trauma, hyperbilirubinemia, hypoglycemia, birth asphyxia etc., Maternal glycemic control has been one of the parameters that determines the occurrence of these problems.Methods: A retrospective study done by analysing the case records of babies born to mothers with gestational diabetes and admitted to the NICU of Govt Kilpauk Medical college from January 2015 to December 2015. The morbidity profile of infants born to mothers with gestational diabetes was analysed and comparison was made between the two groups namely mothers who were managed by meal plan and those who were managed by insulin.Results: About 198 babies were analysed majority were delivered by caesarean section (83%). Only 2 babies (1%) weighed more than 4000gms. The commonest morbidity observed was hyperbilirubinemia (24.2%) which was 27.7% in the insulin group as against 19% in the group on meal plan. The next common morbidity was sepsis (15.2%). This was also common in insulin group 18.5% as against 10.1% in the meal group. Others were hypoglycemia (4%), congenital heart disease (2.5 %) and respiratory distress syndrome (1.5 %).Conclusions: Babies born to mothers with gestational diabetes were found to have morbidities like hyperbilirubinemia and sepsis. Less commonly found morbidities were hypoglycemia, birth asphyxia, respiratory distress syndrome etc., Though the morbidities were more common among insulin group as compared to the group on meal plan this difference was not statistically significant.
Complimentary feeding practices in severe acute malnutrition children admitted in malnutrition treatment centre of RNT medical college
Authors: Jain Rupali , Arora Vivek , Gediya Sandip
Published: April 2017

Background: To assess the complimentary feeding practice in Severe Acute Malnutrition (SAM) children aged between 6months to 5years.Methods: 110 SAM children admitted in Malnutrition Treatment Centre (MTC) of MBGH Hospital, Udaipur over a period of 3 months were taken in the study. Structured questionnaire including child’s personal data, socioeconomic status of the family, breast feeding and complementary feeding status were used. Clinical and anthropometric assessment of children was done.Results: Out of the 110 children included in the study, 58 (52.7%) were males and 52 (47.2%) were females. Mean age of children included was 16.8 ± 10.73 months. Maximum children were in the age group of 6-12months 60 (54.5%), followed by 13-24 months of age 38 (34.5%), followed by >2-5years of age 12 (10.9%). Thirty-four (30.9%) children were on exclusive breast feeding, with 30 (27.3%) in age group of 6-12 months and 4 (3.6%) in 12- 24 months. Breast feeding with complimentary feeding was practiced in 30 (27.3%) children of 6-12 months of age and 22 (20%) children of 13-24 months. Out of the 76 children on additional feed with or without breast feeds, 70 (92.1%) consumed milk- either goat milk, cow milk or buffalo milk.Conclusions: Anthropometric assessment revealed that maximum number of SAM children also had chronic malnutrition. Diet of SAM children mainly included milk and cereals. They did not obtain a balanced diet to meet their nutritional requirement.
Nasal CPAP vs Bi-level Nasal CPAP in preterms with RDS: a randomized control study
Authors: Arora Vivek , Gediya Sandip G , Balai Shaitan Singh
Published: April 2017

