bluuebunny/crossref_metadata_2025 huggingface dataset:
RELATIONSHIP BETWEEN PARENTAL HISTORY OF TYPE 2 DIABETES MELLITUS WITH THE SYMPATHOVAGAL BALANCE IN YOUNG ADULTS WITH COMPARABLE BMI, STRESS AND PHYSICAL ACTIVITY LEVELS
Authors: S Shakthinag , Sardessai Sandip
Published: March 2020

Background: With the heritability of Type 2 diabetes mellitus adding to the disease burden, it would be ideal to find screening tools to detect early changes that could be present in Euglycemic individuals with a genetic predisposition.

Objective: To study if the parental history of type 2 diabetes mellitus has an association with the time domain, frequency domain and nonlinear basal heart rate variability indices

Methods and material: Thiscross sectional study was conducted in the Physiology department of Goa Medical college over a period of 2 months on 70 Medical students between the age of 18-21 years, with low-moderate stress (PAS 10) and fair physical activity(PAI of American academy of health and fitness). Using an Inco Polyrite D instrument, data collection was done and the RR interval data was analysed using Kubios software for the basal Heart rate variability indices of time domain, frequency domain and nonlinear methods. Data was entered into Excel spreadsheet and analysed using SPSS version 14. Mann Whitney U test was done to test for statistical significance.

Result: The mean age of the sample was 18.94± 0.759 years and out of the 70 subjects who had participated in the study 36 (51.4%) subjects had a positive parental family history of type 2 diabetes mellitus while 34 (48.6%) subjects did not. Significant changes were observed in the LF (nu), HF (nu) and LF/HF ratio. A significantly higher LF.n.u (p value - 0,008) and LF/HF (p value- 0.008) was observed in group with family history and a significantly lower HF.n.u ( p value – 0.007)was observed in the same group. No other significant changes were observed in time domain and non linear indices.

Conclusion: Frequency domain HRV may be useful as a predictive index for diabetes mellitus. The presence of higher sympathetic activity and lower parasympathetic activity in individuals (with comparable stress level, BMI, physical activity) having a positive parental history of diabetes mellitus might indicate an underlying autonomic imbalance

Keywords: Diabetes, Family history, Heart rate variability, HRV, parental history, Sympathovagal balance
KNOWLEDGE, ATTITUDE AND PRACTICES ABOUT CONTRACEPTIVE AMONG REPRODUCTIVE AGE GROUP FEMALES
Authors: Beer Sunita Kumari , Aseri Sapna
Published: March 2020

Background: India is the second most populous country in the world having a rapidly growing population which is currently increasing at the rate of 16 million each year.

Methods: A cross sectional study was conducted on females between 15-45 years served as inclusion criteria, while unmarried females were excluded. The women interviewed were informed of the study and consent was taken. The participation was on voluntary basis. Questions regarding factors responsible for non use of contraception were also asked.

Results: Out of 100 women, 68 (68.00%) had knowledge about family planning. 63.00% knew about condom, followed by OCPs & other methods. Contraceptive usage in our study was 62.00%.

Conclusions: Effort should be made to educate the public about the safety and convenience of modern, long term, reversible methods of contraception among both in health care professional and public.

Keyword: Knowledge, Attitude, Practice, Contraception
VITAMIN D AND HSCRP LEVELS AMONG INSULIN RESISTANT PATIENTS IN A TERTIARY CARE HOSPITAL AT KOLKATA.
Authors: Kar Kaushik , Sinha Satwika
Published: March 2020

Vitamin D deficiency probably takes a part in the development of insulin resistance. Insulin resistance also markedly affects the obese population. High-sensitivity C-reactive protein is a sensitive marker of subclinical inflammation and strongly predicts increased risks of insulin resistance.

In this study, 123 obese persons were selected, and homeostatic model assessment (HOMA-IR) was measured in them. Serum Vitamin D and hsCRP were also measured in all participants. Among participants with HOMA-IR >2.7, significantly higher BMI, serum hsCRP and lower vitamin D were observed;

Keywords: Obesity, BMI, HOMA-IR, Vitamin D, hsCRP.
AN ANALYSIS OF SERUM AMYLASE LEVEL IN CHOLELITHIASIS PATIENTS
Authors: Verma Anita , Harsh Prerna
Published: March 2020

Background: Gallstone disease (GSD) is one of the most common gastrointestinal diseases. Gallstones represent a significant burden for health care systems worldwide and are one of the most common disorders presenting to emergency room.

Methods: Hospital based case control study conducted at Department of Biochemistry with close collaboration of Department of General Surgery, S. P. Medical College and associated group of PBM Hospital, Bikaner, Rajasthan.

Results: The insignificant serum amylase level difference in case group (47.80± 21.24) as compares to control group (45.97± 16.38).

Conclusion: In this study comparison of amylase between case and controls group showed that the levels of amylase in cholelithiasis patients were higher than that of the control group, but there was no significant variation in amylase.

