bluuebunny/crossref_metadata_2025 huggingface dataset:
Working together – integration of information literacy in educational programs at Blekinge Institute of Technology
Authors: Gunnarsson Jenny , Pettersson Kent , Stockman Anna
Published: May 2018

Previous experience, literature reviews, as well as continuous contacts with the Schools of Blekinge Institute of Technology (BTH) have led us to assume the following statements for the Information literacy (IL) education at BTH: Information literacy is a generic skill which should be taught as a compulsory part of the educational programs The integration of the teaching of IL in the educational programs is necessary to achieve qualitatively good results concerning IL The Schools of BTH are responsible for the IL education of students The library can, together with the Schools, create and offer IL modules adapted to the educational programs Today IL education at BTH is quite extensive, but also irregular and highly dependent on contacts with individual teachers, which makes IL education vulnerable. In order to bring this problem to light, and inspired by the Borås model (presented at Creating knowledge VI), as well as Sydostmodellen, the library at BTH contacted the Board of Education during the winter of 2012, and presented a plan on how the library and Schools at BTH could cooperate in order to integrate IL education within all educational programs. Suggestions regarding content, extent, progression, timing, assessment and learning outcomes of the IL education are the focal point of the presented plan. As the first result of the proposal, the library has been commissioned by the BTH Quality Assurance Council to review the situation regarding IL education at BTH together with the educational program directors. In cooperation with the programs, the library should also make a plan for each program on how to integrate IL education as a part of generic skills. At the conference, the following themes were addressed and discussed during our presentation: sustainability of IL education, collaboration within the academy regarding IL education and how integration of IL education at university educational programs is reflected in research on IL in general.
Lecturers, librarians and students in collaboration – A way of achieving complex educational goals in information literacy in three programmes at Lund University
Authors: Andersson Cajsa , Reistad Nina , Verdozzi Kristina Holmin
Published: May 2018

A key factor in achieving educational goals is collaboration between lecturers at faculty and departmental level, and librarians. Experience has shown that generic skills should be integrated into courses. For example, exercises in information searching, criticism of sources of information and group work will only be meaningful if they are clearly related to the students' subject of study. This is a challenging logistical problem in large groups of students. In the spring of 2009, we started working on the introduction and integration of generic skills using two variations of a model. The experience gained from these initial attempts has been applied in the introduction of first-year university students. To date (autumn term 2012), almost 900 students starting programmes in Engineering Physics, Environmental Engineering, and Industrial Management and Engineering, have taken part in a compulsory introductory course.
Editorial
Authors: Jönsson Karin , Landgren Lena
Published: May 2018

This special issue of the Nordic Journal of Information Literacy in Higher Education summarizes the conference Creating Knowledge VII held in Lund, Sweden, August 14-16, 2013. The conference was hosted by Lund University Libraries in cooperation with NordINFOLIT. The title was Win-win ways: educational enhancement through collaborative partnership between students, academics, and librarians.
High school teachers and librarians in cooperation throughout the Information Search Process
Authors: Hanberger Karolina , Gardell Sofia
Published: May 2018

At Hulebäck's Upper Secondary School, one fundamental goal is 'learning to learn'. An essential prerequisite for this is information literacy. We show how teachers and school librarians by cooperating in developing assignments can improve student's information literacy based on Carol Kuhlthau's Model of the Information Search Process. The model of the ISP describes actions, thoughts and especially feelings of students involved in complex inquiry tasks. Some of the stages of this process are perceived as both confusing and frustrating and difficult for students to work through on their own (Kuhlthau, Caspari & Maniotes, 2007). There is a great need for guidance and intervention throughout the ISP and in our experience the teacher - librarian collaboration is key when it comes to developing tools to support the student in each stage. In this presentation we focus on practical examples of exercises from our everyday work, based on the role of emotion as students engage in research. Our aim is to enhance each student's own awareness of the learning process by focusing on knowledge construction rather than product construction. "Information literacy is a way of thinking rather than a set of skills." (Kuhlthau, Caspari & Maniotes, 2012). This method also provides a useful framework for both students and teachers which we find leads to increased fulfillment of curricula. ReferencesKuhlthau, C. C., Caspari, A. K. & Maniotes, L. K. (2007). Guided inquiry: learning in the 21st century. Westport, Conn.: Libraries Unlimited. Kuhlthau, C. C., Caspari, A. K. & Maniotes, L. K. (2012). Guided Inquiry Design: A Framework for Inquiry in Your School. Santa Barbara, California: Libraries Unlimited.
Dialysis versus Medical Management at Different Ages and Levels of Kidney Function in Veterans with Advanced CKD
Authors: Kurella Tamura Manjula , Desai Manisha , Kapphahn Kristopher I. , Thomas I-Chun , Asch Steven M. , Chertow Glenn M.
Published: May 2018

Background Appropriate patient selection and optimal timing of dialysis initiation among older adults with advanced CKD are uncertain. We determined the association between dialysis versus medical management and survival at different ages and levels of kidney function.

Methods We assembled a nationally representative 20% sample of United States veterans with eGFR<30 ml/min per 1.73 m2 between 2005 and 2010 (n=73,349), with follow-up through 2012. We used an extended Cox model to determine associations among the time-varying exposures, age (<65, 65–74, 75–84, and ≥85 years), eGFR (<6, 6–<9, 9–<12, 12–<15, and 15–<29 ml/min per 1.73 m2), and provision of dialysis, and survival.

