bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinicopathological study of benign breast diseases a study of 50 cases
Authors: Chaudhary Manish , Bhat Purvesh , Wankhede Vedant , Aagja Jigar , Rathva Dhaval , Ahir Tushar
Published: April 2021

Background: Benign breast diseases are a neglected entity in developing countries despite the fact that they involved in the majority of breast complaints. Benign breast disorders can be defined as any non-malignant breast condition and involved wide range of clinical and pathological disorders. Breast diseases present as swellings. It is a symptom/sign for a different lesion varying from developmental abnormality, inflammatory lesions, epithelial and stromal proliferation to malignancy. Patients were studied on the basis of i.e., clinically, and histopathological ultrasound has done. Our purpose of study is to document various benign Brest diseases to study different mode of presentations of diseases and correlation of clinical and pathological diagnosisMethods: The given study was a prospective and observational study, undertaken in the department of general surgery, govt. medical college Surat, during the study period of March 2018 to September 2019.All the female and male patients with breast related disease were included in this study. Female patients with biopsy proven malignancy were excluded from the study.Results: The study comprised of 50 patients with benign breast diseases; the most common is Fibro adenoma which formed 68% then fibrocystic diseases 20%. With most common age group involved in our study is 21-30 years.Conclusions: Benign breast diseases are more common but ignored entity though it carries majority of complaints and occur mainly in young women less than 30 years of age and were mostly fibro adenoma and fibrocystic change.
Outcome of loop cholecystojejunostomy as a palliative procedure in unresectable distal malignant biliary obstruction
Authors: S. Greeshma , Rajan Ramesh , S. Chandrashekar , C. Jayan
Published: April 2021

Background: Up to 70-80% of patients with malignant biliary obstruction seek medical attention only at unresectable stage. Though R0 resection is the therapeutic modality, surgical palliation has a definite role for securing biliary bypass. Hepatico (choledocho) jejunostomy and cholecystojejunostomy are the procedures of choice. As loop CCJ is technically simple to perform as well as having less operating time and blood loss;anappealing choice. Aim of the current study was to assess the outcome of loop CCJ as a palliative procedure in unresectable distal malignant biliary obstruction.Methods: 25 patients who underwent loop CCJ for radiologically and histopathologically proven unresectable distal malignant biliary obstruction in GMC, Thiruvananthapuram, were studied for a period from 1st January 2015 to 31st December 2016. Each patient was followed up for 6 months post operatively for the occurrence of cholangitis, relief from pruritus, number of hospitalization, duration of hospital stay, postoperative 30 day mortality and life span. Pre and postoperative serum bilirubin were studied using paired t test. Palliative surgery outcome score was calculated to assess the outcome.Results: Serum bilirubin levels were significantly reduced postoperatively. Mean pre and post-operative total bilirubin values were 15.10±1.65 (mg/dl) and 4.30±3.04 (mg/dl) respectively with p<0.001. 80% had relief of pruritus and 96% were free of cholangitis 76% had a PSOS more than 0.7.Conclusions: Loop CCJ has acceptable outcome as a palliative option for surgical bypass to relieve jaundice, pruritus in patients with unresectable distal malignant biliary obstruction with a good PSOS. This procedure is technically simpler and having fewer incidences of post-operative cholangitis, pruritus, post-operative hospital stays as well as 30 day mortality.
Two port laparoscopic retroperitoneal pancreatic necrosectomy: improvement in morbidity and mortality with a less invasive approach
Authors: G. Vinay H. , G. Ramesh Reddy , R. Shwetha Chandra , Mary Merin , Kumar Kiran
Published: April 2021

Background: Severe pancreatitis is associated with a high rate of mortality even with advanced surgical care and practices worldwide. Morbidity and mortality rates are much higher in the presence of infected pancreatic necrosis. From open necrosectomy, simple percutaneous drainage or one of several minimal access approaches, the question of optimal or best treatment is yet debatable. Step-up approach is currently practised by many physicians. We describe our technique of early drainage by minimal invasive two-port laparoscopic retroperitoneal pancreatic necrosectomy in our centre.Methods: Thirteen consecutive patients with proven infected pancreatic necrosis were treated by 2P-LRPN over a two-year period in the setting of a teaching hospital. The median patient age was 44 years (range: 28-66 years) and 10 of the patients were male.Results: The median time to discharge following the procedure of 14 days (range: 08-21 days). There was no mortality and the morbidity rate was 37%, consisting mainly of pancreatic fistula (37%).Conclusions: Two-port laparoscopic retroperitoneal pancreatic necrosectomy is an effective and minimally invasive procedure which had better outcomes with improved patient morbidity, shorter hospital stay and lesser complication rate. Early intervention with necrosectomy has better patient compliance.
A prospective study of outcome and monitoring of patients with perforation peritonits by using APACHE 2 score
Authors: Gupta R. S. , Roshan Santosh , Pandey Vishnukant , Shrivastava Surendra
Published: April 2021