Background: Ventilator induced lung injury prevention may begin from birth, and respiratory support without endotracheal intubation is an attractive option in preterm baby with Respiratory distress syndrome (RDS). The objective of the study was to evaluate the clinical course and respiratory outcomes in preterm infants with moderate RDS assigned from birth to Nasal Continuous Positive Airway Pressure (NCPAP) or Bi-level Nasal Continuous Positive Airway Pressure (Bi-level NCPAP).Methods: 60 infants of 28-34 weeks GA (<35 wks GA), affected by moderate RDS, were considered eligible and were randomized to NCPAP (CPAP level=6cm H2O, Group A n=30) or to Bi-level NCPAP (lower CPAP level=4.5 cmH2O; higher CPAP level=8 cmH2O, Group B n=30), provided with the variable flow devices (Infant Flow CPAP vs Infant Flow SiPAP™, Viasys Healthcare, Yorba Linda, CA).Results: Length of ventilation, oxygen dependency, need for intubation and occurrence of air leaks were considered as outcomes. Infants showed similar characteristics at birth (Group A versus Group B: GA 30.4±2 wks versus 30.3±2wks, BW 1433±545g versus 1415±560g. Group A underwent longer respiratory support (6,2±2 days versus 3,8±1 days, p=0.025), longer O2 dependency (13,8±8 days versus 6,5±4 days, p=0.027) and was discharged later (GA at discharge 36,7±2,5 weeks versus 35,6±1,2 weeks, p=0.02). All infants survived. No BPD or neurological disorders occurred.Conclusions: Bi-level NCPAP was associated with better respiratory outcomes versus NCPAP, and allowed earlier discharge, inducing the same changes in the cytokine levels. In our population, it was well tolerated and safe
Neonatal seizures and outcome in a NICU of a tertiary care hospital of Andhra Pradesh-an two year study
Authors: Nagaram Punith Patak , Piduru Pratima , Munagala Venkata Krishna
Published: April 2017

Background: Seizures are the most frequent clinical manifestation of central nervous system dysfunction in the newborn with the incidence varying from 1-5%. Neonatal seizures often signal an underlying ominous neurological condition, most commonly hypoxia-ischemia, and others include stroke, intraventricular hemorrhage or intraparenchymal hemorrhage, meningitis, sepsis, and metabolic disorders. Neonatal seizures can permanently disrupt neuronal development, induce synaptic reorganization, alter plasticity and "prime" the brain to increased damage from seizures later in life. The present study was undertaken to delineate the various aspects of neonatal seizures, with special reference to etiology, clinical spectrum, and outcome in the Neonatal Intensive Care Unit (NICU) of a tertiary care Hospital.Methods: A prospective cross sectional study was conducted in an NICU of a tertiary care hospital with 65 neonates in the study group for a period of 2 years. Gestational age assessment is done by modified Ballard’s scoring system and detailed neurological assessment was done. Antenatal history of mother, demographic data, and clinical history of neonate was noted and evaluated. Laboratory investigations were done and results noted and outcome was recorded.Results: Subtle seizure was the commonest (40%) clinical seizures in our study followed by tonic (21.5%). Tonic seizures were common in preterm and in full term subtle seizures. Babies with myoclonic seizures had 100% mortality. Hypoxic ischemic encephalopathy was the commonest cause (41.5%) of mortality in our study. The worst outcome was with CNS malformation (50%). A total of 10 deaths were recorded (15.4%) with maximum association in cases with history of onset 7 days (100%).Conclusions: Neonatal seizures are common and may be the first manifestation of neurological dysfunction after a variety of insults. Seizures may interfere with cardio-respiratory function and nutrition and may have detrimental effects on cerebral development. Global cerebral hypoxia-ischemia is the most common etiology of neonatal seizures, followed by intracranial bleed, hypoglycemia, septicemia, hypocalcemia, BE, CNS malformations.
Incidence of HIV, its predictors and risk factors in children
Authors: Goyal Alok Kumar , Agrawal Vijay , Thapar Karuna , Agrawal Ruchi
Published: April 2017