Keywords: Amylase, cholelithiasis, Gallstone disease (GSD).
STATIN INTOLERANCE: CURRENT STATUS AND MANAGEMENT
Authors: Gupta Ajay , Gupta Nisha
Published: March 2020

Statins (HMG-CoA reductase inhibitors), since their introduction in 1987 are considered the first-line pharmacotherapy for cholesterol reduction. Because of their proven therapeutic ability to prevent cardiovascular disease and to extend life, statins are among one of the most widely prescribed medications. Various randomized clinical trials have consistently shown that statins have a beneficial role in both primary and secondary prevention strategies, with a significant reduction in major vascular events, including death, myocardial infarction, stroke, and coronary revascularization[1].
TO DETERMINE THE IMPACT OF ART ON RENAL DISEASES IN HIV PATIENTS
Authors: Romday Rakesh
Published: March 2020

Method: This study was done at Department of Medicine, Amaltas Institute of Medical Sciences, Dewas. All patients admitted with malaria during the study period Feb 2019 to Jan 2020 were taken for the study after considering the inclusion and exclusion criteria.

Result: Among those patients on ART, 52.6% were on Zidovudine based regimen and 47.4% were on Tenofovir based regimen. 39.1% patients among those who had renal dysfunction were on Zidovudine based regimen and 60.9% patients were receiving Tenofovir based regimen. Among those patients on Zidovudine based regimen, 6.9% patients had renal dysfunction whereas 11.9% patients on Tenofovir based regimen had renal dysfunction.

The relation between regimen of ART and risk of renal dysfunction was analyzed using Two sample T test and CI and found to be non significant.

Conclusion: Study shows that there is no association between risk of renal dysfunction with gender, duration of illness and duration of HAART in HIV positive patients. It also shows there is no significant association between the regimen of HAART and the risk of renal dysfunction. ART may have predilection for causing renal damage especially from NNRTI group like Tenofovir, which was found to cause renal toxicity. Our study indicates a need for frequent monitoring of renal functions and early initiation of HAART in HIV positive patients specially in relation to commonly available ART in our country.

Keywords: Impact, Renal Diseases, HIV & AIDS.
CLINICAL COURSE OF FETAL PELVI-CALYCEAL DILATATION DIAGNOSED ON EARLY SECOND TRIMESTER ULTRASOUND.
Authors: Dhawane Sanjay Punjaji
Published: March 2020

Aims and Objectives: Incidental finding of fetal pelvi-calyceal dilatation is common finding on early second trimester anomaly scan. [18 to 23 weeks] It causes significant parental anxiety. The present study aims to apply stringent criteria for accurate assessment.  It also studies the natural course of such findings, pathological cause for such findings and its postnatal outcomes.

Study Design: This study includes 9500 cases that underwent anomaly at 18 to 23 weeks gestation period.

The fetal pelvi-calyceal dilatation [PCD] was diagnosed and categorized according to criteria set by European Society for Pediatric Radiology [ 1]. PCD 0 – renal calyces and pelvis not or hardly visible. PCD 1 – renal calyces not visible and axial renal pelvis diameter is less than 7 mm. PCD 2 – some calices are visible but with normal forniceal and papillary shape, axial renal pelvis less than 10 mm. PCD 3 - marked dilatation of calices and pelvis. Pelvic axial width usually more than 10 mm with flattened papilla and rounded fornices but without parenchymal thinning. PCD 4- gross dilatation of entire collecting system and thinning of renal parenchyma. PCD 5- Only thin membrane like residual renal parenchymal rim.

Result: Among 9500 women who underwent routine anomaly scan at 18 to 23 weeks gestation, total 390 had PCD findings [4.1 %] Single kidney taken as one case while bilateral findings were taken  as 2 cases.

98 [25.1 %] pregnancies had bilateral PCD findings and rest 292[74.9%] had unilateral PCD changes. These findings correlate well with as shown by S Sairam et al, Livera et al, Gunn et al [2, 3, 4]  

 PCD 1 findings were noted in 317 cases, PCD2 findings were noted in 38 cases, PCD3 findings in 23 cases and PCD4 findings in 12 cases. All these fetuses were followed till either PCD findings resolved naturally or till 2 years of their life. These findings also compare well with S Sairam et al, and Persutte et al [ 2, 5]

About 00 cases of PCD1, 3 cases of PCD2 and 2 cases of PCD3 were lost for follow up for various reasons.

Two cases of PCD1 were lost due to additional diagnosis of Down syndrome in one case and multiple anomalies in other cases. Both were excluded from the present study.

Rest of them [383] were studied and analyzed for this paper.

Out of 315 PCD1 cases, all turned out to be normal

Out of 35 PCD2 cases,   19 were resolved, 12 remain unchanged at second year of child age rest were

4 worsened

Out of 21 PCD 3, 2 cases resolved spontaneously, 5 remain unchanged and 14 cases worsened

Out of 12 PCD 4 cases, all needed and underwent surgical intervention. 04 kidneys were saved and rest 8 had nephrectomies.
WIDE EXCISION AND RHOMBOID FLAP RECONSTRUCTION FOR TREATMENT OF COMPLEX PILONIDAL DISEASE. CASE SERIES AND REVIEW OF LITERATURE.
Authors: Athisayaraj Thomas W , Sebastian Boby , Alberts Justin
Published: March 2020

Introduction: Pilonidal disease a chronic inflammatory disorder affecting the sacrococcygeal region with superimposed infection. This problem can present with acute abscess or chronic discharging sinus and often difficult to treat due to high incidence of recurrence.

We are presenting our case series of wide excision and rhomboid flap reconstruction of complex pilonidal sinus disease.

Methods: This is a retrospective review of our series of patients who have had rhomboid flap reconstruction done in colorectal surgery department for complex pilonidal sinus disease. The time period between   is 2003 to 2017. The review was conducted from our electronic data base in our hospital.