Background: Perforation peritonitis is very common surgical emergency and despite newer and advanced technology as a monitoring system APACHE 2 score have a good predictive power to predict outcome and monitoring in such patientMethods: This is a prospective study by which APACHE 2 score was applied over the patient before the surgery and after the surgery at first post operative day and score was calculated in selected preformed and result was concludedResults: The outcome of the Patients largely depends on age, perforation size, duration of presentation, and duration of hospitalization all these are well correlated with APCHE 2 score to predict outcome and monitoring.Conclusions: The accuracy of APACHE 2 score to predict the outcome in perforation peritonitis increases when the result of score was combined which was applied two time prior to surgery and after the surgery.
Correlation of shoulder tip pain in case of low pressure and standard pressure pneumoperitoneum post laparoscopic cholecystectomy
Authors: Agarwal Lakshman , Kumawat Sanjay , Jain Sumita A. , Yadav Amit , Sharma Sandeep
Published: April 2021

Background: Laparoscopic cholecystectomy is gold standard treatment for cholelithiasis now a days. Post-operative shoulder tip pain is common complain after laparoscopic cholecystectomy. The cause of this shoulder tip pain is multifactorial e.g. peritoneal stretching and diaphragmatic irritation. The main cause of this shoulder tip pain is pneumoperitoneum caused by carbon dioxide. Correlation of shoulder tip pain in case of low pressure (7-8 mmHg) and standard pressure (12-14 mmHg) pneumoperitoneum post laparoscopic cholecystectomy.Methods: A prospective randomized study was done in 100 patients of cholelithiasis in SMS hospital Jaipur Rajasthan. The patients were divided into two groups-Group A patients undergoing laparoscopic cholecystectomy at low pressure (7-8 mmHg) and group B patients undergoing laparoscopic cholecystectomy at standard pressure (12-14 mmHg). The intensity of shoulder tip pain were measured by visual analogue score at 1, 6, 12, 24 and 48 hours. In both of the group results were compared in terms of frequency of pain, intensity of pain and requirement of post-operative analgesics. The duration of hospital stay was also compared.Results: Post-operative shoulder tip was found to be less in low pressure group (group A) as compare to standard pressure group (group B). Total requirement of post-operative analgesic dose and hospital stay was also found to be less in low pressure group as compared to standard pressure group. This was statistically significant (p value<0.05).Conclusions: There is less intensity, frequency of shoulder tip pain, less post-operative analgesics requirement and less post-operative hospital stay after laparoscopic cholecystectomy done under low pressure pneumoperitoneum (7-8 mmHg).
Complete occlusive dressing for hypospadias in children
Authors: Khan Tanvir Roshan , Singh Shrikesh , Prakash Divya
Published: April 2021

Background: Dressing after hypospadias repair is particularly important to provide adequate pressure, hemostasis and prevent edema. Ideal dressing remains a challenge and multiple methods of dressings after hypospadias repair have been reported. Not many types of dressings are described in children and it varies from places and institutes. Present study describes the method of application of complete occlusive dressing in the children undergoing hypospadias repair.Methods: It is a prospective analysis of the operated patients of hypospadias who were offered complete occlusive dressing of the penis following surgery in a tertiary teaching hospital. The outcome was assessed on the basis of cosmetic and functional appearance after removal of the dressing namely, edema, ischemia, fistula formation if anyResults: A total of 100 patients were operated during the study period of two years. The age ranged from 1 year to 16 years. All patients were provided complete occlusive dressing of the penis following surgery (urethroplasty). The patients tolerated the dressing very well with minimal postoperative edema with good functional and cosmetic outcome. There were some minor complications associated with this type of dressing.Conclusions: The complete occlusive dressing in the hypospadias surgery is an alternative type of dressing in children after hypospadias surgery. The dressing is easily available, and the method can be easily learned and reproduced. There is no need for repeated changes or pain on removal, the patients are comfortable with the dressing and it keeps them mobile. It is helpful in reducing the postoperative edema and subsequent complications.
Gastrointestinal stromal tumours: a clinico-pathological study
Authors: Satwik Nuvvula , Francis Joseph , Mathias Natasha
Published: April 2021

Background: The aim was to evaluate the clinical presentation, histopathological findings and immunohistochemistry in gastrointestinal stromal tumour (GIST) to better understand the disease.Methods: Patients admitted and suspected to have GISTs in the Departments of General Surgery and Oncology, Yenepoya Medical College from the period of October 2016 to October 2018 were included in the study.Results: From October 2016 to October 2018, 10 patients had been diagnosed with gastro-intestinal stromal tumour in Yenepoya Medical College. Out of the 10 patients 7 were males and 3 females. The age distribution showed that more than 70% of the cases were above the age of 55 years. Stomach was the most common site of GIST. The most common histopathological type was spindle cell type of GIST, and 70% of the GISTs came positive for CD117.Conclusions: To conclude, Gastro intestinal stromal tumours are a rare entity. In this study conducted in a tertiary centre only ten cases were reported in a span of two years of the study period. Further analysis of age and gender distribution, histopathological and immunohistochemistry of these tumours suggested that in majority, age group was found to be above 55 years, with male preponderance. Commonest site was stomach (40%) followed by jejunum. Common histopathological finding was found to be spindle cell variant. 70% cases were CD117 positive with more than 5 mitotic figures/50 high power fields.
De Quervain’s tenosynovitis in a child
Authors: Palaniappan Senthil Kumar , Kulandaivelu Kamalanathan , Ramadhas Kannadhasan
Published: April 2021

