bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk factors that associated with visual outcome of community based cataract surgery
Authors: Novita Hera Dwi , Wahyuningsih Eka Rahmawati
Published: July 2020

Background: Cataract is one of the leading cause of blindness in Indonesia and worldwide. Meanwhile the ability to carry out cataract surgery was not balanced by the increasing of cataract backlog of ± 70,000 per year. In addition to increase the number of cataract operations, it is very important to maintain the quality of surgery results by auditing the result of surgery. This study aims to evaluate post-operative visual acuity in social services organized by the Cataract Blindness Prevention Section of IOA Malang Branch in 2015-2017.Methods: This study is a retrospective study based on medical record data of cataract patients underwent cataract surgery at a social service organized by the Cataract Blindness Prevention Section of IOA Malang Branch in January 2015 - December 2017 period. Data collected included demographic data, preoperative and postoperative visual acuity, type cataract surgery, and intraoperative complications.Results: Cataract surgery carried out from 2015-2017 was 1,662 surgeries with 965 male patients (58.06%). Visual acuity before surgery was 1/300 in 583 patients (35.08%). The most cataract surgery procedure performed was SICS (60.17%). Vitreous prolapse was the most common complication found. There was a significant association between age and type of cataract surgery, with postoperative vision (p <0.05, α = 5%). From the analysis, the progress of post-operative visual acuity was found in 85.93% of patients and the results were significant (p <0.05, α = 5%).Conclusions: Cataract surgery may provide significant visual improvement that elevates vision and quality of life for patients.
A comparative study to assess drinking expectancy and functioning in alcohol dependent patients with and without co-morbid depression
Authors: Mani Anu Mary , Srinivasan K. , Sreedaran Priya
Published: July 2020

Background: Alcohol dependence syndrome (ADS) and major depressive disorder are highly prevalent. Much less is known about the expectancy of alcohol use in depressed patients with ADS. Few studies had compared the expectancy of alcohol use in ADS patients with and without co-morbid depression. Assessing the above factors may help to formulate effective prevention strategies. This study was designed to assess the difference in expectancy of alcohol use and functioning in patients with ADS with and without co-morbid depression.Methods: The difference in expectancy of alcohol use in 96 alcohol dependent patients, of which 24 had co-morbid depression and 72 without co-morbid depression was studied using drinking expectancy questionnaire. In addition, we compared the difference in functioning between the two groups using GAF.Results: Prevalence of depression in alcohol dependent patients was 25%. ADS patients with co-morbid depression had less expectancy about alcohol use for sexual enhancement and had lower level of functioning compared to ADS patients without depression.Conclusions: Less expectancy on sexual enhancement in patients with ADS and co-morbid depression could be possibly due to reduced libido in depressed patients. The observed lower functioning in ADS patients with co-morbid depression despite no difference in severity of alcohol use may be possibly explained by the added burden of both the diseases.
Pattern of alcohol use and drinking antecedents in alcohol dependent patients with and without co-morbid depression: a comparative study
Authors: Mani Anu Mary , Srinivasan K. , Sreedaran Priya
Published: July 2020

Background: Few studies have compared the pattern of alcohol use in Alcohol dependence syndrome (ADS) patients with and without co-morbid depression. Assessing the pattern may throw light into prevention of relapses more effectively in alcohol dependent patients with co-morbid depression. This study was undertaken to assess the difference in pattern of drinking of alcohol in patients with alcohol dependence with and without co-morbid depression.Methods: A descriptive comparative study was designed to compare the difference in pattern of alcohol use in alcohol dependent patients with co-morbid depression and without co-morbid depression. Severity of dependence on alcohol was assessed using Alcohol Use Disorders Identification Test (AUDIT). Drinking pattern was assessed using Timeline Follow back Calender and Drinking Pattern Questionnaire. The data were statistically analysed.Results: Total 96 alcohol dependent patients (24 had co-morbid depression and 72 without co-morbid depression) were included in the study. There were no significant differences in alcohol use in both the groups in terms of AUDIT scores, amount of drinking, abstinence days or binge drinking. More frequent drinking was observed in circumstances related to emotional, physiological, financial and children related situations in patients with co-morbid depression (p<0.05).Conclusions: Drinking circumstances like emotional, physiological, financial and children related situations require more attention while assessing, treating and aiming at relapse of prevention in ADS patients with co-morbid depression.
A study of expressed emotion, perceived stress and socio-demographic profile in patients of dissociative disorder
Authors: Singh Nitesh Kumar , Gupta Pankaj , Yadav Jai Singh
Published: July 2020