Background: Children mostly acquire HIV (Human immunodeficiency syndrome) infection from their parents. There is need to know the HIV status of their parents, associated risk factors and predictors so as to make effective strategies to prevent this disease and save the coming/future generation from this deadly disease. The objective of the study was to know incidence of HIV, its predictors and risk factors in children. Study Setting: This is a Hospital based observation study conducted in Department of Pediatrics, Govt. Medical College, Amritsar.Methods: In this study, all patients admitted to Pediatrics department, irrespective of presenting complaints were evaluated for presence of any of risk factors/predictors as mentioned in Proforma and those children having any of risk factors/predictors were selected, consent was taken and undergone detailed clinical evaluation and investigations for HIV.Results: Incidence of HIV in all patients admitted to children ward was 1.21% (27/2227) and children who had one or more risk factor or predictor was 6.58% (27/410). Weight loss, Failure to thrive (44.44%), Diarrhoea (37.03%), Fever (70.37%), Oral Candidiasis (22.2%), Pulmonary Tuberculosis (11.11%) and Generalized Lymphadenopathy (18.51%) were significant predictors in present study. High risk behaviour of parents (37.30%) and mother's HIV positivity (62.92%) were significant high risk factors, however needle prick (18.5%) was also equally significant in present study.Conclusions: Children brought with various signs and symptoms of HIV or born to high risk behaviour practicing parents and/or HIV positive mother, physician must get their patients tested for HIV (as per NACO Guidelines) so that infected children diagnosed early and referred to a specialized centre for treatment and follow up.
A study on clinical profile of typhoid fever in children
Authors: Devaranavadagi Ranganatha A. , S. Srinivasa
Published: April 2017

Background: Typhoid fever is caused by Salmonella typhi. It is a major public health problem in India. Typhoid fever is endemic in many developing countries. Wide variations in the clinical manifestations of typhoid fever make its diagnosis a challenging task. This study was conducted to understand the wide range of clinical manifestations, complications and antibiotic sensitivity patterns of typhoid fever in children.Methods:Prospectively, 113 children admitted in pediatric unit with confirmed Typhoid fever from September 2015 to December 2016 at KIMS hospital, Bangalore were included. In each case, age, sex, presenting complaint, laboratory investigations and antibiotic sensitivity pattern are collected and analysed.Results: Out of 113 cases, 72 cases (63.8.1%) were males, 41 cases (36.2%) were females. The most common age group was 5-10 years. The most common symptom was fever, seen in 100% cases, followed by anorexia (61%), vomiting (44%) and abdominal pain (18%). The most common sign observed was toxic look in 68% of the cases, followed by coated tongue in 49% and hepatomegaly in 44%. Leucocytopenia was found in 34% of cases. Eosinopenia was found in 39% of cases. Anaemia was found in 16% of cases. Thrombocytopenia was found in 15% of cases. Blood culture was positive in 20% of cases. Use of municipal water for drinking was found in 65% of cases. Outside eating was found in 40% of cases. Unhygienic practices were found in 64% of cases. Duration of hospital stay varied from 3-10 days. No mortality reported.Conclusions:Typhoid fever is most commonly observed with unhygienic practices and eating of unhealthy outside food. This major public health issue can be tackled by bringing awareness among people regarding disease transmission and its various preventive measures.
Pediatric giant cell glioblastoma: a rare entity
Authors: Vijayan Poornima , Shemin Zuhara , Saleem Sharmina , Ponniah Anupama
Published: April 2017

Giant cell glioblastoma (GCG) is a rare subtype of glioblastoma multiforme (GBM) which represents 0.8% of all brain tumors and 5% of glioblastomas. This entity is all the more rarer in the pediatric age group. And, due to the limited number of case reports and case series in literature, its epidemiology, natural history and follow up are not well documented. We present this case for its rarity. A 14-year-old girl presented with history of recent onset headache and vomiting from last 10 days. Magnetic resonance imaging (MRI) brain revealed a mass lesion in the right temporo-parietal region, suggestive of a high-grade glioma. Histopathological examination revealed features typical of giant cell glioblastoma. Giant cell glioblastoma, is an extremely rare variant of gliobastoma multiforme, merits special mention because it has been hypothesized to be associated with a longer survival compared with GBM in both adults and children, possibly because of the younger age at presentation, certain histopathological and molecular characteristics of this entity.
Frasier syndrome: A rare syndrome with WT-1 gene mutation
Authors: Sundaram Vindhiya Kadambavana , Subramanian Sundari , Chinumuthu Lakshmi Charan , Dharmanathan Aishwarya
Published: April 2017