Results: We had 50 patients in total. 30out of 50 have had previous surgery for pilonidal sinus disease. Five patients developed recurrence (10% recurrence rate). 4 out of 5 patients who had recurrence were smokers.4 out of 5 patients with recurrence had previous surgery for pilonidal disease. The median age of the patients was 28.The age ranged from 16 to 49 years. The median length of stay is about 4 days

Conclusion: In conclusion Rhomboid flap reconstruction is a viable operation for complex pilonidal disease. The long term results are good. It can be safely performed by a general /colorectal surgeon with good results. It is a good option for complex pilonidal sinus and recurrent disease following multiple previous operations. The recurrence rate seems to be higher in smokers and in patients who had previous surgery in natal cleft.
SURGICAL APPROACH AND OUTCOMES IN SALIVARY GLAND SWELLING
Authors: Akulwar Akshay , Bavikatte Akshay
Published: March 2020

Introduction: Salivary gland tumours are rare tumours and majority of these are benign and about 20% are malignant. The incidence of salivary gland cancers ranges from 0.5 to 2 per 100,000 in different parts of the world. Salivary gland swellings in the parotid or submandibular glands usually present as an enlarging mass and may be associated with neurological symptoms like facial nerve paralysis or pain. Minor salivary gland tumours present as a submucosal intraoral mass which subsequently ulcerates. Acute inflammatory conditions generally can be diagnosed by history and physical examination alone, whereas chronic inflammatory diseases and granulomatous disorders require supplemental diagnostic information including lab tests, imaging studies and biopsy. FNAC of salivary gland tumours is advantageous to both the patient and the clinician because of its immediate results, accuracy, lack of complications and economy. Appropriate therapeutic management may be planned earlier, whether it is local excision for a benign neoplasm, radical surgery for a malignant one or any other alternate treatment.

Material and Methods: All patients admitted to surgical wards due to obstructions of the salivary duct and neoplasia were included in the study. Demographic data from all the patients were collected, also they were evaluated for clinical examination, routine laboratory investigations and specific investigations. After evaluation of the swellings by clinical examination and by specific investigations, a surgical plan was formulated. The final decision was taken by the operative surgeon.

Results: 40 cases of salivary gland swellings were admitted during study period. Age of the patients varied from 9 years to 80 years. 62.5% (25 cases) were found in the parotid gland, 30% cases (12) in submandibular gland and 7.5% cases (3) in the sublingual gland. Surgery was the treatment for all cases of tumors. Superficial parotidectomy was done in all the 21 cases of parotid tumour (56.41%) without deep lobe involvement and total parotidectomy was done in 3 cases (7.6%) with deep lobe involvement. In all the cases of submandibular gland lesions, excision of submandibular gland was done. Excision of the sublingual gland was done in 3 cases of ranula. One case of adenoid cystic cacinoma was referred to higher center because   of the advanced malignancy.

Conclusion: Salivary gland tumors occur more commonly in the parotid gland, most often benign, pleomorphic adenoma constitute majority of all neoplasm. Surgery is the main modality of treatment in salivary gland sialolithiasis. Most commonly done surgery is excision of submandibular salivary gland & superficial parotidectomy and also for salivary gland tumors. Awareness and early referral is necessary, as prognosis is good if treated early.

Keywords: SALIVARY GLAND, TUMOUR, NEOPLASM, SURGERY
SKIN TAGS IN TYPE 2 DIABETES MELLITUS: A VALUABLE MARKER
Authors: Saxena Kshitij , Zaidi Aliza , Shaafie Harris Ishtiyaq , Singh Nishant , Singh K K
Published: March 2020

INTRODUCTION- Acrochordons [Skin Tag (ST)], are common, small, soft, benign connective tissue tumors of the dermis containing loose fibrous connective tissue. They are usually skin colored or brownish pedunculated papules, may be single or multiple, with smooth or irregular surface, ranging 1 mm to 20 mm in diameter. The ST developing in diabetes mellitus (DM) is due to hyperinsulinemia that is increase in insulin-like growth factor-1 (IGF-1) which leads to keratinocyte and fibroblast proliferation.

MATERIALS AND METHODS- Patients presenting with skin tags to the dermatology OPD in Era’s Lucknow Medical College and Hospital from a period of December 2018 to May 2019 were taken into account, 110 cases were enrolled whereas same no. of controls were included in the study. The details of the study were explained to all subjects and informed consent was taken. Detailed history taking and examination was done. The site and number of skin tags was recorded and fasting blood glucose levels of both groups were measured to screen them for DM by WHO criteria (Normal Range <126mg/dl) by venous blood sample taken overnight fasting of 8 hrs.

RESULT AND DISCUSSION- Total no. of subjects were 220 (110 cases and 110 controls), out of which 63.6% were males and 36.4% were females with average age of 44.05 yrs. Duration of skin tags ranged from 6 months to 180 months however 85.5% cases had a single skin tag. Multiple skin tags were common in males (21.4%). Family history of skin tags was higher in cases (41.8%) than in controls. Family history of diabetes mellitus was seen in 15.6% cases and 13.6% controls. FBG levels ranged from 68mg/dl to 220mg/dl in cases, and 65mg/dl to 178mg/dl in controls, with a mean value of 123mg/dl (cases) and 115mg/dl(controls).

CONCLUSION- Association of Type 2 Diabetes Mellitus (high fasting blood glucose levels) and skin tags was positive in our study. We should encourage patients with skin tags to get their blood glucose levels checked to rule out diabetes mellitus.