Background: Dissociation is understood as one of coping mechanism to deal with intense stressors. Individuals vary widely in their subjective response to a similar stressful event depending on number of factors including their family and social support system. So, authors tried to study the expressed emotion in patients of dissociative disorder along with other socio-demographic factors and its relation with perceived stress.Methods: This cross-sectional descriptive study was done on 100 patients with primary diagnosis of dissociative disorder. Hamilton depression rating scale (HAM-D) was used to assess comorbid Depressive symptoms and Hamilton anxiety rating scale (HAM-A) was used to asses comorbid anxiety symptoms. Perceived stress scale (PSS) was used to assess the perception of stress. Family emotional involvement and criticism scale (FEICS) was used to measure perceived criticism (PC) and intensity of emotional involvement (EI).Results: Mean perceived stress in this study was 25.8. Mean score for perceived criticism (PC) was 16.5 and emotional involvement (EI) was 15.7. Both measures of expressed emotions were significantly higher in females and subjects belonging to joint families and rural area. In this study perceived stress by subjects was significantly (p=0.001) correlated to perceived criticism (Pearson r = 0.78) and emotional involvement (Pearson r = 0.77).Conclusions: High perceived criticism and emotion over involvement of family member was associated with perceived stress in dissociation patients.
Menstrual knowledge associated with adolescent’s attitude of intellectual disability on facing menstruation in Bantul, Indonesia
Authors: Yati Dwi , Lutfiyati Afi , Riyadi Sujono , Hafiz Abdul
Published: July 2020

Background: Menstruation is an important event in puberty as a biological sign of sexual maturity for young women. Adolescent with intellectual disability has the same stage of biological development as normal adolescent. Menstruation often causes many problems such as menstrual pain, emotional changes and menstrual personal hygiene (such as: using sanitary napkins). It causes a lot of negative reactions and anxiety. The phenomenon that has often happened in community is feeling taboo to discuss menstrual problems, so that adolescents are not well informed. Objective of this study was to determine the association between menstrual knowledge with adolescent’s attitude of mental retardation (intellectual disability) on facing menstruation.Methods: This research is a descriptive analytic with a cross-sectional study. It was conducted at SLB Masudi Putra I and II Bantul, in August to October 2018 with intellectual disability adolescents who experienced menstruation, those were 39 respondents. Data collection is done by using a questionnaire. Bivariate analysis was done by the Spearman rank test.Results: The results of this research indicate that the percentages of adolescent’s knowledge of intellectual disability on facing menstruation were in medium category of 16 respondents (41.0%), and adolescent’s attitude of intellectual disability on facing menstruation mostly were negative of 24 respondents (61.5%) with p-value 0.001 (p<0.05 ) and the correlation coefficient (r) is positive at 0.495. It shows that there is an association between menstrual knowledge with adolescent’s attitude on facing menstruation with the closeness of the correlation in medium category.Conclusions: There were an association between menstrual knowledge with adolescent’s attitude of intellectual disability on facing menstruation at SLB Marsudi Putra Bantul with p-value 0.001 (p<0.05).
Study of prognostic importance of hs-CRP levels in acute stroke patients coming to Theerthanker Mahaveer Medical College, Moradabad, Uttar Pradesh, India
Authors: Banthia Bajranglal , Shakir Saad Mohammad
Published: July 2020

Background: Stroke has been found to be the fourth most fatal cause of death around the globe. Decreased activity and physical work are the major causes of increased incidences of stoke worldwide. It has also been studied that elevated levels of high-sensitivity C-reactive protein (hs-CRP) have been related to vascular inflammation whereas CRP is an important biomarker of systemic inflammation. Aim of this study to measure serum high-sensitivity C-reactive protein (hs-CRP) levels in the patients presenting with stroke, and evaluating its correlation as a prognostic marker in stroke patients.Methods: It was an observational prospective hospital-based case study carried out at Teerthanker Mahaveer Medical College and Research Centre, a tertiary care hospital situated in Moradabad, India for 5 months period from 1st November 2018 to 31st March 2019. 100 patients of new-onset stroke were included in the study.Results: According to the Scandinavian score, the majority of the patients who had ischemic stroke depicted a score range from 2-8. On the other hand, the majority the patients with hemorrhagic score had a Scandinavian score >14. The mean hs-CRP, when observed between different ranges of the Scandinavian score, showed that in 2-8 range the mean hs-CRP was 31.49±15.00, the mean hs-CRP for 9-14 range was 7.99±6.32 and the mean hs-CRP for >14 range was 7.10±0.32.Conclusions: It can be identified that levels of hs-CRP can be used as a marker to predict the long term prognosis of patients with stroke. In addition to this, it can also be identified that patients with higher levels of hs-CRP have lower Scandinavian score and the patients with lower hs-CRP levels have a higher Scandinavian score. Also, the results show that patients with ischaemic stroke have higher hs-CRP levels as compared to hemorrhagic stroke.
Morphological evaluation of the humeral length and application as indicator of sexual dimorphism among Southern Nigerian children
Authors: Omotoso Dayo R. , Akinshipe Felix O.
Published: July 2020

Background: This study was carried out to evaluate humeral length among children in Southern Nigeria and to describe its sexual dimorphism among study population.Methods: This study involved 450 children (230 males and 220 females) between 3-14 years old in Southern Nigerian.  The humeral length was measured as distance between lateral epicondyle distally palpated when elbow was flexed to 90 degrees and acromion proximally palpated lateral end of clavicle. Definitive right and left humeral lengths (RHL and LHL) were derived by subtracting 2.5 mm from measured length. Average values of RHL and LHL were evaluated as morphological humeral length (MHL) for each subject. Data were analyzed using IBM-SPSS version 20 and statistical comparisons done using t-test with p < 0.05 regarded as level of significant difference.Results: In all age groups, non-significant bilateral variation was observed with the RHL higher than the LHL among both male and female subjects. In addition, the results showed significant (p<0.05) sexual dimorphism in all age groups with mean±SEM of MHL among 3-6 years old higher in females (19.45±0.81) than in males (18.63±0.83).  However, the reverse was observed among higher age groups with mean±SEM of MHL in 7-10- and 11-14-years old males (24.43±0.95 and 28.75±0.94) significantly higher than in 7-10 years old and 11-14 years old females (22.85±0.91 and 26.73±0.84) respectively.Conclusions: Based on findings of this study, humeral morphometrics particularly the humeral length can be applied as a significant indicator of sexual dimorphism among the study population.
Evaluating the relationship between serum uric acid levels with Killip classification suggestive of left heart failure in acute myocardial infarction
Authors: Gosar Piyush , Sonwani Sutakshee , Gosar Pravi , Rani Bhawana
Published: July 2020