De Quervain’s tenosynovitis is common in adults but extremely rare in children. Current investigation report a 9 year old girl who was diagnosed to have De Quervain’s tenosynovitis presented with pain over lateral end of right wrist with very minimal swelling lasted for 10 days. Clinical and ultrasonographic examinations contributed to the diagnosis. Overuse of mobile phone by this child resulting in repetitive movements and strain injuries of the thumb and wrist contributed to the development of tenosynovitis of the tendons of thumb which is reported in literature. Current case is reported to create awareness among pediatricians about this rare condition which may become common in the future.
Ohtahara syndrome progressing to West syndrome
Authors: Patel Tapan , Patel Shivani
Published: April 2021

West syndrome is a severe epilepsy syndrome composed of the triad of infantile spasms, hypsarrhythmia on electroencephalography (EEG) and mental retardation. It is sometimes due to the progression of a rare and fatal condition called early infantile epileptic encephalopathy (Ohtahara syndrome). Here we describe the case of a 3 year old male, who is a known case of West syndrome, presenting with recurrent breakthrough convulsions.
Growth hormone deficiency and hypoglycemia: a case report
Authors: B. Thanuja , Puttappanavar Ashok V. , Narasimhegowda Meghana , K. B. Namratha , S. Prashanth
Published: April 2021

Recurrent hypoglycemia in childhood may be caused by various endocrine or metabolic disorders, of which growth hormone deficiency is a rare cause. A 5-year-old girl presented to us with short stature and recurrent episodes of hypoglycemic seizures. On evaluating for the same, critical sample showed normal cortisol and low c-peptide levels. Neuroimaging ruled out pituitary anomalies. Growth hormone deficiency was diagnosed after GH stimulation test (with clonidine and insulin) revealed low basal and post-stimulation values. Following GH supplementation, no further hypoglycemia was noted. This rare case is being reported to highlight the importance of treating the underlying etiology of hypoglycemia to prevent adverse neurological outcome.
Prevalence and death rate of COVID-19 in some selected countries and its socio-economic impacts in Khulna division of Bangladesh
Authors: Sohidullah M. , Khan Shahidur R. , Alam Ashiqul , Rahman Nahid , Kundu Swarup K. , Rahman Arifur
Published: April 2021

Background: 2019-nCoV has been declared by WHO as a global pandemic in March 2020. The present study was undertaken to find out the global as well as local prevalence, and death rate of COVID-19.Methods: A developed questionnaire was used in Khulna division of Bangladesh to record the percentages of people who were mask user, involved with different risk groups, harmed by socio-economic impacts of COVID-19, involved with the issue of government taking measures for controlling COVID-19. Some of the highly risk countries of the world were selected for recording the data.Results: As of October 20, 2020, we found USA, and Bangladesh at 1st and 17th position respectively in terms of global prevalence of COVID-19. We found Dhaka at 1st position in terms of division wise prevalence in Bangladesh. In terms of death rate of COVID-19, Mexico reported 10.10% death rate by securing 1st position. We recorded the data related with percentages of people who were involved with mask using and risk groups like hypertension, diabetes, respiratory illness, smoking; harmed by socio-economic impacts of COVID-19 that changed their lives, believers of different levels on government taking measures for controlling the spread of COVID-19 from Khulna division.Conclusions: The findings of this research work would certainly help the government of highly risk countries as well as Bangladesh to take appropriate measures to control COVID-19. Moreover, it will be helpful for the government of Bangladesh to take necessary steps to mitigate the socio-economic crises existing among the people.
State led innovations for achieving universal health coverage in a low resource setting Odisha, India: opportunities and challenges
Authors: Rout Sarit K. , Ghosh Upasona , Parhi Amrita , Chandrashekhar Sudhashree , Kadam Shridhar M.
Published: April 2021

Background: Odisha, a developing state of India, has introduced an innovative scheme known as Biju Swasthya Kalyan Yojana (BSKY), which aims at providing free health care to all the people. This paper examines the scope, key features, challenges and potentiality of BSKY to achieve universal health coverage (UHC) in Odisha.Methods: We reviewed policy documents and conducted qualitative interviews with key state government officials and other stakeholders to understand implement processes and constraints.Results: The scheme intends to provide free health care to all people in public health care institutions and additionally, 71 lakh poor households can avail health care services from the empanelled private hospitals with financial coverage up to 5 lakhs per family and women members up to 10 lakhs annually. This is implemented in assurance mode by merging state-run schemes- Rashtriya Swasthya Bima Yojana (RSBY), Biju Krushak Kalyan Yojana (BKKY) and Odisha State treatment fund (OSTF). The implementing agency is introducing several measures to control unnecessary health care utilisation and cost. Gate keeping mechanism and reserved packages by public hospital are major initiatives in this direction. Further, efforts to settle claims on time and IT related challenges are teething problems of the scheme. The findings further suggest that public expenditure on health stands at 1.3% of GSDP and inadequate human resources and health infrastructure are affecting service delivery.Conclusions: Achieving UHC with such a low public spending on health and different service delivery constraints looks ambitious. Odisha may learn from other countries to implement UHC phase wise.
Clinical profile and outcome of patients with Coronavirus disease 2019 (COVID-19): a large-scale observational study from Tamil Nadu, India
Authors: K. Senthil Raj , Suresh Adithyan Geetha , S. Selvavinayagam T. , Geetha Shruthee Suresh , K. Vinay Kumar , B. Viduthalai Virumbi , Nithyanandham Saravana Kumar , Palani Sarath
Published: April 2021