Result Over the mean±SEM follow-up of 3.4±2.2 years, 15% of patients started dialysis and 52% died. The eGFR at which dialysis, compared with medical management, associated with lower mortality varied by age (P<0.001). For patients aged <65, 65–74, 75–84, and ≥85 years, dialysis associated with lower mortality for those with eGFR not exceeding 6–<9, <6, 9–<12, and 9–<12 ml/min per 1.73 m2, respectively. Dialysis initiation at eGFR<6 ml/min per 1.73 m2 associated with a higher median life expectancy of 26, 25, and 19 months for patients aged 65, 75, and 85 years, respectively. When dialysis was initiated at eGFR 9–<12 ml/min per 1.73 m2, the estimated difference in median life expectancy was <1 year for these patients.

Conclusions Provision of dialysis at higher levels of kidney function may extend survival for some older patients.
A Tale of Two Sectors: Why is Misallocation Higher in Services than in Manufacturing?
Authors: Dias Daniel A. , Marques Carlos Robalo , Richmond Christine
Published: May 2018

Recent empirical studies document that the level of resource misallocation in the service sector is significantly higher than in the manufacturing sector. We quantify the importance of this difference and study its sources. Conservative estimates for Portugal (2008) show that closing this gap, by reducing misallocation in the service sector to manufacturing levels, would boost aggregate gross output by around 12 percent and aggregate value added by around 31 percent. Differences in the effect and size of productivity shocks explain most of the gap in misallocation between manufacturing and services, while the remainder is explained by differences in firm productivity and age distribution. We interpret these results as stemming mainly from higher output-price rigidity, higher labor adjustment costs, and higher informality in the service sector.
Trends in behavioural ecology: Putting South African research in a global perspective
Authors: Le Roux Aliza
Published: May 2018

South Africa remains at the leading edge of scientific publishing on the African continent, yet few analyses of publication patterns exist outside the biomedical field. Considering the large number of protected areas and mammalian guilds within the country, I examined trends in South African ecological research as it pertains to the behaviour of mammals. I assessed the topics and taxonomic focus of mammalogists at South African institutes over the span of 15 years (2001–2015), and contrasted local research with the shifting focus of international behavioural research. This review of more than 1000 publications indicates that South African based researchers exhibit a strong tendency towards field-based research, as opposed to laboratory-centred experiments. In terms of topical focus, local ecologists place significant weight on the behavioural categories of mating, social and foraging behaviour – reflecting a global priority for these topics. This finding contrasts with an increased emphasis on animal cognition and communication research in the international research arena, including field-based studies on these themes. I make suggestions on how behavioural ecologists in South Africa can align themselves with global trends while also continuing to distinguish those facets that make South African behavioural ecology unique.
Significance:

This review is the first of behavioural ecology in South Africa.
Suggestions are made for where South African researchers can profitably shift research focus.
International trends in behavioural ecology are highlighted.
Computed tomography angiography in the diagnosis of arteriovenous malformations
Authors: Merhemic Zulejha , Lincender Lidija , Guso Emir , Bicakcic Emina , Avdagic Edin , Thurnher Majda M
Published: May 2018

Introduction: The most common cause of intracranial bleeding in younger patients and children are vascular anomalies. Digital subtractions angiography presents a gold standard in diagnostics of aneurisms and vascular malformations. Our aim is to present our experience in using computed tomography angiography in diagnosing arteriovenous malformations.

Methods: We included 150 patients with acute non-traumatic intracranial hemorrhage diagnosed by non-contrast CT examination, after which they were subjected to CT angiography of the cerebral vessels, and then underwent maximum intense projection and volume rendering reconstruction.

Results:  Out of 150 patients with non-traumatic intracranial hemorrhage, in 121 (81%) a diagnosis of  aneurysm was rendered, while in 8 (5%) arteriovenous malformation was found. In 29 (14%) patients cause of bleeding was not identified. Patients with arteriovenous malformations, were age 17-77 years, with mean age 42.75 years. Five (62.5%) of them were female patients and three (37.5%) were male.

Conclusion: Spontaneous non-traumatic intracranial hemorrhage is a significant cause of morbidity and mortality. Computed tomography angiography is sufficiently specific and sensitive in diagnosis of arteriovenous malformations in our experience.
Drugs affecting sleep and wakefulness: a review
Authors: Amar Avishek
Published: May 2018