Background: Present evidence shows that increased uric acid level is a negative prognostic factor in patients with moderate to severe heart failure. A study has highlighted a correlation between serum uric acid levels and Killip class in patients of acute myocardial infarction (AMI). Aim of this study the relationship between serum uric acid level and Killip classification in patients with AMI.Methods: Sixty patients with AMI were studied prospectively in Department of Medicine/ Department of Cardiology, JA Group of Hospitals between 2016-2018. Patients were grouped based on the Killip class. Age, sex, history of smoking, alcohol consumption, hypertension and diabetes were recorded. Serum uric acid level were measured on Day 1, 3 and 5, which was compared with Killip class.Results: Majority of the patients were males (65%) and had age between (28.3%) 51-60 years. No significant association was obtained between any risk factors of AMI and Killip’s class (p>0.05). Serum uric acid levels were significantly higher in Killip grade III (7.80±3.57) as compared to Killip’s grade II (6.64±2.88) and I (6.30±2.33) (p=0.014). Majority of the patients with Killip’s grades I and II, had uric acid level ≤7.0 mg/dl (n=18 and n=9 respectively) (p=0.040). Serum uric acid was equally distributed among different types of killip’s grades between patients who expired and survived. (p>0.05).Conclusions: Serum uric acid levels has been found to be well correlated with Killip classification in patients with AMI. Combination of Killip class and serum uric acid level after AMI is a good predictor of mortality after AMI.
Evaluation of the diagnostic utility of leucocyte in comparison to other biomarkers in the management of patients with pulmonary tuberculosis
Authors: Ibeh Nancy C. , Ibekie Adaora G. , Amilo Grace I. , Manafa Patrick C. , Chukwuanukwu Rebecca O.
Published: July 2020

Background: Pulmonary tuberculosis (PTB) is an infectious and debilitating disease that affects millions of people each year. Simple, reliable and cost effective biomarkers are vital to fore-stall the morbidity and mortality that is hallmark of the infection especially in resource poor economy.Methods: This comparative study enlisted 140 subjects: 80 had PTB and 60 do not. Blood of 8mls was collected; 3mls in K2-EDTA for FBC testing with XE-2100 Sysmex and ESR by Westergreen method. The remainder was used for serum CRP assay by ELISA. The radiological extent was determined from Chest X ray report and disease severity using modified Bandim TB scoring was extracted from the case note. The aim of the study is to investigate the relationship and diagnostic utility between leucocyte with CRP, ESR, radiological extent of disease and disease severity in PTB.Results: Mean Lymphocyte count was lower while TWBC, Neutrophil and Monocyte counts were higher in subjects compared to control (p<0.05). Median CRP, ESR, NLR, NMR and MLR were higher in subjects compared to control (p<0.05), NLR and MLR showed strong positive significant correlation with ESR, disease severity, and radiological extend of disease. NMR (p= 0.00) had a negative correlation with ESR (p<0.05) and inverse correlation with disease severity and radiological extent.Conclusions: This study found NLR, MLR and NMR as a readily, easily available and inexpensive indices that are as efficient and comparable to known biomarkers in PTB infection, therefore could serve as valuable predictive biomarker in areas of high disease burden with weak economy.
Comparison of Friedewald’s formula, modified Friedewald’s formula and Anandaraja’s formula with direct homogenous serum LDL cholesterol method in CHD patients
Authors: P. Brindha Devi , T. Ilanchezhian , D. Sarguru , S. Ayyappan , R. Karnaboopathy , Karnik Aarti , A. Saddam Hussain
Published: July 2020

Background: Elevated serum Low-Density Lipoprotein Cholesterol (LDL-C) concentration is a well-known atherogenic risk factor with a high predictive value for coronary heart disease. An important aspect of the assessment of coronary heart disease risk for a dyslipidemic subject is the estimation of serum Low-Density Lipoprotein Cholesterol (LDL-C). There are many homogenous assays currently available for the estimation of serum LDL-C. Most clinical laboratories determine LDL-C (mg/dl) by Friedewald’s formula (FF), LD-=(TC)-HDL-C)-(TG/5), Modified Friedewald’s formula (MFF), LDL-C=(TC)-(HDL-C)-(TG/6), Recently Anandaraja and colleagues have derived a new formula for calculating LDL-C, AR-LDL-C=0.9 TC-(0.9 TG/5)-28.Methods: It is cross-sectional study. Lipid profile data was collected from known of CHD patients, who had come for lipid profile investigation to the Central Biochemistry laboratory of ACPM Medical College and hospital. LDL-C estimation was done by direct homogenous assay and also calculated using the Friedewald’s Formula, Modified Friedewald’s Formula and Anandaraja’s Formula for assessing and validity of the LDL cholesterol.Results: From the present study, The LDL-FF, MFW and AR are increased with levels of TGL > 200 mg/dl and decreased level of TC < 200 mg/dl seem to interfere with the estimation of Direct LDL cholesterolConclusions: Authors conclude that, LDL-C by direct method is most reliable and sensitive in CHD patients compare with FF, MFW, and ARF.
Comparative assessment of Industrial air pollutant exposure on pulmonary function and respiratory symptoms among primary school children, Kala Amb, Sirmour, Himachal Pradesh, India
Authors: Kashyap Rashmi , Barall Deepesh , Mazta Saligram
Published: July 2020