 

KEY WORDS- Acrochordons, Skin tags, Diabetes Mellitus
EFFECTS OF TELE-NURSING INTERVENTION AMONG PATIENTS WITH SCHIZOPHRENIA: AN EVIDENCE BASED
Authors: Abu-Baker Rasha Zaid
Published: March 2020

Background: Nonadherence with medication occurs in all chronic disorders. It is a challenge in schizophrenia due to the nature of illness’s association with social isolation, stigma, and substance misuse, lack of insight and cognitive impairment. It increases the risk of relapse, rehospitalization, self-harm, increases inpatient costs, and lowers quality of life. Tele-nursing interventions improve medication adherence, shared decision-making, ensuring that treatment is effective and that side effects are managed, promoting a positive therapeutic alliance and good communication between the physician, nurse and patient. Objective: To systematically evaluate the tele-nursing interventions and their efficiency in schizophrenia patient care. Method: This study was conducted using scientific search engines Cumulative Index of Nursing Allied and Health Literature (CINAHL), OVID, Pubmed, Wiley, Science Direct and PsycINFO database were searched for relevant information from 2010 until 2016. Results: According to the findings that were evaluated within the scope of the systematic review, it was observed that the tele-nursing interventions were telephone calls and text messages used, shown to extend the time spent by schizophrenia patients in society and decrease the duration of days spent at the hospital after rehospitalization. Conclusion: According to this systematic review, the applications of tele-nursing interventions are effective among schizophrenia patients.

Keywords: schizophrenia; tele-nursing; adherence; nonadherence
A STUDY FOR COMPARISON OF CAREGIVER BURDEN AND BEHAVIORAL AND PSYCHOTIC SYMPTOMS IN FRONTOTEMPORAL DEMENTIA AND ALZHEIMER’S DEMENTIA
Authors: Yadav Nirad , Jain Sanjay , Jain Richa
Published: March 2020

Background:  Dementia is a syndrome that results in the progressive deterioration of cortical functioning including comprehension, memory and thinking. Alzheimer’s disease (AD) is the most common cause of dementia accounting for 50-75% and Front temporal dementia (FTD) around 5-10% of dementia cases. Behavioral and psychological symptoms (BPSD) form a major part of the presentation of the dementia patients at psychiatric clinic and play a crucial role in caregiver distress which in turn is a major determinant of welfare of dementia patients in society.

Objective:  Present study is to compare care giver burden and BPSD in patients with FTD and AD.

Method:  We compared 41 patients’, of which 15 of FTD and 26 of AD with respect to the Neuropsychiatric Inventory (NPI), Hindi Mental State Examination (HMSE) and Zarit Burden Inventory (ZBI) at SMS Medical College, Jaipur.

Results: FTD patients obtained a significantly higher NPI behavioral score And ZBI than AD patients and mean value of HMSE is higher in FTD than AD. Significant positive correlation between NPI and ZBI is observed in both groups. Significant positive correlation between HMSE and ZBI is found in FTD obtained,

Conclusion: More behavioral problem in FTD makes it difficult for patient’s caregiver to manage patients at home this leads to rapid institutionalization, although severity of dementia is less.

Keywords: Alzheimer’s disease, Front temporal dementia, BPSD, Caregiver Burden
AWARENESS AND PERCEPTION OF REPRODUCTIVE HEALTH AMONG SCHOOL GOING LATE ADOLESCENTS
Authors: Gait Arvind , Varma Mahesh , Meena Shyam Lal , Meena KK , Mahatma Rajiv
Published: March 2020

Background: Adolescence is ideally a healthy period, having the lowest mortality and morbidity compared with other population age groups. Adolescence is the transitional stage of development between childhood and full adulthood, representing the period of time during which a person is biologically adult but emotionally not at full maturity. Puberty is a unique and distinctive period and is characterized by certain developmental changes that occur in no other time in life span. During adolescence, puberty can occur at anytime between ages thirteen to nineteen year.

Aim: To study the awareness and perception of reproductive health among school going late adolescents (class 11th and 12th) and factors associated with it.

Methods: It was a Community based cross sectional study. The study was carried out at senior secondary Govt. and private school (students from class 11th to 12th) of Jaipur city. All the school going students of class 11th and 12th (late adolescents) of selected schools of Jaipur city were selected as participants. The proposed study duration was 6 months with effect from 1st July 2019 to 10th December 2019. Sample size of 800 was calculated at 95% confidence interval and α error of 0.05 assuming willingness for better perception of reproductive health among school going late adolescent level 76.3%.

Results: Result showed that highest participants (34.3%) were 17 year of age. The majority was of female respondents (51.6%) and remaining (48.4%) were males. Out of the population, 22.8% belonged to lower middle class, 22.0% belonged to lower class, 19.5% belonged to upper middle, 19.1% belonged to upper class and 16.6% belonged to upper lower class. Majority of the males (50.9%) feel that female conceives when male and female do intercourse. On the other hand, majority of the females (50.6%) feel that female conceives when sperms of male enter into ovum of female. Highest number of males (17.6%) shares their private talks with cousins whereas highest number of females (20.1%) shares with their father. Highest number of male participants (22%) watches adult movies, whereas, highest number of female participants (21.5%) refer magazines to gain reproduction and sex education.