It was in the second half of the twentieth century that Sleep Medicine was recognized as an immensely respected field of clinical research. As a result, past few decades have seen this field making some giant strides towards a better understanding of the neurochemical mechanisms that regulate the state of sleep and wakefulness. This involves a complex interplay of neuronal systems, neurotransmitters and some special nuclei located in the brain. Major wakefulness promoting nuclei being the orexinergic neurons in the lateral hypothalamic region and the tuberomammillary nucleus (TMN) while the sleep-promoting nucleus being ventrolateral preoptic nucleus (VLPO). Sleep-related complaints are one of the common complaints encountered by the physicians and the psychiatrists. As, long-standing sleep disturbances can have far-reaching implications on an individual’s physical, mental and social wellbeing, the importance of drugs affecting sleep and wakefulness could not be stressed upon anymore. Broadly, the sleep disorders are classified as insomnia, hypersomnia, and parasomnia and the presently available drugs work either by acting on the sleep-promoting GABAergic system like benzodiazepines, barbiturates etc. or by interacting with wakefulness promoting system like histaminergic system, 5- hydroxtryptaminergic system, orexinergic system etc. There are drugs which interact with other mechanisms which modulate arousal, like melatonin receptor agonists which promote sleep and adenosine receptor antagonists which promote wakefulness. This review article tries to have an overview of the available drugs for use in pathological states of sleep and wakefulness with a special emphasis on the commonly prescribed drugs and the recently approved one’s.
A comparative study of efficacy of tadalafil and alfuzosin regimens in patients of benign prostate hyperplasia
Authors: Das Supratik , Singh Harjinder , Kumar Vijay , Singh Jasbir
Published: May 2018

Background: Aim of the study was to compare efficacy of Tadalafil and Alfuzosin regimens in patients of Benign Prostate Hyperplasia.Methods: It was a comparative, prospective, observational, non-invasive, parallel and randomised study conducted at the Outpatient Department of Urology, Rajindra Hospital, Patiala. 60 patients diagnosed with Benign Prostate Hyperplasia along with Lower Urinary Tract Symptoms, out which, 30 patients, consuming Tadalafil and 30 patients consuming Alfuzosin were considered. History regarding the concerned disease and the compliance of treatment was taken. Symptom scores were assessed with the help of International Prostate Symptom Score, Quality of Lifestyle Score and Erectile Dysfunction Score. Physical examination consisting of Focused Neurological Examination along with Digital Rectal Examination were conducted. Parameters like Renal Function Test, Urine analysis, Ultrasound of Prostate and uroflowmetry were also considered.Results: The mean age selected for study was 64 years for Tadalafil and Alfuzosin group. The mean level of IPS Score, Qol Score and ED Score at the first day of inclusion of patients were 23.96±4.49, 4±0.78, and 25.33±4.02 respectively for Tadalafil group and regarding Alfuzosin group they were 25.23±4.84, 3.56±0.81, and 26.1±4.04 respectively. Follow ups were conducted at 15 days, 1 month and 3 months for both the groups which were found to be statistically significant after 3 months and Alfuzosin showed a favourable result.Conclusions: Alfuzosin 10mg given at daily dose was found to have higher efficacy than Tadalafil (5mg).
Evaluation of the antipeptic ulcer activity of the seed extract of sesame (Sesamum indicum) in stress induced peptic ulcers in rats
Authors: Sori Ravi K. , O. Balaji , Adiga Shalini , Thomas Huban
Published: May 2018

Background: The peptic ulcers can be developed inside the inner lining of the stomach (gastric ulcer) or the small intestine (duodenal ulcer). Around 10% population of the world is suffering from the peptic ulcer disease. From the ancient times there is a reference about herbal extracts like Sesame indicum for the treatment of various diseases. The aim of the study is Evaluation of the anti-peptic ulcer activity of the seed extract of sesame (Sesamum indicum) in stress induced peptic ulcers in rats.Methods: The study was carried out by stress-induced ulcer model in wistar rats. The antiulcer activity of S. indicum (0.5, 1mg/kg p.o. for 7 days) was compared with standard drugs (pantoprazole). The studied parameters were mucin content, gastric volume, pH, total acidity, free acidity, ulcer index, size and number.Results: The low and high dose of S. indicum extract significantly reduced gastric mucosal lesion, mucin content, volume of gastric juice, gastric pH, free and total acidity when compared to positive control group. The high dose of S. indicum extract showed comparable results in parameters like effect on mucin content, gastric volume, pH, free acidity and total acidity with standard group. The statistical significant changes noted only in ulcer size, number and index.Conclusions: Although the high dose S. indicum (1mg/kg) group showed significant gastric protection against ulcer induced by cold restraint method. However, no clear inference can be drawn at this stage and hence there is a need for further extensive research.
Evaluation of the oral hypoglycemic activity of methanolic extract of Garcinia indica seeds in streptozotocin induced diabetic Albino rats
Authors: Shetty K. Padmaja , H. Pushpa V.
Published: May 2018