Frasier syndrome is a rare disorder of sex development. It is caused by mutation in Wilms’ tumor suppressor gene (WT-1) located in 11p23. This gene encodes a transcription factor involved in the development of kidney and gonads. The syndrome is characterized by female external genitalia in 46, XY patients, streak gonads with a higher risk of gonadal tumors, mainly gonadoblastoma. Nephropathy consists of nephrotic syndrome (NS) mainly due to focal segmental glomerular sclerosis (FSGS). NS presents early in childhood and responds poorly to steroid and immunosuppressive agents. Progression to End Stage Renal Disease (ESRD) usually occurs by second or third decade of life. We present a 6 years old female child with insignificant past medical history diagnosed as steroid resistant nephrotic syndrome. Renal biopsy showed FSGS. CT Abdomen showed streak gonads with rudimentary uterus. Further genotype showed WT-1 mutation with Karyotype of 46XY. Elective bilateral gonadectomy was done and histopathology showed bilateral dysgerminoma. After a year, her disease progressed to ESRD and she succumbed to the illness.
Rapid onset obesity and ondine’s curse: a deadly syndrome
Authors: Akunuri Shalini , Vuppu Dinesh Kumar , Sapare Anil Kumar , Bagde Abhijith , Murthy Rashmi Vasudeva , Kannan Subramanian
Published: April 2017

ROHHADNET syndrome is characterized by rapid-onset-obesity, hypoventilation, hypothalamic dysregulation, autonomic dysfunction and neural tumors. A 2.4-year-old girl presented with inability to be aroused from sleep. She was obese, obtunded, hypoventilating with severe hypercarbia. Non-invasive ventilation (NIV) was started following which her sensorium, hypercarbia normalized. History revealed hyperphagia, rapidly increasing weight after 1½ year of age with normal height centiles. Hormonal profile revealed hyperprolactinemia, central hypothyroidism, suboptimal growth hormone response and normal cortisol. She had presacral tumor, pain insensitivity, fluctuating blood pressure, constipation and strabismus. ROHHADNET syndrome was clinically diagnosed based on constellation of these features. She was discharged on nocturnal NIV. Over 8 months, her hypoventilation progressed requiring tracheostomy. She also underwent excision of the presacral tumor which proved to be ganglioneuroma. Whole exome sequencing was negative for CCHS and ROHHAD genes, which could be due to somatic mosaicism; variation in the genomic region not covered by the test; or large insertions, deletions, complex rearrangements. Arriving at the diagnosis is difficult due to its overlap with other hyperphagic obesity syndromes and lack of confirmatory genetic testing.
Association of household food security with toddler stunting in the Sleman Regency Indonesia
Authors: . Susetyowati , Palupi Ika Ratna , Rahmanti Annisa Ristya
Published: April 2017

Background: Stunting prevalence in Indonesia toddlers has increased (37.2%) in 5 years and became risk factor of obesity and metabolic disease in adulthood. Identification of risk factors by looking at household food security as the cause of stunting can provide information to the appropriate interventions. This research aims to know association between households food security with stunting in toddlers.Methods: This is observational study with retrospective cohort design. Anthropometry parameter and household food security data is used to assess the subject. The sample used is families who have toddlers from study Health Demographic Surveillance System (HDSS) in Sleman Regency which totaled 150 toddlers of households.Results: There is no association between food expenditure proportion with stunting (p=0.089), between energy consumption level with stunting (p=0.876) and between households food security with stunting (p=0.357).Conclusions: Food security based on the food expenditure proportion and energy consumption level is not associated with stunting in toddlers in Sleman Regency.
Outbreak of cholera at Dutsen-Abba Ward Zaria local government area, Kaduna State Nigeria 2015: the importance of hygienic practices
Authors: Ibrahim Baffa S. , Mohammed Yahaya , Usman Rabi , Okon Ubong A. , Katchy Uche I. , Olufemi Abayomi A. , Niyang Mercy , Gobir Bola , Okunromade Oyeladun Funmi
Published: April 2017