Conclusion: The present study revealed that the majority of the adolescents have correct knowledge about puberty, pregnancy and childbirth, family planning methods, STDs, and request for treatment. Moreover, adolescents had correct knowledge about the appropriate age for marriage and HIV than other STDs. Regarding the hygiene practices, most students had correct practices with respect to menstruation, while a few had incorrect practices. The majority had positive attitudes regarding RH, while a few had negative attitudes. The main reason behind high awareness and knowledge among adolescents about reproductive health is due to change in educational system and easy access to internet. Improved education status of parents also plays an important contribution towards this.
THE RATE AND INDICATION OF CAESAREAN SECTION IN A TERTIARY CARE CENTRE
Authors: Kumawat Urvashi , Natu Neeta
Published: March 2020

Method: The rate of caesarean section was only slightly higher than recommended by the WHO. Most of caesarean sections were emergency caesarean sections. Data on all live births were collected, including type of delivery, and indication was recorded if cesarean section was done. Total, primary, & repeat cesarean section rates were calculated for each year. The cesarean rate was calculated as the number of cesarean births divided by total live births. The rate for each indication was calculated annually as the number of cesarean births performed for each indication per 1,000 live births.  

Result: These two groups constituted nearly 87.7% of total C-Sections. Only 3.4% of the cases belonged to the elderly age group of above 35 years. Maximum no. of caesarean sections was in multiparous females (54.3%).  Out of 550 caesarean deliveries 76.7% were from urban area. Also, result showed that only 68.7% were booked for antenatal care.

Conclusion: The rate of cesarean section has increased with time with primary and repeat cesareans both showing an increase. In the primary CS rate, indications like labor arrest disorders & fetal distress show an increase more than the objective indications like malpresentation. In repeat CS, history of 02 or more previous sections & scar tenderness contributed more than the fetal distress.

Keywords: Indication, Caesarean
EFFICACY OF SOFOSBUVIR AND RIBAVIRIN BASED TREATMENT IN CHRONIC HEPATITIS C GENOTYPE 3 PATIENTS
Authors: Laway Mushtaq , Shiekh Shabir , Sideeq Shafat , Wani Zafar , Shafi Peerzada Mohd
Published: March 2020

Introduction: Hepatitis C virus (HCV) infection represents a major healthcare challenge in both industrialized and developing countries. The standard treatment for hepatitis C virus (HCV) infection has been interferon-based over many years with less than satisfactory cure rate and many side-effects. Directly acting antivirals (DAAs) have promise for a treatment regimen free of interferons with much better cure rate and minimal side-effects.

Aims and Objectives: To evaluate efficacy and safety of an oral interferon-free regimen, sofosbuvir plus ribavirin in the treatment in genotype 3 chronic hepatitis C patients.

Materials and Methods: 200 treatment naïve chronic hepatitis C genotype 3 patients of either sex with age more than 18 years were enrolled in the study. Sofosbuvir 400 mg once daily plus Ribavarin weight-based was given to all the patients. Duration of treatment was 24 weeks and 12 weeks to cirrhotics and non-cirrhotics respectively.

Data analysis was performed using the IBM SPSS version 22.

Results and Observations: In this prospective study the total number of patients was two hundred (n=200). The mean age (in years) of patients was 44.2 ± 14.7. The number of male patients was 112 (56 %) and 88   (44 %) were females. The number of cirrhotic patients was 70 while 130 were non-cirrhotic.

On comparison on the basis of sustained virological response at twelve weeks of the completion of treatment (SVR12) we observed that treatment naïve cirrhotic patients had  SVR 12 of  92.8 %  while in the non cirrhotic patients SVR 12= was 96.9 % . Adverse effects were insignificant and none of the patients dropped out because of side effects.

Conclusion: The sofosbuvir and ribavirin based therapy showed very good rates of sustained virological response in chronic hepatitis C genotype 3 patients irrespective of the state of fibrosis. In addition it was found to be cost effective, safe and very well-tolerated.

Keywords: Hepatitis C; Genotype 3; directly acting antivirals, Sofosbuvir, Sutained virologic response (SVR).
TO DETERMINE THE DIFFERENCE IN HAEMODYNAMIC PARAMETER OF ORAL 75MG, 150MG PREGABALIN PREMEDICATION AND CONTROL GROUP AMONG PATIENTS UNDERGOING ABDOMINAL HYSTERECTOMY.
Authors: Singh Naveen Kumar , Shakeet Jayesh
Published: March 2020

Background: In preemptive analgesia, the analgesic treatment is started before and is operational during the surgical procedure so that the physiological consequences of nociceptive transmission are reduced.

Methods: This Hospital based, prospective, randomized, double blind, comparative study was conducted in Department of Anaesthesiology.

Results: The mean baseline variable i.e. pulse rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure were comparable in both the groups. (P value>0.05). Thus we can say that the randomization was done adequately. Hemodynamic variables (pulse rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure) were also comparable during intraoperative period.

Conclusion: Although preemptive use of both pregabalin 75mg and pregabalin 150 mg are effective for prolongation of postoperative analgesia but pregabalin 75mg is superior to pregabalin 150mg as it provides similar postoperative analgesia as compared to 150mg without causing significant change in haemodynamic variables and any adverse effect.

Keywords: Preemptive analgesia, Gabapentin, Rescue analgesic.
A STUDY OF HEPATIC DYSFUNCTION IN DENGUE EPIDEMIC
Authors: Goyal Kamlesh , Lakhawat Vivek , Chandra Subhash
Published: March 2020

Background: To study liver function test in dengue fever patients.

Methods: This study was hospital based prospective study, which included 100 cases of dengue fever.