Background: Diabetes mellitus is a multifactorial metabolic disorder with several microvascular and macrovascular complications. Several plants have been used as dietary adjuvants to conventional drug therapy. Garcinia indica exhibits significant hypolipidemic and hypoglycemic activity. This study was conducted to evaluate the hypoglycemic effects of methanolic extract of seeds of Garcinia indica on blood glucose levels in Streptozotocin induced diabetic albino rats.Methods: Five groups of wistar albino rats (n=6) weighing 150-200g of either sex aged 3-4 months were obtained for the study. After overnight fasting, streptozotocin (50mg/kg) was administered intraperitoneally to induce diabetes. Five groups are: Group-1: Non diabetic control group, Group-2: diabetic control, Group-3: diabetic standard, Group-4: test group, Group-5: half of test + half of standard. Fasting blood sugar was estimated on 1, 3, 7, 14 and 28th day by capillary blood glucose method. The data obtained were subjected to statistical analysis.Results: In this study, following Streptozotocin administration the blood glucose levels increased in all groups on day 0. In group 2, blood glucose level gradually increased to 445.6±1.75mg/dl over a period of 4 weeks. Following glibenclamide administration in Group 3 - there was a gradual reduction in blood glucose levels: 269.8mg/dl - day 7 to 101.8mg/dl - week 4. Group 4 - persistent and significant (p<0.05) fall in blood glucose levels reaching upto 107mg/dl at the end of 4 weeks. Group 5 - 330mg/dl on day 1 which significantly (p<0.05) reduced to 101mg/dl on day 28. There was improvement in weight in group 4 and group 5 diabetic rats.Conclusions: The extract alone and in combination with glibenclamide showed significant hypoglycemic activity in comparison to diabetic control group.
Analysis of adverse drug reactions encountered in a tertiary care hospital: a cross sectional study
Authors: F. Syed Hussain , V. Sathyanarayanan , R. Jamuna Rani
Published: May 2018

Background: Adverse drug reactions are due to hazards of drug therapy and can occur with any class of drugs. The aim of this study was to evaluate and record adverse drug reactions reported from various departments of a tertiary care hospital.Methods: A Cross Sectional study conducted in a tertiary care hospital for a period of 4 months from March to June 2017 after Institutional Ethics Committee approval. ADRs reports collected and analyzed for causality, severity and preventability by international standardized scales.Results: A total of 38 ADR’s were reported during the study period with male predominance (58%). Most of the ADR’s (42%) were common in patients in the age group 19-39 years. More number of ADR’s were from Medicine (29%). Most commonly affected organ systems were skin (45%). The drugs mostly accounted were antibiotics (55%) especially Cephalosporins (33%). According to Naranjo’s causality assessment scale 74% of reactions were probable, 26% were possible, Modified Hartwig and Seigel severity assessment scale revealed 45% ADRs to be moderate, 42% were mild and 13% were severe, Modified Schumock and Thorton Preventability assessment scale which revealed 61% ADRs were not preventable, 32% were probably preventable,7% were definitively preventable.Conclusions: Adverse Drug Reactions are common and some of them resulted in increased healthcare cost due to need of some interventions and increased length of hospital stay. The health system should promote the spontaneous reporting of ADR’s. The proper documentation and periodic reporting to Pharmacovigilance Centres is required to ensure drug safety.
A case series on drug induced hyponatremia: uncommon adverse effect of commonly used drugs
Authors: Joshi Harsh M. , Gupta Sapna , Malhotra Supriya , Patel Pankaj
Published: May 2018

Older patients suffering from depression and psychosis have markedly increased since last decade. So, has the use of antidepressants and antipsychotics. The prevalence of hyponatremia due to these drugs is common in general as well as psychiatric practice. It may also lead to life threatening morbidity and mortality. Loss of renal function, polypharmacy, dementia and other conditions of advanced age can either exacerbate the severity of hyponatremia or mask its onset. In this case series, total four cases were reported of hyponatremia and drugs causing it were escitalopram, quetiapine, tianeptine and oxcarbazepine. Due to polypharmacy, a chance of hyponatremia was more in these patients. Patients received infusion of hypertonic saline with salt added diet to treat hyponatremia. Symptoms of hyponatremia were improved after the treatment. In all four cases, WHO and Naranjo’s causality assessment revealed ‘possible’ causal relationship with the prescribed drug. Prescribers should be aware of such adverse effect due to these drugs.
Study of serum uric acid level as a prognostic marker in acute ST elevation myocardial infarction patients
Authors: Behera Suresh Kumar , Samal Akshaya Kumar
Published: May 2018

Background: The study was conducted to correlate serum uric acid levels with Killip class i.e. severity of heart failure in patients with ST elevation myocardial infarction (STEMI) and to assess any influence of serum uric acid levels on in-hospital mortality in STEMI patients.Methods: Authors evaluated 250 consecutive (STEMI) patients who were hospitalized within 24 hours of symptom onset from September 2015 to august 2017. Detailed history, physical examination was done as per a structured proforma and necessary laboratory investigations were done.Results: There was significant difference in mean serum uric acid level between diabetic and non-diabetic population. There was significant difference in mean uric acid level between hypertensive and non-hypertensive population. Serum uric acid level was high among STEMI patients with Killip class III and IV and low among patients with Killip class I and II. The higher the uric acid level was, the higher was the percentage of mortality during 5 days hospital course.Conclusions: Patients of higher Killip class had higher levels of serum uric acid as compared to patients of lower Killip class. Serum uric acid level when combined with Killip class is a good predictor of severity of heart failure and short-term mortality after STEMI.
Bone marrow profile in hematological disorders: an experience from a tertiary care centre
Authors: Bashir Nusrat , Musharaf Bilal , Reshi Ruby , Jeelani Tazeen , Rafiq Danish , Angmo Dekyong
Published: May 2018