Background:  This study aims to assess the socio-demographic and clinical profile of the patients infected with SARS-CoV-2 in Tamil Nadu, India and to identify the associated prognostic determinants.Methods: Facility-level observational data pertaining to the case investigation of 15045 lab confirmed cases of COVID-19 reported in Tamil Nadu from March to June 2020 was used for the purpose of the study. The demographic and clinical profile of the COVID-19 confirmed cases and age-sex specific estimates of severity of illness were analysed. Determinants of prognosis were tested for statistical significance using Chi square and Student t test as appropriate.Results: The mean age was 40±7 years with a male predilection. Thirty six percent of the cases were symptomatic, with fever being the predominant symptom, followed by cough and breathlessness. The Case ICU rate and Case Fatality rate were found to be 6.2% and 2.9% respectively. Increasing age, male sex and underlying comorbid illness were found to significantly affect prognosis in these patients. However, it was observed that females experienced higher risk of severe illness and fatality in the younger age groups.Conclusions: While the observed findings reiterate the prognostic significance of age, gender and comorbidity as evidenced by other studies, the increased risk of severe illness and fatality among younger females provides a new direction for further research from a socio-epidemiological perspective.
Body image issues among school going adolescent girls in a rural area of Haryana: a cross sectional study
Authors: . Vinay , Kumar Neelam , Malik J. S. , Sachdeva Aman
Published: April 2021

Background: Adolescent girls in today’s world are extremely conscious of perceptions of a perfect body. With the growing sense of thin ideal body image during adolescence, they try to lose body weight to attain the perfect body size. The emphasis on thinness and on an ideal female body shape and size is physically and psychologically detrimental to the health of many young women. This study was carried out with objective to find the prevalence of body image issue among adolescent girls in rural area.Methods: This cross-sectional study was conducted in block Lakhanmajra, district Rohtak, Haryana. Adolescent girls in age group 13-19 years studying in class 8 to class 12 in 10 government and private senior secondary schools of Lakhanmajra block were included in the study. The total sample of 500 students was included in the study. A pre-designed pre-tested semi-structured interview schedule was used, and the responses were recorded by the investigator herself.Results: The findings of the present study show that 20.2% adolescent girls did not like their appearance when they look in the mirror and thus had body image dissatisfaction. 88.0% adolescent girls were satisfied with their weight and 12.0% were dissatisfied. 80.0% of the study subjects who were dissatisfied with their body weight had normal age specific BMI values. Only 20% of the adolescent girls who were not satisfied with their weight were underweight or overweight.Conclusions: More worries and less satisfaction about body image are found in girls. The relatives, the media, the peers and the community all have an impact on body shape satisfaction. But the greatest influence is that of the media and the community through standardising a thin ideal for female beauty.
A study to assess the knowledge and practices of menstruation among rural adolescent girls
Authors: Hiremath Bhavana R. , Shettar Deepti
Published: April 2021

Background: Adolescence is phase of maturations where an individual experiences drastic changes in growth and development. Age group 10-19 years is defined as adolescent age by World health organization. In developing countries, this is the period when many children drop-out of school and miss out on education. Among adolescent girls’ menstruation is a major life changing event. We conducted this study among rural adolescent girls to know their knowledge, attitude and practices towards menstruation. We also educated all girls on physiology and hygienic practices during menstruation.Methods: A cross-sectional study was conducted among adolescent girls attending our out-patient clinic in the rural area. All girls were interviewed to assess their knowledge and practices towards menstruation. Informed consent was taken from all girls before stating the study. Data presented in form of frequency, percentages. Chi-square test was applied to analyze for association.Results: 87% were students, 88% adolescent girls belonged to Below Poverty Line (BPL) families. 98% adolescent girls had attained menarche before 15 years of age, 27% adolescent girls had dysmenorrhea presenting as pain in abdomen region. Sanitary pad was being used by only 64% adolescent girls, of whom, 59.4% change sanitary pad twice daily, 75% dispose it by burning. Overall, 36% adolescent girls used cloth, of whom, 41.7% changed cloth twice a day, 69.4% adolescent girls wash and burn the cloth. Among adolescent girls still studying in school 71.2% used sanitary pads which was statistically significant.Conclusions: Education is essential to empower girls to take informed decisions. On receiving adequate information on menstruation, girls were willing to adapt healthy hygienic practices. Hence, health education activities should be started at all schools so as to inculcate good practices early in life.
Outcome of hypoxic COVID-19 patients treated with dexamethasone-based treatment protocol in a designated COVID center
Authors: B. Adarsh M. , Abraham Anitha , P. Kavitha , Nandakumar Meera M. , Vaman Raman Swathy
Published: April 2021