Background: Cholera is an infection caused by Vibrio cholerae, which may lead to severe dehydration and death if not treated promptly. On August 31, 2015, the Kaduna Ministry of Health received a notification of increase cases of vomiting and diarrhoea at Dusten-Abba in Zaria. A response Team was sent to confirm the outbreak, describe the socio-demographic characteristics and identify possible risk factors for the outbreak.Methods: We defined cases according to the world health organization (WHO) criteria. We conducted an unmatched case-control study and descriptive study. We retrieved line-listed cases at the ward facility. We interviewed cases at the facility and recruited controls from the community, and administered questionnaires to both cases and controls. We analysed data using Epi-Info7 and Microsoft Excel 2016.Results: A total of 50 cases were recorded, with a median age of 20years and age range of 1 – 50 years. There were more females (68%) than males. Majority of cases (52%) were under 20 years, while all cases are below 50 years. Seven (7) deaths were recorded giving a Case Fatality Rate (CFR) of 14%. The CFR was higher in females (14.7%) than in males (12.5%). Index case was seen on August 29, 2015. The outbreak lasted five days. Last cases were seen on September 2, 2015. Highest number of cases seen in a day (23) was on third day of the outbreak. Only two cases (4%) had their samples tested using cholera RDT, and both tested positive. Drinking un-boiled water (OR: 12.67, 95%CI: 2.33–68.93), regular hand washing (OR: 0.22, 95% CI: 0.06–0.90) and proper waste disposal practices (OR: 0.07, 95% CI: 0.02–0.36) are factors we found to affect cholera infection during the outbreak.Conclusions: Our investigation confirmed a cholera outbreak with a high CFR, especially among females. Poor hygienic practices among the populace seem to be the drivers for this outbreak.
A study of maternal morbidity associated with caesarean delivery in tertiary care hospital
Authors: Gayathry Dasari , Guthi Visweswara Rao , Bele Sameer , Vivekannada Achanta
Published: April 2017

Background: Cesarean section is one of the most commonly performed surgical procedures in the world. Several studies have demonstrated that c/s poses a greater risk of maternal morbidity and mortality compared to vaginal delivery. Therefore, it is important to assess the morbidities associated with a c/s. Methods: A hospital based, cross sectional study was conducted among 240 women during the period of March-May 2014. A semi-structured questionnaire was used to evaluate the socio-demographic characteristics, obstetrical characteristics, indications and complications following c/s. Results: A total of 150 (62.5%) respondents underwent emergency c/s whereas 90 (37.5%) were having elective c/s. The most common indication for cesarean delivery was a previous c/s observed in 70 (29.2%). No postpartum morbidity was observed in 152 (63.3%) of the respondents, whereas 88 (36.7%) had reported some or other kinds of morbidities. Among the various maternal morbidities, postpartum anemia was the most commonly observed morbidity in 22 (9.2%) of the respondents, followed by postpartum hemorrhage by 10 (4.2%) and wound infection was observed in 15 (6.25%). Conclusions: High maternal morbidity following c/s was observed in studied sample as more than one third of the women had shown some or other kinds of morbidities. Efforts should be made to evaluate the reasons for increasing c/s rate and to reduce the incidence of c/s by careful antenatal and intranatal management.
PrevaPrevalence of musculoskeletal disorders among heavy earth moving machinery operators exposed to whole-body vibration in opencast mininglence of musculoskeletal disorders among heavy earth moving machinery operators exposed to whole-body vibration in opencast mining
Authors: Mandal Bibhuti B. , D. Manwar Veena
Published: April 2017