Background: Bone marrow aspiration and trephine biopsy are two most important techniques which are complementary for diagnosing both neoplastic and non- neoplastic haematological diseases. The present study was conducted in the department of pathology to compare the role of bone marrow aspirate and trephine biopsy for diagnosing the haematological diseases.Methods: The study was conducted in the department of pathology government medical college Srinagar over a period of 2 years from Feb 2016 to Jan 2018. The study was one-year retrospective and one year prospective. Bone marrow aspiration was done in 626 cases out of which biosy was done in 300 cases.Results: Out of the selected 300 cases were both aspiration and trephine biopsy were available, diagnostic material on bone marrow aspirate was adequate in 288 cases. 12 cases were aparticulate. Biopsy was inadequate in 8 cases. Overall megaloblastic anaemia (26.6%) was most common followed by dual deficiency anemia. Multiple myeloma was the most common neoplastic pathology (13%) followed by followed by acute leukaemia’s (6%) and Chronic lymphoproliferative disorders (CLPDS) (5%). 1 case each of visceral leishmaniasis and malarial parasite were also noted. 4 cases (1.3%) of granulomatous pathology and 2 cases (0.6%) of Hodgkins lymphoma were diagnosed exclusively on bone marrow biopsy.Conclusions: Bone marrow aspiration and biopsy are complimentary to each other in diagnosing hematological disorders with biopsy being gold standard in the assessment of cellularity, pattern, extent of tumor infiltration and focal infiltration. It is more helpful in diagnosing granulomatous pathology and metastatic deposits of tumors eliciting fibrotic response.
Effect of anti-tuberculosis treatment on thyroid profile in newly detected smear positive pulmonary tuberculosis cases
Authors: Varghese Vimi , Menon K. Surendra , Green Siva Ranganathan
Published: May 2018

Background: Tuberculosis being a systemic disease and has a capacity for wide spread dissemination. Present study aims to identify the effects of antituberculous treatment on thyroid profile in new smear positive pulmonary tuberculosis cases.Methods: This study was conducted among 60 new smear positive pulmonary tuberculosis cases attending pulmonary medicine OPD from May 2015 to April 2017. Thyroid function test in the form of free T3, free T4 and TSH was measured before initiating Anti tuberculosis treatment (ATT), at 3 months and at the end of 6 months.Results: Out of 60 patients enrolled in present study, majority were males. Diabetes mellitus was the major co morbidity. Sick euthyroid was found to have decreasing trend during the course of treatment, and hypothyroidism was found to be increasing trend end of 6 months.Conclusions: The common Thyroid Dysfunction seen during the study period was Hypothyroidism and Sick euthyroid. Anti-tuberculous medication preferably Rifampicin probably would explain the cause for these thyroid dysfunctions noticed during the study time. And those patients with significant hypothyroid need to started on thyroid supplements. Among the drugs used for treatment, rifampicin was probably the cause for thyroid dysfunction noticed during the course of treatment. Hence, authors recommend that these patients should be started on thyroid supplements after the diagnosis of significant hypothyroidism.
Profile, types, duration and severity of muscular dystrophy: a clinical study at a tertiary care hospital
Authors: P. Viswajyothi , M. V. Rambabu
Published: May 2018

Background: The cause of muscular dystrophies is genetic. It is a disorder of muscular system. The classification of the muscular dystrophies is based on the signs and symptoms. Present study was done to evaluate the profile, types, duration and severity of muscular dystrophy at a tertiary care hospital.Methods: A hospital based cross sectional study was carried out at department of General Medicine, Malla Reddy Institute of Medical Sciences, Hyderabad from October 2015 to December 2017. During the study period, it was possible to study the 20 cases of muscular dystrophy.Results: Muscular dystrophy was more common in males. Maximum cases were of Duchenne type of muscular dystrophy. Majority of the patients presented at 5-10 years of age. Muscular dystrophy was seen in early childhood. Out of 10 patients of Duchenne muscular dystrophy five patients were of grade I. There was no correlation between the duration of the disease and the severity of the disability. All patients had lower limb proximal weakness. Pathological Q wave (width > 30 ms) and Pathological Q wave (depth >more than 25% of the QRS amplitude) were present in 35% of the cases. All patients had rhythm NSR and QRS +60 to +75. Conduction abnormality was present in 5% of the cases. In half of the patients, serum creatinine kinase levels are moderately elevated.Conclusions: Muscular dystrophies are a common disorder of the childhood. Detailed studies will help to focus more light on this condition to improve outcome in future patients.
Correntional study of the health-related quality of life, chronic obstructive airway disease in Northern India, New Delhi
Authors: Ghilley Ved Prakash , Bhadoria D. P. , Pandit Sanjay
Published: May 2018