Background: Outdoor air quality has been connected with the prevalence of allergic respiratory infections in children. The impact of industrial pollution on respiratory health during early years of life in school children is a major concern. Pulmonary function tests can be used to assess the impact of air pollution and the degree of airway reactivity.Methods: A cross sectional comparative study was conducted between Primary school children aged 6 to 10 years in the industrial area and non-industrial area. Structured questionnaire based data was recorded from the students regarding respiratory symptoms. Spirometric parameters recorded were Forced Vital Capacity (FVC), Forced Expiratory Volume at one second (FEV1), Maximal Midexpiratory flow (FEF 25-75%) and Peak Expiratory Flow Rate (PEFR).Results: Data from 102 students from each of the two primary schools revealed mean forced expiratory volume in 1 second (FEV1) as 1.01±0.31 L/sec in industrial area and 1.12±0.34 L/sec in non-industrial area (p=0.01). Four or more episodes of allergic rhinitis in the last year were present in 24/84 (28.5%) children in the industrial area as compared to 8/90 (8.8%) in the non-industrial area (p=0.002). Point prevalence of allergic rhinitis was 36 (35.3%) students in industrial area and 22 (21.6%) students in non-industrial area (p=0.03).Conclusions: Industrial air pollution has impact on the lung function tests of school children in the age group of 6 to 10 years with significant difference in spirometric parameters of FEV1, frequency of episodes of allergic rhinitis and point prevalence of allergic rhinitis.
Treatment of psychological morbidity secondary to benign prostatic hyperplasia: a comparative study
Authors: Alqaralleh Ayman A. , Al Majali Ashraf S. , Jaradat Alen M. , Alnaser Tareq G. , Abo Qamar Maysaa K. , Alkhawaldah Belal A. , Alqaisi Qasem M. , Abdeldayem Mohammad A. , Al Qudah Mohammad A.
Published: July 2020

Background: Authors tend to compare the medical treatment of benign prostatic hyperplasia with the surgical option regarding lower urinary tract symptoms (LUTS) and related psychological morbidity.Methods: A retrospective study of (1614) patients who were managed by either transurethral resection of prostate (TURP) or medical treatment for lower urinary tract symptoms secondary to benign prostatic hyperplasia (BPH) over a period of 5 years between (Sep. 2013 and Sep. 2018) carried out in Prince Hussein Urology Center at Jordanian Royal Medical Services. Patients were classified into two groups, group1 (807 patients) who get a medical option and group 2 (807 patients who underwent TURPs. A comparison between both groups according to the effect of minimizing the psychological morbidities was done over a period of 1-year follow-up after reviewing the patient’s medical records.Results: Ages of the patients for group1 and 2 were (47-68 years), (49-73 years), respectively. There were significant differences at the level of depression, anxiety and psychiatric morbidity pre-treatment between both groups p-value <0.05, and no significant differences after treatment in group 1 regarding these levels, p-value>0.05, but significant differences in the level of improvement after treatment between both groups and in group 2 were found, p-value <0.05.Conclusions: The severity of LUTS and psychological morbidity have a positive relationship and were higher in the pretreatment surgical group, but the effect of TURP was superior to the medical group in the management of this morbidity and its causative (LUTS).
Evaluation of adjunctive analgesia with intrathecal fentanyl along with hyperbaric bupivacaine in spinal anesthesia for elective cesarean section
Authors: Surana Ranu Neelamchand , Jain Trishala
Published: July 2020

Background: Cesarean section (CS) is one of the most common surgical procedures in female patients. Authors aimed to evaluate the postoperative analgesic efficacy of adding intrathecal fentanyl to bupivacaine, and its effect on the onset and duration of spinal anesthesia along with its effect on mother and neonate.Methods: Study was performed on 60 cesarean section parturients divided into two groups. Group F received 2 ml of 0.5% hyperbaric bupivacaine (10 mg) plus 0.4 ml fentanyl (20 µg), and Group B received 2 ml of 0.5% hyperbaric bupivacaine (10 mg) plus 0.4 ml of normal saline. The parameters taken into consideration were pain scores, analgesic requirement, hemodynamic stability and side effects.Results: It was found that duration of sensory block was prolonged in fentanyl group (111 minutes vs 86 minutes, p<0.001). Duration of effective analgesia (174.36 minutes vs 127.81; p value <0.001) were also found to be prolonged in Group F with requirement of fewer postoperative analgesics (1.02 vs 2.76, p=0.03). There was not much difference in the occurrence of side effects in both the groups.Conclusions: Addition of fentanyl to intrathecal bupivacaine for cesarean section increases the duration of postoperative analgesia without increasing maternal or neonatal side effects.
Correlation between cytomorphology and acid fast bacilli positivity in tubercular lymphadenopathy in far Western Nepal: a hospital based study
Authors: Shreepaili Ashok , Dhakal Sushil
Published: July 2020