Background: Managing severe COVID-19 is a difficult situation in resource limited settings. With the inclusion of steroid based treatment guidelines, this can be made feasible in such settings.Methods: This was a hospital record based retrospective cohort study done at a designated COVID hospital. Data of all patients who were 18 years and above, hypoxic and required initiation of dexamethasone-based protocol were analysed. Hypoxia was defined as a finger pulse oximeter value less than 95%. The primary outcome was the percentage of patients who required a referral to the higher centre or died in hospital.Results: 109 patients with hypoxia with a mean age of 55.2±13.5 years and a median symptom duration of 4 days were analyzed. Seventy-eight (71%) patients were male and 81 (74.3%) had other comorbid illnesses. Of the 109 patients, 5 (4.6%) patients died in hospital, 22 (20.2%) patients were referred to higher center for further management and 82 (75.2%) patients could be treated and discharged. Those who were referred or died had lower SpO2, reduced time to initiation of protocol, more severe pneumonia, lower absolute lymphocyte count and lower platelet count. New onset diabetes was detected in 20 (18.3%) patients.Conclusions: Detection of hypoxia early and initiation of dexamethasone-based treatment protocol with timely referral of worsening patients can help to improve outcome in COVID-19 patients. This model can be effectively constructed in limited resource settings and can be of much help to the struggling health infrastructure.
Outlook of first year medical students in a Government Medical College in Mysuru
Authors: K. Manasa , R. Mythily M. , Khan Mudassir Azeez
Published: April 2021

Background: The medical field has been one of the top choices for students. It is one of the promising career choice but along with it the students have to go through long period of course and hard work. The aspirations and perception of students are important to make necessary changes in curriculum and work settings which in turn leads to quality output.Methods: The study was conducted among the first year medical students in the government medical college Mysore. The proforma included details about demographic characteristics and influencing factors to choose medical field.Results: Among 143 students, 97 were males and 46 females. 91 students entered the course in first attempt and 52 students in the subsequent attempts. The most important influencing factors to enter medical field were doing service, passion for the profession and parents wish.Conclusions: Self interest in medical field was main reason for joining course. Majority of the students were happy, proud but also felt fear and anxiety on joining the course.
Nutritional and medicinal values of common green leafy vegetables consumed in Delta State, Nigeria: a review
Authors: Dada Taiwo Esther , Otitoloju Kekere , Adjonu Randy , Crockett Judith , Nwose Ezekiel Uba
Published: April 2021

Green leafy vegetables (GLVs) play an important role in human nutrition. In sub-Saharan African countries, GLVs are a vital source of essential micronutrients, and their consumption has long been a part of the cultural heritage of African households. In Nigeria, GLVs are either cooked as a stew or consumed raw and used as a main or a supporting dish. These GLVs have great nutritional and medicinal value. It is hypothesized that providing knowledge about the botanical description, nutritional and medicinal benefits to consumers could improve consumption, but much of existing knowledge is poorly documented and inaccessible. This paper aims to address this gap by collating information on some consumed in Delta State, Nigeria: African jointfir (Gnetum africanum, locally known as Ukazi), jute mallow, (Corchorus olitorius, locally known as Malafiya), and cassava (Manihot esculenta, Crantz), giant yellow mulberry (Myrianthus arboreus), okra (Abelmoschus esculentus), clove (Syzygium aromaticum) and bush buck, (Gongronema latifolium, locally known as Utazi) leaves.
A review of Lassa fever cases in Nigeria for the year 2020
Authors: Nyinoh Iveren Winifred , Utume Laura Nguoron , Bob-Echikwonye Ooja
Published: April 2021

Lassa fever (LF) is a zoonotic disease endemic in west Africa and the knowledge of its epidemiology is important in the prevention of infection. In Nigeria, LF occurs majorly in the dry months and individuals in rural communities are mostly infected, however, there have been reports of a shift to urban households. Clinical symptoms vary and may be non-specific thus making diagnosis challenging. In this paper, we reported data routinely collected in 2020 from all individuals diagnosed with LF in Nigeria. Data were obtained from the Nigerian centre for disease control (NCDC) website online. Out of 6791 suspected cases from 30 December 2019 to 3 January 2020 there were 1189 laboratory-confirmed cases and 244 deaths. By comparison to the same period in 2019 where there were 833 cases and 74 deaths, this represents an increase of 42.74% confirmed cases from 2019. Data indicates that there was a minimum of 1 confirmed case of LF in 131 local government areas across 27 of the 36 states. Ondo state Nigeria had the highest number of confirmed cases with 75%, which was followed by Edo (32%) and Ebonyi (7%). By age, the 21-30 year old were mostly affected. Collated data showed the numbers of LF cases are significantly increasing yearly. The results obtained will assist the government in mapping the disease and taking precautionary measures to prevent the spread of LF amongst individuals in Nigeria.
Short stature among girl child: a psychological burden or a social stigma-a review
Authors: Sharma Karishma , Singh Brijendra , Naithani Manisha , Chandra Rishita , Verma Prashant K.
Published: April 2021

Short stature (SS) is defined as “height below the third percentile or less than two standard deviations below the median height for that age and sex according to the population standard”. Short stature is not itself a pathology or disease but sometimes may be present as a manifestation of some underlying pathological condition. This condition is seen to impact adversely on the psychological wellbeing of the affected individuals and gives rise to the social stigma which further worsens the quality of life of short-statured persons. Hence, there is a need to acknowledge and break this stigma thereby improving the psychological wellbeing of the short-statured population.
Oromucosal lesions in women smokers: an Indian perspective
Authors: Shende Vaishali Waghmare , Kaushik Shruti , Nagpal Indu
Published: April 2021