Background: The Global Initiative for Chronic Obstructive Lung Disease (GOLD) defines chronic obstructive pulmonary disease (COPD) as “a disease state characterized by airflow limitation that is not fully reversible. Due to progressive airflow limitation, the patients become increasingly symptomatic leading to worsening in their health-related quality of life (HRQOL). Objective of present study was to examine that correlation of health related quality of life with the chronic obstructive pulmonary disease.Methods: One hundred twenty consecutive stable COPD patients (diagnosed as per GOLD guidelines), without any co-morbid conditions (diabetes, congestive heart failure, coronary artery disease, hypertension) were recruited in this study after intuitional ethical clearance and informed consents. The health-related quality of life (HRQOL) was assessed using Hindi SGRQ-C. Forced expiratory volume in first one second (FEV1), forced vital capacity (FVC) and FEV1/FVC% and reversibility were measured using Spirolab III (Medical International Research USA, Inc.). The descriptive and the Pearson’s correlation coefficient were done in data treatment with SPSS version 20.Results: The component of SGRQ scores were as follows: Symptom score: 31.27±14.6 (range 2.3-64); Activity score: 59.01±23.08) (range 0-100); Impact score 42.19±22.25 (range 0-88.8) and the total score was = 45.34±17.96 (range 1.1.-88.6). There were significant negative correlations between all the parameters of SGRQ and FEV1% predicted (i.e. with lower FEV1% parameters of SGRQ will be high).Conclusions: Indian patients with COPD show significantly reduced HRQOL as measured by disease specific questionnaire SGRQ, similar to COPD patients in other countries. In our study, only FEV1 % predicted was significantly correlated with HRQOL, all other measures including GOLD staging were not significantly associated with HRQOL.
Epidemiological profile and predictors of mortality in acute coronary syndrome: a prospective study
Authors: Sarkari Madhavi , Jaiswal Mukesh
Published: May 2018

Background: India has shown a rising trend in the prevalence of coronary artery disease (CAD) in urban as well as in rural population. Acute coronary syndrome (ACS) is the main reason for the mortality in India. Study of risk factors and biomarkers is important to catch the diagnosis early in order to decrease the mortality. Objective was to study risk factors and brain natriuretic peptide (BNP), troponine I, and CKMB and their effect on outcome in ACS patients in tertiary hospital.Methods: One hundred and fifty ACS patients were studied in Emergency Department of Medicine, Nehru Hospital, BRD Medical College, Gorakhpur from January 2017 to December 2017. Data on age sex socioeconomic status, medical history, baseline clinical characteristics, time to reach hospital and treatment in hospital, along with biomarkers including BNP, Troponin Iand CKMB was estimated. Baseline ECG was obtained at admission and repeated at 12 -24 hours and every 24 hours thereafter. A 2D Echocardiogram was performed within initial 48-72 hours for analysis of LVEF and wall motion abnormalities.Results: Male (58.7%) preponderance was observed with mean age of 60.12±10.58 years. Most of the patients were from rural areas (87.3%) and had hypertension (44.7%). Chest pain was most common symptom (56%). Most of them had duration of symptoms for 6-12 hours (56%). NSTEMI, STEMI and unstable angina were equally distributed between the genders (p>0.05). Out of 150 patients, 15 (10%) were thrombolysed, 78.52% had RWMA. In-hospital mortality was higher; among the patients of age >75 years (38.5%) (p=0.008), male patient (12.5%) (p>0.05), rural patient (10.7%) (p>0.05), hypertensive patient (17.3%) (p>0.05), patients of Killip class IV (48.3%)(p=0.0001) and patients having severe LVD (33.3%) (p=0.0001). In-hospital mortality was 1.2% and 1.1% among those in whom beta blocker and ACE inhibitors was present (p>0.0001). BNP and CKMB was significantly higher among expired patients (1762.62±1444.89 vs 840.76±1294.82; p=0.001) similarly troponin I was significantly higher among expired patients (67.29±45.63 vs 43.99±41.73; p=0.006) than alive.Conclusions: ACS was more prevalent in male, living in fifth to sixth decade of life, had hypertension. STEMI was more common. Patients on ACE inhibitors and beta-blocker had better outcome. Mortality was higher in patients with Killip’s class IV, higher value of troponin I, age more than 75 years and had hypertension and dyslipidemia.
Concurrent hepatitis B and autoimmune hepatitis a rare presentation of acute liver failure: a case report
Authors: Verma Sudhir Kumar , Singh Ajay Pratap , Daga Prachi , Kulraj Seetaram Singh
Published: May 2018

Acute liver failure with concurrent Hepatitis b and autoimmune hepatitis is an extremely rare case. We report a 25 year female presenting to our emergency with fatigue and somnolence, distention of abdomen, jaundice, melena and increased hair loss leading to alopecia. Physical examination revealed jaundice, an enlarged liver, ascites and tenderness of upper right abdomen. Laboratory tests revealed an increased level, bilirubin, GGT, increased INR and prothrombin time with elevated IgG levels, and the presence of anti-smooth muscle antibodies, Anti-nuclear antibodies and HBV infection markers. The patient was diagnosed with liver failure resulting from chronic active hepatitis B with an autoimmune component. The treatment consisted of steroids, azathioprine, vitamin K, low-protein diet and lactulose enemas. After undergoing a molecular test (HBV DNA 3.23 × 10 IU/mL and HBeAg reactive), the treatment was modified by adding tenofovir disoproxil fumarate. After one month the patient was discharged in good clinical condition, with the recommendation of continued tenofovir disoproxil fumarate and prednisone. In subsequent follow-ups, no clinical deterioration or abnormal biochemical liver function test results were found.
Beti bachao, beti padhao programme: a right initiative to save the girl child
Authors: Verma Ramesh , Dhaka Rohit , Agrawal Ginni
Published: May 2018