Results: 28 patients had ALT >1-3 ×UNL (upper normal limit), 18 patients had ALT >3-10×UNL and 6 patients had >10×UNL. 24 patients had AST >1-3×UNL, 23 patients had AST >3-10×UNL and 11 patients had >10×UNL.

Conclusion: The aspartate aminotransferase (AST) levels in dengue patients was higher than alanine aminotransferase(ALT) levels. This differs from the pattern in viral hepatitis but is similar to that seen in alcoholic hepatitis.
FUNCTIONAL PAIN ABDOMEN IN CHILDREN
Authors: Smith Abhilasha , Lata Sandhya
Published: March 2020

Background: Chronic abdominal pain is one of the most common problem dealt in day to day practice by paediatricians. In most of these children, no cause can be identified. Although it is common but its definition, pathophysiological mechanisms and predisposing factors are not completely understood & there is need for large well performed clinical trials for evidence based treatment.

Methods: Hospital based prospective case control study conducted at Department of Paediatric. The study was commenced after obtaining clearance from institutional ethical committee. Written consent were taken from the parents for this study and those who were not willing excluded from study. Patients of age group 5 to 15 yrs of any gender presenting to paediatrics hospital (who fulfill inclusion and exclusion criteria) with >3 episodes of abdominal pain in preceding year were enrolled for study.

Results: Most common site of pain was upper abdomen present in 72% children, followed by lower abdomen in 22% children and generalized pain abdomen in 8% children. Prevalence of functional GI Disorders in children with RAP. 92% children had FGIDs while rest 8% children had organic or infectious aetiology.

Conclusion: This study reports higher prevalence of FGIDs in children with RAP and also identifies the variables associated with increased risk of this disorder in children with RAP. Female gender, school going children, psychological stress, traumatic life event and lower socioeconomic status increase the prevalence.

Keywords: Recurrent abdominal pain (RAP), Functional abdominal pain (FAP), Chronic abdominal pain.
TO ASSESS THE RESPONSE AND OUTCOME OF THE TB PATIENTS REGISTERED AT DTC REWA OF CENTRAL INDIA
Authors: Niranjan Anjana , Sharma Sanjeev , Trivedi Rohit , Adhikari Pahram , Jain Achala , Patel Seema
Published: March 2020

Background-Tuberculosis is a highly infectious disease caused by Mycobacterium tuberculosis. The disease primarily affects lungs so it known as Pulmonary TB and other tissues of the body which is known as Extra-pulmonary TB. The vast majority of TB deaths are in the developing world left untreated, Tuberculosis is treatable with a course of antibiotics. The most successful strategy to treat TB patients is DOTS.

Material and Method: This is a Prospective Longitudinal  study conducted  among the patients attending DOTS center of DTC located at S.G.M.H. campus  Rewa for the Treatment  provided under of a definitive time period ( as per RNTCP, last quarter of 2014) from 1st Oct to 31st Dec 2014.

Aim & Objective:  1. To observe the sputum conversion rate of study population. 2. To find out the outcome of treatment. Result: 69.92%were pulmonary tuberculosis and 30.07% was Extra-pulmonary tuberculosis and sputum conversion rate of Pulmonary TB cases at the end of IP in new sputum smear positive cases was 96.66% but at the end of 5 month it was 100%. In retreatment cases Sputum Conversion rate at the end of IP was 89.28% and at the end of 5 month 92.85%.and overall treatment success rate were 90.97%. 

Conclusion: At the end of treatment as per DOTS schedules sputum smear examination is mandatory to know the exact treatment cure rate.

 Key words: Pulmonary, Extra-Pulmonary, Sputum Conversion, cured, Treatment completed, Defaulter etc.
CLINICAL PROFILE OF CHILDREN PRESENTING WITH SEIZURE
Authors: Aiyaloo Diwakar , M Banumathi C.
Published: March 2020

Seizure is a sudden, uncontrolled electrical disturbance in the brain which causes changes in behavior, movements or feelings, and in the levels of consciousness. Suffering from more seizures or tendency to have recurrent seizures that may lead to epilepsy. This study is to describe the clinical profile of children presenting with seizure including common causes of seizure and classify the seizure types.

Methods:  Hospital-based, analytic and descriptive study. This study includes all children in the age group 6 months to 12 years who presented in the department of paediatrics with seizure. Demographic analysis and analysis of different seizure types, analysis of patient based on the cause of seizure as well as outcome of patient presented with seizure in relation to demographic, fever diagnosis and status epilepticus.

 Results: The total numbers of patients with seizure under study are 100 in which 61 were males and 39 were females. The most common clinical seizure type was generalized tonic- clonic (56.00%).

Conclusions: Seizures are one of the common causes of hospitalization. It can be inferred from this study that CNS infections are the most common cause of acute symptomatic seizure. The improvement in health care facilities like sanitation and immunization is warranted to prevent it.

Keywords: Generalized tonic-clonic seizures, Neurocysticercosis, Encephalitis, Tubercular meningitis
COMPLICATIONS IN DENGUE LIKE ILLNESSES
Authors: Anand Thakur Vikrant
Published: March 2020

Abstract

Background: Dengue is the most important arthropod-borne viral infection of humans.

Methods: The hospital based study was conducted on patients presenting to paediatric hospital, who fulfilled inclusion and exclusion criteria.