Women smoking is looked down upon by Indian society. However, a young woman smoking is not a rare sight on college campuses in metro cities. Substantial body of literature indicates that nicotine is the major component which leads to addiction. The habit which starts to look cool and fashionable in no time becomes an addiction. Indian society, which doesn’t acknowledge that women are indulging in smoking, makes the whole fight about tobacco addiction a turbulent journey. As society doesn’t accept that women smoke, there is no need to create awareness about its gendered impact. The study was undertaken by evaluating the oromucosal conditions and haemoglobin levels of 100 women smokers. Smokers’ palate, smoking associated pigmentation on lips and calculus deposits were observed in most of the participants. The participants were not aware about the hormonal issues and detrimental side effects of smoking to their health.
Skin disorders prevalent among orphanage children in Puducherry
Authors: Kanagaraj Preethi , Kaliyaperumal Damayandhi , Paquirissamy Oudeacoumar
Published: April 2021

Background: Around 20 million children, about 4% of the total population of India, higher than the population of Delhi, are abandoned and most of them dwell in orphanages.

Methods: There are only few studies were carried out to analyse the spectrum of skin diseases in orphanage children and there is a paucity of data from orphanages in Puducherry. Hence this study was carried out to analyse the spectrum of skin disorders in orphanage children, in and around Puducherry. In this cross sectional study, three orphanages in and around Puducherry was chosen. Two dermatologists carried out the examination, including the skin, hair, nails and oral cavity of all the residents for a period of six months. Diagnoses were made clinically and recorded, treatment recommendations were offered.

Results: The data analysis was carried out using Graphpad Prism, a p<0.05 was considered significant. A total of 216 children were enrolled in this study, of which 203 (93.98%) were found to have skin diseases. Infectious dermatoses were observed in 148 (68.52%) children whereas non-infectious dermatosis was evident in 83 (32.43%). Among the infectious dermatoses infestation was the most common (37.50%), followed by fungal in 48 (22.22%), bacterial 12 (5.56%) and viral in 7 (3.20%). Acquired disorders such as acne, eczema and xerosis and pigmentary, papulosquamous and other miscellaneous dermatoses constituted the non-infectious group dermatoses.

Conclusions: Skin disorders in orphanage children are ought to be more common due to overcrowding, lack of personal hygiene etc, which is evident from higher incidence of contagious infectious dermatoses. Hence improving the standard of living, counseling and education to the care takers, and the children and good nutrition will help to bring down the skin diseases in orphanages.
Evaluation of serum ferritin, vitamin B12 and vitamin D levels as biochemical markers of chronic telogen effluvium in women
Authors: Belgaumkar V. A. , Chavan R. B. , Deshmukh N. S. , Patil P. , Bhatt N. , Agrawal K.
Published: April 2021

Background: Diffuse hair loss is a common complaint encountered by dermatologists in clinical practice and can be alarming to the patients. Chronic telogen effluvium (CTE) is characterized by an abrupt onset of diffuse loss of scalp hair persisting for more than six months, predominantly affecting healthy women in their fourth to fifth decade of life. Although CTE is considered to be associated with various nutritional deficiencies, currently the evidence to substantiate this assertion is conflicting.

Methods: A cross-sectional study was conducted on 100 adult non-pregnant women with CTE to document serum ferritin, B12 and vitamin D levels in an attempt to validate their role as biochemical markers using Statistical package for social sciences (SPSS) version 25:0 and Fisher’s exact test.

Results: Mean ferritin level was 31.17 ng/dL. 23% patients had serum ferritin levels lower than the normal range (13-150 ng/dL). Vitamin D levels (normal range 5.2-60.4 ng/ml, mean 21.41 ng/ml) were low (deficiency range) in 2%. Vitamin B12 levels (normal range 191-663 pg/ml, mean 239.79) were low in 35.7% patients. Other parameters like duration, family history, past history of treatment did not demonstrate any statistically significant correlation.

Conclusions: Our study detected low levels of serum ferritin and vitamin B12 in approximately one-fourth and a third of females with chronic telogen effluvium respectively with vitamin D deficiency found in only a small proportion. Although a statistically significant correlation could not be established between these nutrients and participant age or other parameters; we concur with most authors who recommend that all females with diffuse hair loss deserve a thorough screening for nutritional deficiencies to facilitate prompt recognition and timely supplementation.
Unilateral morphea following unilateral vitiligo: a rare occurrence
Authors: Salam Arisha , Danny Geo , Kumar N. Ashok , Manohar Archana
Published: April 2021

Morphea and vitiligo are two different conditions for which etiology is unknown. Many pathogenic mechanisms have been postulated for these two conditions, of which autoimmune mechanism is common to both. We here by present a case of a 36 years old female with occurrence of unilateral morphea following unilateral vitiligo.
Zosteriform cutaneous leiomyoma: a case report
Authors: Munuswamy Rajesh , Begum Shameera , Thamilselvam Sneha
Published: April 2021