Background: Tuberculous lymphadenitis is the most common manifestation of extrapulmonary tuberculosis. Fine needle aspiration cytology (FNAC) is a valuable tool in diagnosis of tubercular lymphadenitis. The present study aims to determine the prevalence of different cytomorphological patterns in fine needle aspiration cytology of tubercular lymph nodes and their correlation with Acid Fast Bacilli (AFB) positivity on Ziehi-Neelsen (ZN) Staining.Methods: Fine needle aspiration cytology of 274 cases diagnosed as tubercular lymphadenitis over a period of a year were reviewed. Cytomorphological patterns were categorized into three patterns. Pattern I: Epithelioid granuloma without necrosis, Pattern II: Epithelioid granuloma with caseous necrosis and Pattern III: Caseous necrosis only. Fischer Exact test was applied to correlate cytomorphological pattern and AFB positivity.Results: Tuberculous lymphadenitis was most frequent in age group 21-30 years (24.81%). Cervical lymph nodes were the most frequent lymph nodes involved (84.67%). Pattern I was the most common cytomorphological pattern observed (49.3%). Overall AFB positivity was 28.10%. Maximum AFB positivity was seen in pattern III (73.3%).Conclusions: FNAC is the simple, cost effective and minimally invasive tool to diagnose tuberculous lymphadenitis. Study of both cytomorphological pattern and ZN staining for AFB can improve the diagnostic accuracy.
Hearing among children with neurological disorders
Authors: Uju Ibekwe Matilda , Nneka Gabriel Job
Published: July 2020

Background: Neurologic disorders are not rare in our environment but studies determining the hearing of these children are almost non- existent. This study therefore is to determine the prevalence of hearing loss in these children and also determine the care seeking attitude of the parents/guardians concerning the hearing.Methods: A hospital based descriptive study of all children attending the children neurologic clinic of university of Port Harcourt teaching hospital. A semi structured questionnaire was administered to parents / guardians who gave their consent for their children to be recruited into the study. Hearing loss in the children was taken as reported by the parents/guardians. Data collected were then entered into Microsoft Excel and then exported to the IBM Statistical Package for Social Sciences (SPSS) version 20 for statistical analysis.Results: The study comprised 49 children; 29 males and 20 females. Age range was from 8months to 18years.  Age group 1-5 years comprised the majority of the study population. Commonest neurological disorder seen was childhood epilepsy n=27, 55.1%. Prevalence of hearing loss was 26.5%. Children with childhood epilepsy had 15.4% having hearing loss while children with cerebral palsy, autistic spectrum disorder and microcephaly had 50% hearing loss recorded. Maternal illness during pregnancy was significantly related to the hearing loss with a p value = 0.045 and presence of neonatal illness with p value =0.009.  Only 7.7% was formally treated while 92.3% had no form of treatment whatsoever.Conclusions: Childhood epilepsy was the commonest type of neurologic disorder seen while highest point prevalence for hearing loss was in cerebral palsy. Majority of parents/caregivers did not seek medical care concerning the hearing loss neither were there any form of treatment given to the children.
Utility of urine reagent strips in rapid bedside diagnosis of bacterial meningitis
Authors: Patil Nanda , Kanetkar Sujata , Agarwal Garima , Karmakar Supriya
Published: July 2020

Background: Bacterial meningitis is a medical emergency and late diagnosis and treatment can lead to neurological damage and death. For definitive diagnosis of meningitis, laboratory based CSF analysis is required which is based on microscopy, protein and sugar estimation. This requires laboratory set up with experienced pathologist and long turn around time. Hence urinary reagent strips as a semiquantitative method can be applied for CSF analysis. This method can be used where laboratory set up is not available as well as bedside test for early diagnosis of bacterial meningitis. The present prospective study was undertaken to evaluate the utility of urine reagent strips in rapid diagnosis of bacterial meningitis. The aim of the present was to evaluate the role of urine reagent strips in the analysis of cerebrospinal fluid in suspected cases of meningitis.Methods: The prospective study was carried out in the department of pathology in a tertiary care centre for a period of 6 months from September 2018 to February 2019. CSF analysis of suspected cases of meningitis was done with urine reagent strip as well as with standard laboratory method. The results of both were compared.Results: Out of 79 cases of meningitis, 68.35% cases were of bacterial meningitis. The specificity and sensitivity of CSF analysis with reagent strip was 93.33% and 82.35% respectively, for cell count, 94.4% and 88.2% respectively for proteins and 91.3% and 60.2% respectively for glucose.Conclusions: Semiquantitative analysis of CSF sample with urine reagent strips helps in rapid diagnosis of bacterial meningitis and can be useful to facilitate therapeutic decisions in resource constrained settings.
Epistaxis: comparison of chemical cautery with topical vasoconstrictor in adult anterior epistaxis
Authors: Hussain Raj Tajamul , Deeba Farah , Ali Mariya , Ahmad Rauf
Published: July 2020