Results: According to complications, in dengue positive cases, bleeding was the most common complication seen in 47.00% cases while shock, myocarditis, and convulsion were present in 33.00%, 4.00% and 1.00% of cases respectively. Among the dengue negative cases, 58.00% had no complication while shock and bleeding were present in 29% and 13.00% cases respectively.

Conclusion: It concluded that shock was most common complication.

Keywords: Hematocrit, Dengue, Dengue like Illness
EPIDEMIOLOGY OF PEDIATRIC BURNS IN TERTIARY CARE CENTER OF VINDHYA REGION OF MADHYA PRADESH
Authors: Tiwari Vinit Kumar , Saxena Saurabh
Published: March 2020

This retrospective review contains 100 paediatric burns up to 14 yrs of age admitted to the Burn unit of the Department of surgery, SS Medical College, Rewa Madhya Pradesh. over a period of one year from January 2019 to December 2019.Epidemiological data include age sex, seasonal variation, place of burn, family size, economic status, period of time between the accident and admission to hospital. The cause and mode of burn, the relationships between mortality and age, cause of burn and extent of burn are discussed. Most of the burn injuries occurred in the winter months between November and February. Males were affected predominantly. The majority of burns occurred at home. Most of the patients belonged to the low socioeconomic strata. The commonest causes of injury were scalds in children under 5 yrs of age and flames in the older children. The overall mortality was 18 % percent.
COMPARISON OF TRAMADOL AND OXACEPROL IN PATIENTS WITH OSTEOARTHRITIS
Authors: R. Amarjeeth
Published: March 2020

Introduction: Osteoarthritis (OA) is a chronic, degenerative disease of unknown origin which is characterised by gradual loss of articular cartilage. It is the most prevalent disease with a worldwide distribution. Earlier, osteoarthritis was seen as an inevitably progressive, degenerative disease process. Now it has been suggested that it is a dynamic process that may progress episodically. It is a heterogeneous group of diseases characterised by an adaptive response of synovial joints to a variety of genetic, environmental, aging and biomechanical stresses. NSAIDs intake increases the risk of gastritis and does not a have direct impact on the underlying pathogenesis of articular diseases. Tramadol augments serotonergic and noradrenergic neurotransmission, although it’s main active metabolite, O-desmethyltramadol.  Oxaceprol is an atypical inhibitor of inflammation, used as a drug for joint disease without less side-effects with better safety profile than non-steroidal anti-inflammatory drugs (NSAIDs).

Material and Methods: Participants were randomized in two study groups of 50 patients each sing computer generated random number list. Each group was given either oxaceprol 200 mg capsule or tramadol 50 mg capsule, thrice daily after food, for 12 weeks. The primary efficacy variable for this study was symptom relief stiffness, and physical function, measured on 100 mm Visual analogue scale (VAS) scale. Rescue medication used during the study period was also recorded. Complete blood count, blood glucose, liver function tests, and serum creatinine was recorded at the start of the study and. Vital signs were recorded at each visit and adverse events were reported. 

Results: A total of 100 patients were included in the study of which 50 each were placed in tramadol group and oxaceprol group. No statistically significant difference was noted in both the group about baseline parameters about sex, age and blood pressure. Blood sugar was higher in Oxaceprol group as compared to tramadol group (P =0.0042) which was statistically significant. No statistically significant difference was observed between groups for WOMAC scores. Significant reduction in pain, stiffness and physical function was observed between oxaceprol and tramadol group at baseline and after 6 months follow-up. None of the adverse events were severe in nature in both the group commonest were dizziness and nausea.

Conclusion: Oxaceprol efficacy and tolerability was comparable with tramadol and the drug can be considered as an alternative to low-potency opioids in the management of knee osteoarthritis. Further studies are required to confirm the clinical utility of oxaceprol in osteoarthritis.

Keywords: OA, tramadol, oxaceprol, NSAID, WOMAC
RELIABILITY OF WIDE CANAL SIGN N DIFFERENTIATING BETWEEN DEGENERATIVE FROM ISTHAMIC SPONDYLOLYSTHESIS
Authors: Kalode Ravindra R , Nawasthale Swapnil
Published: March 2020

To determine whether a visually apparent increase in the antero-posterior diameter of the spinal canal can be used reliably to differentiate degenerative from isthamic spondylolisthesis on midline sagittal MR images.  It is hypothesized that the wide canal sign would be present only in isthmic spondylolisthesis, where the vertebral ring is disrupted by defects in the pars interarticularis and absent in degenerative spondylolysthesis where there is no such defect.
ELEVATED PLASMA LEVELS OF TNF-ALPHA, INF-GAMMA, IL-10 AND TGF-BETA IN MALARIA PATIENTS FROM TWO MALARIA NON-ENDEMIC REGIONS IN KARNATAKA, INDIA
Authors: G Mukthayakka , Sajjan Annapurna G , Kashid  Ragini Ananth , Shannawaz Mohd , HS Thejaswini  , S Vanitha
Published: March 2020

Purpose: In India, Plasmodium vivax malaria is endemic and accounts for 50-55% of the total malaria burden in the country. There has been limited sero-epidemiological data available from malaria non-endemic regions in Karnataka state. In this study, we aimed to evaluate the plasma levels of Tumor necrosis factor-α (TNF-α), Interferon- γ (IFN-γ), Interleukin-10 (IL-10), and Transforming growth factor- β (TGF-β) and correlate with malaria parasitaemia and infection type in vivax and falciparum malaria cases reported from two study centres.