Cutaneous leiomyomas are rare, benign soft tissue tumors arising from smooth muscles of the skin and comprise of three distinct subtypes, namely piloleiomyoma, angioleiomyoma and genital leiomyoma. Piloleiomyomas can present as solitary form, multiple disseminated and zosteriform or segmental forms. Cutaneous leiomyomas are rare, of which zosteriform leiomyoma is not commonly encountered. Here we report an uncommon case of Type I zosteriform cutaneous leiomyoma in a middle-aged individual which was confirmed on histopathology. Patient was further started on nifedipine with significant symptomatic improvement. The patient is planned for surgical excision and long-term follow in view of its association with aggressive renal malignancy.
A rare case of peripheral T cell lymphoma, not otherwise specified with cutaneous involvement and diffuse systemic metastasis
Authors: Khade Pandharinath K. , Bose Agni K. , Kharkar Vidya D.
Published: April 2021

Peripheral T-cell lymphoma (PTCL), a subdivision of T-cell non-Hodgkin lymphomas (NHLs), is rare and different from the more common cutaneous T-cell lymphomas. PTCL is a diverse group of disorders and carries a poor prognosis. Peripheral T cell lymphoma not otherwise specified (PTCL-NOS) is the most common and aggressive disorder out of the group, which involves the lymph nodes followed by the skin, liver, and gastrointestinal tract. We hereby report a case of a 60 years old female who presented to us with complaints of multiple painful dark-coloured nodular lesions and indurated plaques over bilateral upper limbs, lower limbs and trunk, for 3 months. After detail laboratory investigations, histopathological and immunohistochemistry which was positive for CD30 antigen we confirmed the diagnosis as PTCL-NOS.  Radiological imaging showed involvement of gastrointestinal tract, adrenal gland and vertebrae. After thorough workup the patient was started on palliative radiotherapy, unfortunately she succumbed to death. In conclusion, PTCL-NOS with CD30 positivity is rare and aggressive with a poor prognosis, it is important to identify such cases and work in conjugation with an oncologist for proper management.
Diagnosis Biosafety Protocols in the Tourism Sector
Authors:   Inter-American Development Bank
Published: April 2021

This document includes a diagnosis of the adequacy of existing biosafety protocols in the tourism sector (with a focus on accommodation, restaurants, local transport, beaches, airports, and ports) to address the risks of Covid-19. Diagnosis identifies the main risk nodes of contagion and their level of coverage by protocols. It also discusses implementation, communication, and control procedures and existing needs to strengthen them.
Mechanistic Mathematical Modelling of Pothole Development from Loss of Roadway Subsurface-Materials
Authors: Ezekwesili Okechukwu Joseph Ifeanyi , Agunwamba Jonah Chukwuemeka
Published: April 2021

In this paper, we developed a mechanistic mathematical model. It implies the engineering problem of pothole development on roadways. The issue involves internal erosion, a decline of subsurface materials, voids creation, depression, materials damage, and potholes’ appearance on the road’s surface. Our study aims to predict why, how, and when pothole develops from the loss of roadway subsurface materials. We reviewed many sources as our first method. It involved using and adapting the guiding principles for migrating particles upwards. We then changed specific parameters, formulated our model equation, solved it using the separation of variables, and then verified it. Observations from our review show that high traffic load pressure and water must be present on the road for particle migration to occur. They generate excess pore-water pressure that enables the movement of particles upwards. Particle relocation causes voids and dislocation of materials. Results show that an increase in time, cracks, soil erosion coefficient, and a decrease in the roadway’s height led to a rise in the number of materials lost from the pavement. Our study is relevant because it will better inform road managers and modelers on potholes, and they can-do preventive measures to avert total road failure.
A Multi-Objective Risk Return Trade off Models for Banks: Fuzzy Programming Approach
Authors: Chaudhury Rahul , Islam Sahidul
Published: April 2021

The main focus of banking sector is on the risk management. Asset liability management (ALM) is one of the key processes to manage the risks. The objective of this paper is to develop a multi-objective asset liability optimization model for banks with the maximization of market value of equity and minimization of duration gap as the objective function. Several liquidity ratios, concept of duration and convexity are considered to manage the risk properly. Interest rate risk and liquidity risk are two major considerations in both the regulation and management of a bank. As we know that, with the fluctuation of the market interest rate, the market value of assets and liabilities of a bank changes and that affects a change in owner’s equity. In order to overcome such type of situation here we will use the concept of duration and convexity to manage the interest rate risk. In case of liquidity risk the shortage of liquidity may also put that bank in risk and simultaneously it is very crucial to manage the cash flow properly. So here we will use some major liquidity ratios to manage the liquidity risk. We will take the help of fuzzy programming technique to solve our model properly. A numerical example is given to illustrate our model by considering a hypothetical bank balance sheet. Also we will compare the result obtained by fuzzy technique with result obtained by a non fuzzy based technique.
An Efficient VLSI Architecture Design of Antilogarithm Converter with 10-Regions Error Correction Scheme
Authors: Nandan Durgesh , Mahajan Anurag , Kanungo Jitendra
Published: April 2021