Background: To compare efficacy of 75% silver nitrate chemical cautery as opposed to topical vasoconstrictor spray (xylometazoline 0.1%) in adult anterior epistaxis.Methods: This randomized controlled trial study was carried out at SMHS Hospital Srinagar from Jan 2019 to Dec 2019. 110 subjects that presented to ENT & HNS emergency with epistaxis and fulfilled the inclusion criteria were selected. Subjects were randomly distributed into two groups. Group-A individuals were treated by cauterization with 75% silver nitrate and Group-B individuals were treated with topical vasoconstrictor spray (xylometazoline 0.1%). All the subjects were reviewed at 1 month and success was determined in terms of control of epistaxis from same side of nose.Results: The mean age of the cohort was 48.5yrs (age range, 17-59). There were total 60 (54.4%) males and 50 (45.4%) females among the cases. Both the groups were comparable as regards the age, sex, duration and frequency of epistaxis. 91.2% cases in Group-A (silver nitrate cautery) and 73.5% cases in Group-B (xylometazoline spray 0.1%) had no further epistaxis at one-month follow-up (p=0.014).Conclusions: Chemical cauterization with silver nitrate is a feasible and safe technique for the treatment of adult anterior epistaxis and is more effective than topical vasoconstrictor spray.
Assessment of cardiac complication in diabetic patient of rural India
Authors: Ahmad E. , Singh A. , Chaudhary R. R. , Sarda M. S.
Published: July 2020

Background: Diabetes mellitus (DM) is a common endocrine disorder affecting approximately 382 million people worldwide. Diabetes mellitus (DM) is group of metabolic disorder in which glucose is underutilized, thus producing hyperglycemia resulting from a defect in insulin secretion, action, or both. Cardiovascular disease is the most common cause of death and disability among people with diabetes. The cardiovascular disease that accompany diabetes include angina, myocardial infarction (heart attack), Stroke, peripheral artery disease and congestive heart failure. In people with diabetes, high blood pressure, high cholesterol, high blood glucose and other risk factors contribute to the increased risk of cardiovascular complications.Method:  This study was conducted to determine the cardiac complication in diabetic patient of rural India. It was Cross sectional retrospective study, done in between period of January 2018 to December 2019.Result: In the present study authors found that   47.7% patients have Coronary artery disease (CAD), Silent 21.6% have myocardial ischemia (SMI), 36% Diastolic dysfunction (DF), 28.8% have Systolic dysfunction (SDF).Conclusion: In this study authors found that wide spectrum of cardiac complications in diabetic patients ranging silent myocardial ischemia to heart failure. CAD was the most common complication including silent myocardial ischemia (SMI) which is the one of the major concern of rural diabetic population which need proper screening by exercise treadmill test.
Housing conditions, knowledge and perceived health effects of indoor air pollution in tribal women of rural Maharashtra
Authors: Shah Anuradha Kunal , Yetalkar Ashwini D. , Kaware Alka C.
Published: July 2020

Background: Dependence on using biomass fuels for cooking and heating leads to Indoor Air Pollution (IAP) which can lead to adverse health outcomes. Aim of this study was to observe the housing and kitchen conditions in households of tribal areas, assess the knowledge of women regarding the IAP and perceived health effects due to it.Methods: Cross-sectional community- based study conducted in 100 women above the age of 18 years in a tribal village. A semi-structured questionnaire was used and spot observations were made. Chi-Square was used to calculate the association between type of stove, housing conditions and health effects of IAP. Logistic regression was used to identify determinants of the health effects of IAP.Results: The mean age of women was 29 years; all houses had a separate kitchen; 34% used mud stove with wood. Easy availability and economic reasons were cited for using wood. 47% of women thought IAP present in their homes and the most common source was cooking. Symptoms like asthma, sweating, burns/rash, and headache had a significantly higher association in women using mud stove (P<0.05) than LPG stove. A strong association was found between cooking hours and health effects due to IAP (P< 0.004).Conclusions: IAP due to cooking and unfavorable housing conditions are associated with health problems in women. Knowledge regarding IAP is poor. Reasons for reliance on using mud stove needs to be addressed.
A study on WHO Frax score to predict fracture risk in predialysis patients of chronic kidney disease
Authors: Manda Ramawtar , Bhargava Shashikant
Published: July 2020

Background: Disturbances in mineral and bone metabolism are prevalent in chronic kidney disease (CKD) and are an important cause of morbidity and decreased quality of life. These disturbances include renal osteodystrophy and CKD-Mineral and Bone Disorder (CKD-MBD). The Frax tool developed by WHO is an attempt to better estimate the fracture risk. It calculates a 10 year probability of osteoporotic fractures of spine, forearm, hip or shoulder based on clinical risk factors with or without BMD measurements.Methods: It is a Cross sectional observational study which was done from 01 November 2013 to 31 March 2015. The study group included 60 cases of pre dialysis Chronic Kidney Disease attending OPD, Emergency or admitted in medicine wards of Dr. RML Hospital, New Delhi. Bone mineral density measured by dual-energy X-ray absorptiometry and all patients were classified according to World Health Organization criteria. DEXA SCAN (manufacturer-Hologic INC.) was done of the lumbar spine, radius bone and neck of the femur. Frax score was calculated as per WHO guidelines.Results: On using the Indian Frax calculator the average 10 year probability for major osteoporotic fractures in stage 4 (9.47±2.62%) was found to be significantly higher (p<0.0001) than that in stage 3 (1.92±0.8%).Similarly, the average 10 year probability for hip fracture in stage 4 (4.61±1.45%) was also found to be significantly higher (p< 0.0001) than that in the stage 3 (0.75±0.49%).Conclusions: The study confirmed the high incidence of low BMD in patients of CKD. The 10 year fracture risk in these patients as predicted by Frax score was significantly higher in CKD patients irrespective of whether the Chinese or the Indian calculator was used.
What is the prevalence of dyslipidemia in patients with idiopathic tinnitus?
Authors: Erdogdu Suleyman
Published: July 2020