In world, almost half of the total population made up of women but they still lag behind men in a lot of areas. The skewed child sex ratio is a prime indicator of women disempowerment, lack of value attached to her and disrespect. Over few years, a significant fraction of number of women has been at the receiving end of discrimination and exploitation. The skewed child sex ratio is because of both gender biased sex selection, and post birth discrimination against girls. The proliferation and abuse of advanced technologies coupled with social factors such as dowry, concerns with family name and looking up to the son as a breadwinner. Female feticide resulting in a decline of the child sex ratio has led to enforcement of Preconception and Prenatal diagnostic Techniques (PC & PNDT) act.  On 22 January 2015 at Panipat in Haryana, Prime Minister of India launched the scheme Beti Bachao, Beti Padhao (Save daughters, Educate daughters) programme. The initiative aims to improve the present low child sex ratio and increase the value of girl child by focusing on three pronged strategy for empowerment of girl child.
Emerging market of tobacco
Authors: Datta Dipayan , Ramesh Kumar S. G. , Aswath Narayanan M. B. , Leena Selvamary A. , Sujatha A.
Published: May 2018

Tobacco industry throughout the world started growing larger and larger. Large firms like British American Tobacco, Imperial Tobacco, China National Tobacco Co. etc. have been manufacturing and exporting tremendous amount of tobacco products. But concurrent research works were also growing to investigate the ill impact of tobacco on health and environment. Since the mid-1960s, strong evidence of the lethal effects of tobacco consumption has led to a sharp decline in official support for producers and manufacturers of tobacco. As the industry is struggling with reduction in smoking rates, huge sales taxes and strict regulations in mature markets, developing economies are offering the emerging markets with better prospects. Ideally, interventions that specifically address a market failure should be implemented as the “best” options. As part of moving towards a more sustainable form of globalization, a global enabling environment linked to local actions should focus on the following strategies: global information management; development of nationally and locally grounded action; global regulation, legal instruments, and foreign policy; and establishment of strong partnerships with purpose.
Quality of antenatal care services in selected health facilities of Kaski district, Nepal
Authors: Bastola Pabitra , Yadav Dipendra Kumar , Gautam Himlal
Published: May 2018

Background: Antenatal care service is an evidence based interventions given to the pregnant women. Objective of the study was to assess quality of antenatal care services in selected health facilities of Kaski district, Nepal.Methods: A cross sectional study was conducted in selected health institutions in Kaski district of Nepal during June to November 2017. Two hundred seven participants were selected from health facilities of Kaski district. Structured questionnaires were employed as tool for data collection.Results: This study showed that 50.7 percent respondents waited less than 35 minutes for receiving service. More than half of the total respondents (63.3%) reported that the consultation time provided for them was less than 20 minutes. All respondents reported that weight and blood pressure measurement was undertaken while none of them reported that height was measured. It was found that maximum number of participants (99.0%) were received iron/folate tablets and tetanus vaccination. Similarly, 97.6% of participants reported that they were counselled on nutrition and 96.6% of reported they get counselling on danger signs. In overall, 48.3% of the respondents were satisfied with the services they received and 43% of the respondents received good quality ANC service from different health institutions.Conclusions: In overall satisfaction of antenatal care services was found to be low and more than half of respondent does not received good quality ANC services.
Measles vaccination coverage among children aged (12-23) months in Marawi locality - Northern state, Sudan - 2016
Authors: Osman Wafaa Mubark Mohamed
Published: May 2018

Background: Worldwide measles remains the fifth cause of mortality among children under 5 years. Immunization coverage is the proportion of individuals in the target population who are vaccinated. It is a key measure of immunization system performance. Coverage for measles in Eastern Mediterranean region in 2015 for MCV1 was 85%, and MCV2 was 61%.Methods: A total sample size of 462 mothers was determined according to WHO guidelines regarding coverage survey in (February - July 2016). Data were collected using a prepared and pretested questionnaire, reviewing cards of children, and interview with EPI personnel. Data were analyzed using SPSS version 20, p≤0.05 was considered significant.Results: The majority of the children (96.1%) were vaccinated against MCV1, and (77.4%) were vaccinated against MCV2. Small group of mothers (5.7%) had a negative attitude towards immunization. Most mothers (94.3%) were satisfied with measles immunization services. More than half of mothers (55.7%) wait for <15 minutes to immunize their children. Most of the mothers (62.3%) went to the immunization centers by public transports. The main factors affecting vaccination coverage were: weakness of incentives, lack of means of transport for staff, poor working environment like: shortage of water, furniture and technological materials.Conclusions: The coverage with MCV1 was reaching the WHO elimination standards while the coverage of MCV2 was not; due to many factors that affected the vaccination coverage. The study recommends health education covering all aspects of immunization, improvement of the working environment, and availing outreach centers.
Is internet hampering mental health of medical students: a cross sectional study
Authors: Shinde Rupesh D. , Rajderkar Shekhar S.
Published: May 2018