An applications of signal processing are frequently used everywhere in day-to-day life. “Digital Signal Processing (DSP)” has been basic requirement of efficient and accurate arithmetic operations for performing fast and accurate signal processing. Logarithm arithmetic provides an option of that desire. In this work, it is presented an efficient VLSI implementation of an antilogarithm converter by using 10-region error correction. It provides error efficient implementation with significant hardware gain. VLSI implementation of reported and proposed antilogarithmic converters design created in Xilinx ISE 12.1. Antilogarithmic converters (reported and proposed design) are synthesized by using Synopsys design software perform the RTL Synthesis analysis by using package design compiler. This paper presents 10- region converter which considers design trade-off where proposed demonstrates 19.75%, 31.02%, 12.65%, 44.65% and 29.91% respective reduction in comparison of previous design. Error analysis was done using MATLAB for proposed conversion method and reported methods. Suggested antilogarithmic converters have 1.559% error only in comparison of 1.7327% error reported by Kuo et al. On behalf of hardware complexity and error analysis results, it can say that the proposed converters could perform better in comparisons of all aspects of reported design.
A Finite Difference-Spectral Method for Solving the European Call Option Black–Scholes Equation
Authors: Talaei Younes , Hosseinzadeh Hasan , Noeiaghdam Samad
Published: April 2021

In this paper, we present a novel technique based on backward-difference method and Galerkin spectral method for solving Black–Scholes equation. The main propose of this method is to reduce the solution of this problem to the solution of a system of algebraic equations. The convergence order of the proposed method is investigated. Also, we provide numerical experiment to show the validity of proposed method.
¿Aceptación o rechazo de la estandarización clínica? Médicos chilenos hablan de las guías clínicas y canastas de prestaciones
Authors: Lemp Sebastián , Calvo Esteban
Published: April 2021

Este estudio analiza la aceptación de los médicos respecto de la estandariza­ción de la atención clínica que conlleva la reforma de Acceso Universal con Garantías Explícitas (AUGE) y de Garantías Explícitas en Salud (GES) iniciada en el año 2005 en Chile. Se realizaron 18 entrevistas semiestructuradas, en las que se exploran cuatro hipótesis vinculadas al nivel de aceptación de la estandarización y su variación según los años de práctica clínica, el tipo de instrumento (guía clínica o canasta de prestaciones) y la especialidad (médica o quirúrgica). Los resultados sugieren que no existe un rechazo generalizado hacia la estandarización de los procesos clínicos, sino importantes diferencias en el discurso de los médicos. El grado de aceptación depende tanto de los años de experiencia clínica como del tipo de instrumento evaluado. Se discute la implicancia de estos resultados para diseñar e implementar reformas de salud exitosas, que consideren la racionalidad de la profesión médica y su énfasis en la discrecionalidad individual, variabilidad terapéutica y capacidad para adecuarse a las circunstancias particulares de su práctica.
Dengue en la Argentina: un análisis económico del impacto de la epidemia de 2009
Authors: Tarragona Sonia , Monteverde Malena , Marchioni Silvia , Caporale Joaquín , Pereiro Ana Cristina , Palacios Julio Maximiliano
Published: April 2021

El presente estudio estima la carga económica de los casos notificados de dengue durante la epidemia argentina de 2009. Entre los costos considerados, se encuentran los costos médicos para el tratamiento de las personas afectadas y los costos de oportunidad de aquellas personas que dejaron de trabajar o estudiar a causa de la enfermedad. Para la determinación de los costos, a fines de 2009 se llevó a cabo una encuesta ad hoc a 201 hogares en los que habitaban personas que habían padecido la enfermedad durante la epidemia. Los resultados obtenidos permiten estimar entre los 26 y los 40 millones de pesos (entre 6 y 9 millones de dólares) el costo total de los casos notificados. Las regiones del norte argentino son las que habrían soportado la mayor carga económica (más del 90% de la carga total). Para todas las regiones, el costo social de un caso de dengue representaría más del 40% de la remuneración neta mensual promedio de los individuos.
Evaluación de una propuesta pedagógica de enseñanza de la Medicina
Authors: Silberman Martín Salvador , Silberman Pedro , Pozzio María
Published: April 2021

En el presente artículo nos proponemos discutir el papel que cumplen las escuelas de medicina en la formación del perfil de los profesionales. Para ello, se analiza el impacto de dos experiencias de prácticas en terreno realizadas en 2006 y 2009, por los alumnos de la cátedra de Epidemiología de la Facultad de Ciencias Médicas de la Universidad Nacional de La Plata (Provincia de Buenos Aires, Argentina). Mediante cuestionarios semiestructurados individuales aplicados a los alumnos y estrategias de grupos focales se buscó obtener información de las ideas y representaciones de los estudiantes, antes y después de las experiencias pedagógicas. Entre los principales resultados se destaca la posibilidad de que los alumnos se replanteen los modelos explicativos del proceso salud-enfermedad-atención y el peso real de los problemas sociales sobre los fenómenos de salud y enfermedad.
La enfermedad en su laberinto: avances, desafíos y paradojas de cien años del Chagas en Argentina
Authors: Zabala Juan Pablo
Published: April 2021

El artículo analiza la persistencia de la enfermedad de Chagas en la Argentina durante más de un siglo, prestando atención a las diferentes dimensiones (biológica, de conocimiento, política, profesional y técnica) que participan en su definición. Se pone el acento en la identificación y discusión de algunas de las tensiones fundamentales que han marcado la historia de la enfermedad, con la intención de discutir cuáles han sido los condicionamientos concretos que han marcado, por un lado, la continuidad de la enfermedad dentro de la consideración política pero, al mismo tiempo, la imposibilidad de alcanzar una situación de control definitivo.