Background: Dyslipidemia is a metabolic disorder that results from imbalanced and overfeeding as well as sedentary life. Elevated blood lipid levels can affect cochlear blood flow and fluidity, leading to decreased hearing and tinnitus. We aimed to determine whether there is a relationship between tinnitus and dyslipidemia by investigating the blood lipoprotein values of patients with tinnitus.Methods: The lipid profiles of the patients with idiopathic tinnitus who were selected among the patients who applied to Istanbul Haydarpaşa Numune Training and Research Hospital with the complaint of tinnitus between January 2019 and May 2020 were examined. The test results and age and gender distributions were compared with control groups without tinnitus complaints and statistical evaluation was performed.Results: Hypercholesterolemia in 42% of 6472 patients with idiopathic tinnitus, 18% low HDL, 50% high LDL, Hyperlipidemia was detected in 21%. 1942 (30%) of these patients were male; 4530 (70%) are women. The number of patients in the control group without tinnitus was 6470. Hypercholesterolemia in 49% of this group; 21% low HDL, 42% high LDL, 16% hyperlipidemia was detected. In this control group, 1950 (30%) of the patients were male and 4520 (70%) were female. Cholesterol of male and female patients with tinnutus. When the cholesterol, LDL and triglyceride values of HDL and LDL values and female and male patients in the control group were examined, a statistically significant difference was found (p <0.005). No statistically significant difference was found between HDL values of female and male patients with tinnutus and HDL values of female and male patients in the control group (P> 0.05).Conclusions: There is a statistically relationship between tinnitus and dyslipidemia. The presence of dyslipidemia is vital due to atherosclerosis caused by dyslipidemia, especially coronary artery involvement. Therefore, dyslipidemia should be treated as it causes many diseases.
Life style patterns and adherence to pharmacotherapy after acute coronary syndrome: one year follow up study from a tertiary care center in Kashmir, India
Authors: Najar Zubair A. , Dar Mohd Iqbal , Wani Mohd Iqbal , Lone Ajaz A. , Rather Hilal A. , Alaie Mohd Sultan
Published: July 2020

Background: Acute coronary syndrome is the leading cause of cardiac mortality and morbidity world over. Modification of life style pattern and adherence to pharmacotherapy plays a vital role in primary and secondary prevention of coronary events. This study was aimed at assessing the penetration of life style modifications and adherence to pharmacotherapy after acute coronary event in our population.Methods: Acute coronary syndrome patients enrolled in the study were examined, interviewed and all the demographic and clinical data was recorded at index event and at 3, 6 and 12 month intervals.Results: A total of 260 patients were enrolled in the study and followed for 12 months. Mean age of patients was 55.6±8.27 years. Males 78.6% and females 21.5%. Hypertension was risk factor in 67.7%, diabetes in 26.2%, smoking in 63.8%, BMI ≥25 in 67.3% and family history of coronary artery disease in 8.8% of the cases at index event. Uncontrolled hypertension was observed in 30.11%, 38.63% and 44.88% patients at 3, 6 and 12 months follow up. Uncontrolled diabetes at 3, 6 and 12 months was found in 58.82%, 66.17% and 73.52% patients. 5.42%, 15.06% and 21.08% cases continued to smoke at 3, 6 and 12 months respectively. Drug non-compliance overall was noted in 9.61%, 17.69% and 23.84% cases at 3, 6 and 12 month follow up.Conclusions: This study highlights the under prevalence of modifiable risk factor change in practice and drug non-compliance after an acute coronary event.
The road to good spirits: perceived stress, self esteem and coping skills in patients with alcohol dependence
Authors: Ghorpade Geetanjali S. , Kadam Kranti S. , Angane Amey Y. , Unnithan Vishnu B.
Published: July 2020

Background: Alcohol is the commonest psychoactive substance used by Indians. Stress and self-esteem issues may cause alcohol use as a coping mechanism. The purpose of this study was to analyze the severity of alcohol dependence, gauge levels of perceived stress and self-esteem and study coping skills in patients. It further examined the relations between sociodemographic variables of patients, their perceived stress, self esteem and coping skills as well as duration and severity of alcohol dependence.Methods: Cross-sectional study of 200 patients with alcohol use disorder recruited by complete enumeration technique was undertaken. They were administered a semi-structured questionnaire along with Perceived Stress Scale (PSS-10), Rosenberg’s Self-Esteem Scale (RSES), Coping Inventory for Stressful situations (CISS-21) and Severity of Alcohol Dependence Questionnaire (SADQ). Associations and correlations were examined.Results: Almost half the patients had severe alcohol dependence. Less than one-fourth of the patients had low self esteem. There was a significant negative correlation between self esteem and severity of alcohol dependence as well as duration of alcohol use. Nearly half the patients had high perceived stress. There was a significant positive correlation between severity of alcohol dependence and perceived stress. Majority patients used task oriented coping skills. Patients of alcohol dependence having low self-esteem used predominantly avoidant-oriented coping skills.Conclusions: This study highlights the importance of thorough evaluation and screening in patients having alcohol dependence for self-esteem issues and perceived stress levels. Teaching effective coping skills, supportive psychotherapy and counselling can be effective. Multimodal treatment protocols will effectively lighten the stress caused by alcohol dependence.
High sensitive C reactive protein as an inflammatory indicator in preeclampsia
Authors: Sayyed Anjum A. K. , Pratinidhi Shilpa A.
Published: July 2020