Background: Internet addiction was first studied in 1996 and findings were presented to American Psychological Association. Recent studies examined the prevalence of Internet addiction and investigated its causes. Internet users in India are around 205 million. Internet usage among medical students is high. Internet addiction has both physical and psychological withdrawal symptoms. This study aims to understand the patterns of internet use and its effects on mental health among medical college students. The objectives of the study were to study the patterns of internet usage among medical college students and to study the depression in them and its relation to internet usage.Methods: Cross sectional study was conducted in government medical college. Taking prevalence of mild internet addiction 34% from previous Indian studies, minimum sample size of 90 was calculated. 23 students of 1st, 2nd 3rd year and internship were randomly chosen for study. Pretested Young’s 20-item IAT scale and DASS 21 questionnaire was used for the study. Statistical analysis was done using percentage and chi square test.Results: Mild internet addiction was found in one third of medical students. Depression is seen in 61% of students with internet addiction.Conclusions: Internet addiction is affecting mental health of medical students.
Microbial contamination of mobile phones in a teritary care hospital
Authors: Anupriya A. , Puhalenthi K. , Keerthi S. Jeya , R. Prethi , V. Hemasri
Published: May 2018

Background: Mobile phones could act as a reservoir of infection which may facilitate patient to patient transmission of microorganisms in hospital settings. Objectives of the study were to screen the mobile phones of health-care workers versus non health care workers for microbial contamination with special reference to methicillin-resistant Staphylococcus aureus (MRSA) and extended-spectrum beta lactamases (ESBL).Methods: This is a cross-sectional prospective study conducted in a tertiary care hospital among 110 swab samples collected from the mobile phones of health care workers versus non health care workers. The study duration was 3 months.Results: 87.3% and 56.4% of the mobile phones of health care workers versus non health care workers yielded growth. Two and more than two types of growth were predominant among both health care workers (56.4%) versus non health care workers (29.1%). Coagulase negative Staphylococcus was predominant followed by aerobic spore bearers and micrococci in the study group.Conclusions: Health-care personnel should practice increased adherence to infection control precautions such as hand hygiene.
Satisfaction among the patients attending the health centres attached to a tertiary care hospital in Gandhinagar, Gujarat
Authors: Jadav Pranay A.
Published: May 2018

Background: There is a need of quality health services in developing countries like India. Uneducated patients are transformed in to educated clients and demands for better services. It is important to measure satisfaction of the patients towards catered health services for betterment of the institute as well as community. The objective of the study was to know the satisfaction of patients attending the OPD of Rural health training centre and urban health training centre of a medical college.Methods: A cross-sectional survey was conducted among people attending the OPD of RHTC and UHTC of a Medical college and they were interviewed by using patient satisfaction survey from.Results: Overall satisfaction was 98% participants in RHTC and 99% in UHTC were satisfied. Almost all patients were satisfied with the behaviour of the doctor, paramedical staff and class 3 workers at RHTC and UHTC (100% in RHTC and 98.5% in UHTC.Conclusions: Overall patient satisfaction was good but based on the statistics; areas which had a void can be corrected by implementing the suggestions given by respondents.
A study of micro vascular complications and associated risk factors in newly diagnosed patients of type 2 diabetes mellitus
Authors: Prakash Bharti , Yadav Laxmi K.
Published: May 2018

Background: Diabetes and its complications are one of the leading causes of death and disability worldwide. The aim of the study is to elucidate the prevalence and associated risk factors of microvascular complication among diabetes mellitus type 2 population of Ajmer, Rajasthan India.Methods: This is the study of 464 newly detected type 2 diabetic people screened for their biochemical parameters, attending outpatient department comprising of 256 male and 208 female. The presence of complications was evaluated by relevant investigations.Results: Microvascular complication namely retinopathy was diagnosed in 344 (74%) of type 2 diabetic patients, neuropathy in 200 (43%), nephropathy in 138 (30%). Linear regression analysis concluded that age, body mass index, duration, family history, stress, glycated haemoglobin (HbA1C), triglyceride and total cholesterol were significantly associated with these vascular complications. Prevalence of microvascular complications increases with age, duration, body mass index (BMI), hereditary and poor glycemic control.Conclusions: Retinopathy and neuropathy were the most prevalent microvascular complication in type 2 diabetic population.
A study on injuries of road traffic accident victims attending a tertiary care hospital, Tirupathi
Authors: P. Shakeer Kahn , N. Bayapa Reddy , C. Chandrasekhar , Altaf Hussain R. , Reddy Jawahar Basha K.
Published: May 2018

Background: Rapid motorization bought a boon along with the curse of road traffic accidents toll. Injuries and deaths due to road traffic accidents (RTA) are one of the major public health problems across the globe especially in developing countries due to lack of comprehensive legislative measures. It will have immeasurable impact on the families affected by RTAs.Methods: A hospital based, cross sectional study with victims of road traffic accidents admitted in S.V.R.R. Government General Hospital, Tirupathi, as study subjects was done during June 2013 to May 2014 for one year where 820 victims of road traffic accidents were interviewed after taking prior consent using a predesigned questionnaire.Results: External injury was seen in almost all cases (97.9%) and 61.5% suffered grievous injury. Laceration, fractures and abrasion are the most common types of injuries found. Regarding anatomical sites, head injury is the commonest (68.8%). Majority of the victims suffered grievous injury during 6AM to 12 PM (66.2%). The proportion of grievous injury was most commonly found in victims who were hit by Unknown vehicle (84.6%).Conclusions: Road side medical assistance by their timely action can prevent the toll of RTA fatalities and disabilities. Studies on injuries help in developing improved personal protective gear and safety measures inside the vehicles through novel engineering technology.