Methods: This hospital-based cross sectional observational study was conducted at BLDEU SHRI B.M. Patil Medical College, Hospital and Research Centre Vijayapur, Karnataka and BGS Global Institute of Medical Sciences, Bengaluru, Karnataka during 2016 to 2019. A total number of 45 microscopy positive and molecularly confirmed malaria cases were included in the study. Plasma samples were analyzed for the concentrations of four cytokines by Enzyme-linked immunosorbent assay (ELISA). 20 uninfected healthy volunteers were used as controls. Correlation of cytokines and parasitemia was done using Pearson correlation analysis.

Results: The results show an overall significant elevation of plasma TNF-α (p<0.05), IFN-γ (p<0.005), IL-10 (p<0.001), and TGF-β (p<0.001) in malaria patients compared to healthy controls. Except TNF-α (p<0.001), there was no significant difference in infection type specific immune responses. No significant correlation was seen among all the four cytokines with parasite load. A Receiver operating curve (ROC) was generated and showed that TNF-α, IL-10, and IFN-γ were the best individual predictors of malaria.

Conclusions: We conclude that significantly elevated plasma concentrations of TNF-α-, IL-10, IFN-γ and TGF-β in both P. vivax and P. falciparum cases suggest their active involvement in mounting defensive immune response against malaria infection.

Keywords: Malaria, Plasmodium vivax malaria, TNF-α, INF-γ, IL-10, TGF-β, Karnataka
A STUDY ON ASSOCIATION 0F TOOTH LOSS & PERIODONTAL DISEASE IN PATIENTS SUFFERING FROM DIABETES FROM BIHAR REGION
Authors: Manish Kumar , Raman Nikita , Gautam Abhishek , Jain Samir , Jha Prakash Chandra , Kumar Amar
Published: March 2020

Diabetes is one of the common diseases of modern times and one of the most common systemic disorder that is connected to periodontal disease. Periodontal diseases are bacterially induced chronic inflammatory diseases affecting the tissues surrounding and supporting the teeth. The lesion begins as gingivitis, an inflammation of the gingival tissues only, and may progress to periodontitis, where destruction of connective tissue attachment and alveolar bone can eventually lead to tooth loss. Hence based on above reported findings the present study was planned for study of prevalence of tooth Loss in Patients Suffering from Diabetes from Bihar Region.

The present study was planned in Department of Dentistry, Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar. Total 100 cases were enrolled in the present study. In the enrolled patients 50 cases were Diabetic and 50 were non-diabetic cases.

The data generated from the present study concludes that periodontal disease increases in diabetes group than in control group. Thus, a diabetic patient should always see that he/she maintains his/her oral hygiene by following proper tooth brushing habits. Diabetics should take care to see that they get their teeth restored as early as possible, if decayed. They should follow the instructions given by the physician or the dietician for the intake of non-cariogenic diet. The prevention of periodontal breakdown in diabetic patients is mostly based on the education of the individual. Thus, patients should be informed about the importance of oral health for diabetics, and they should be taught that the main symptom of periodontal disease is gingival bleeding.

Keywords: Tooth Loss, Diabetes, periodontal disease, bihar, etc
HYPERTENSION CONTROL AND DEPRESSION A STUDY IN SSPM MEDICAL COLLEGE & LIFETIME HOSPITAL PADAVE SINDHUDURG
Authors: Gatagat Sheetal Ratankumar
Published: March 2020

Introduction:  Hypertension is a major public health issue worldwide, affecting millions of patients. Although control rates have improved during the past few years, the actual rate is still unacceptably low, and control rates in more vulnerable populations, like people living with diabetes mellitus, are even lower. Optimal BP control could prevent a high percentage of coronary heart disease events, and early BP control significantly reduces the risk of stroke and cardiovascular events Depression is usually not detected at primary levels, and patients do not typically receive adequate treatment, which may not only affect their quality of life, but may also interfere with the treatment and prognosis of other chronic diseases such as ischemic heart disease and stroke. 

Material and Methods: 46 hypertensive patients undergoing antihypertensive therapy for longer than six months were included in the study. After a 5 min of rest period, measurement of BP was recorded in triplicate at 3 min intervals between measurements. Adherence to antihypertensive therapy was monitored. All patients completed the Zung Self-rating Depression Scale survey; depression was diagnosed if the patient scored >50 points (the maximum possible score using this scale was 80). The Zung Self-rating Depression Scale is said to be a sensitive measure of clinical severity in depressed patients.

Results: Out of 46 patients there were 22 (47.8%) female and 24(52.2%) male. Patients who were depressed were 20 (43.5%) of which 8(40%) were male and 12 (60%) were female. Of the total 20 depressed patients 1 male having controlled hypertension while 19 (80%) were in the group of uncontrolled diabetes. In controlled hypertension group only 1 mild depression patient was observed while in uncontrolled group of the 19 patients 10 (50%) were having mild, 8 (40%) were having moderate and 1 (20%) were having severe depression according the Zung Self-rating Depression Scale. Mean blood pressure in depressed controlled BP group was 128/73 mmHg while in depressed uncontrolled group was 149/90 mmHg. Mean blood pressure in normal controlled BP group was 121/75mmHg while in depressed uncontrolled group was 146/95 mmHg. There was a significant correlation observed between depression and systolic and diastolic blood pressure value (P<0.001).

Conclusion: Depression is common in patients having uncontrolled hypertension and screening of depression in hypertensive patients is simple and effective tool to control the hypertension.

Keywords: Hypertension, Depression, controlled, uncontrolled.