Background: Preeclampsia is one of the most serious complications of pregnancy and one of the leading cause of maternal, prenatal morbidity and mortality. The present study was carried out to estimate serum high sensitive C- reactive protein in both mild and severe preeclampsia as an indicator of inflammation and to correlate Hs-CRP with blood pressure.Methods: A case control study was conducted in the Department of Biochemistry and Department of Obstetrics and Gynecology, MIMER Medical College and Bhausaheb Sardesai Rural Hospital Talegaon Dabhade, Pune. The study group include 50 cases of normal pregnant women, 43 clinically diagnosed cases of mild preeclampsia and 7 cases of severe preeclampsia in second and third trimester of pregnancy. 2 ml venous blood samples was collected from all the study participants for estimation of Hs-CRP by ultra-sensitive immunoturbidometric assay spin react method.Results: There was signiﬁcant increase in the mean serum Hs-CRP levels in normal pregnant women and mild preeclamptic women (p<0.001). Serum Hs-CRP levels were signiﬁcantly higher in severe preeclamspia than mild preeclamptic women (p<0.001). The degree of inflammation increases as HsCRP rises. Hence, present study shows that HsCRP levels increases as disease progresses from mild to severe condition. Significant positive correlations was found between Hs-CRP and Blood Pressure in preeclampsia.Conclusions: In preeclampsia there is an exaggeration of systemic inflammatory response that might induce reactive oxygen species which further induces endothelial dysfunction. This leads to clinical symptoms of hypertension and proteinuria in preeclampsia. Early detection might minimise systemic complications and maternal death due to preeclampsia. Hence, HsCRP may be used as an important indicator of severity of preeclampsia.
Role of comprehensive diabetes care in known diabetes patients from western Mumbai region: an observational study
Authors: Sane Rohit , Mandole Rahul , Amin Gurudatta Anand , Ghadigaokar Pravin , Paranjape Sneha , Gond Bipin , Asnodkar Prajakta , Badre Aarti , Shinde Supriya , Ahmed Amirullah
Published: July 2020

Background: The occurrence of Diabetes Mellitus (DM) has been creating a havoc since past few decades on a global platform. As per available literature, prevalence of DM in Mumbai is around 10%. Comprehensive Diabetes Care (CDC) is a form of Ayurvedic therapy which combines panchkarma and diet management. The present study was planned to evaluate the effectiveness of CDC in patients of DM by analysing changes in body mass index (BMI), body weight, OGTT, HbA1c, etc.Methods: The present study was of retrospective design, conducted at Madhavbaug clinics in western Mumbai. The duration of study was of one year, conducted from October 2018 to September 2019. It included patients diagnosed with type 2 DM i.e. HbA1c>6.5%, who were given CDC therapy.Results: In the present study, out of 183 type 2 diabetic patients, 99 were males (52%), while 84 were females (48%), thus male: female ratio was 1.17:1. On analysing the results of HbA1c in patients who had completed 12 weeks of CDC therapy, it was found that controlled DM status was seen in 109 patients (59%), while uncontrolled DM status was noted in 33 patients (19%) as compared to 102 patients (58%) at baseline.Conclusions: From the findings of the present study, it is clear that CDC is effective in the form of increasing number of euglycemic patients at the end of study period, as well as reduction in all glycaemic and anthropometric parameters, and reducing dependency on conventional medicines.
Clinical profile of dengue fever infection in patients admitted in NC Medical College, Haryana in the year 2019
Authors: Shah Mohd Y. , Shah Faisal Y. , Kitab Ifrah S. , Shah Faizan Y.
Published: July 2020

Background: Dengue infections can result in a wide spectrum of disease severity ranging from an influenza-like illness (dengue fever; DF) to the life-threatening dengue hemorrhagic fever (DHF)/dengue shock syndrome (DSS). The study was aimed to compare the clinical profile of all patients diagnosed with dengue viral infection at NCMC.Methods: This retrospective study included 24 patients infected with dengue virus, aged 19 years to 45 years. Laboratory and haematological data were included.Results Peak of infection occurred in November 2019 and no cases were recorded in October 2019. Common clinical symptoms were fever, joint pains, headache and rash. Common haematological abnormalities were thrombocytopenia. All patients survived. There was no case of dengue hemorrhagic fever or dengue shock syndrome.Conclusions: Significant differences in the clinical profile is possibly because of infection with different serotypes of dengue virus (DENV), concurrent/sequential infection of more than one serotype, and differences in host immune responses associated with host genetic variations.