Background: Low back pain (LBP) and degenerative changes in the spinal system are reportedly associated with exposure to low frequency (0.5- 80 Hz) whole-body vibration (WBV). The main objective of the study was to determine prevalence of musculoskeletal disorders among Heavy Earth Moving Machinery (HEMM) operators exposed to WBV in an opencast mine in western India.Methods: Forty six operators from an opencast mine were recruited as exposed group in a questionnaire based cross-sectional study. Twenty eight employees engaged in sedentary office work were taken as control. All subjects were asked about location and severity of body pain in the past 7 days and 12 months. A four point pain scale was used. Significance of difference of demographic / anthropometric parameters was studied using t-test of independent samples. Association between the pain type and exposure was obtained using Chi-square test. Risk of each type of pain was determined in terms of odds ratio. Adjusted estimate of ORs were obtained through logistic regression modelling, wherein the model fitness was judged using Hosmer-Lemeshow test.Results: The mean exposure duration was 11.30 ± 7.45 years. LBP was the most predominant MSD which showed highly significant association with exposure (P <0.001). Overall, the risk analysis revealed a significant increase in the likelihood of MSD due to exposure. 39% of the exposed group required medical attention.Conclusions: Based on subjective response of exposed group, it can be said that prevalence of musculoskeletal pain as manifestation of MSD due to exposure to WBV especially LBP is high among HEMM operators which affected their quality of life.
A study on nutritional status of adolescent girls of Dongria Kondh tribe
Authors: Nanda Sikata , Dhar Rabi Narayan
Published: April 2017

Background: Nutritional status of adolescent girls are different from the younger children and older adults. In the tribal population they are more neglected in comparison to boys because of limited resources and health care facilities. In the present study we have done assessment of nutritional status of adolescent girls in the Dongria Kondh tribe in Odisha. Methods: Dongria Kondh’ residing in Rayagada district of Odisha, having its maximum concentration was studied. Bissam Cuttack block was selected randomly as the study area. Moreover, coincidently majority of the study population resided in the block having villages like Kurli, Khambesi, Hundijali, Muthesi, Khajuri, Mundabali and Uppar Gandatallli which are situated as a distance of 5000 ft height above sea level. 89 adolescent girls were considered to assess the nutritional status of tribal adolescent girls of Dongria Kondh tribe to study the different factors associated with the nutritional status of the girls and to suggest remedial measures for integrated development of the adolescent girls. Results: Most of the girls (81%) were from nuclear family. All girls belonged to low socio economic status. The energy intake was adequate only in 35% of study subjects. The protein intake was adequate in only 38% of study subjects. The common types of food consumed was rice, ragi and seasonal fruits and all were non vegetarian. Conclusions: The widespread problem of poverty, illiteracy, malnutrition, absence of sanitary living condition, ignorance of cause of disease still are the contributing factors for the deplorable condition prevailing amongst the adolescent girls of the tribal group. As they are future mothers, improvement of nutritional status should be the primary objective.
Prevalence and factors associated with hypertension: a community based cross-sectional study among adults in an urban area of Puducherry, South India
Authors: Paul Pramila J. , Samson Rebecca , William Annie , Akila Bridgitte , Purty Anil J. , Bazroy Joy
Published: April 2017

Background: The prevalence of hypertension and other non-communicable diseases in India are on the increasing trend. Hypertension is a major public health problem in India. This study aimed to estimate the prevalence and associated factors of hypertension in an urban area of Puducherry, South India.Methods: A community-based cross-sectional study was carried out among adults in an urban area of Puducherry, South India, between Oct 2013 to Nov 2013. A total of 236 adults aged ≥ 35years were selected and data was collected using piloted questionnaire. Blood pressure was measured following standard technique.Results: Out of 236 participants 123(52.1%) were found to be hypertensives. Among the hypertensives, nearly one fourth 32(24%) of them were undiagnosed hypertensives. Advanced age, male gender, housewives compared to their counterparts, family history of hypertension, alcohol intake, sedentary lifestyle, and abdominal obesity (among females) were significantly associated with hypertension. Conclusions: The prevalence of hypertension is found to be high. Regular health education programme to raise awareness and community-based screening programme should be given priority for early detection of hypertension and prevention of complications.