bluuebunny/crossref_metadata_2025 huggingface dataset:
Congenital hypothyroidism screening by umbilical cord blood: thyroid stimulating hormone
Authors: Zion Gaddam Eluzai , . Raheemunnisa
Published: January 2020

Background: Congenital hypothyroidism (CH) is one of the common preventable cause of intellectual disability. Most cases of CH result from thyroid dysgenesis. CH is often asymptomatic in early infancy, and any delay in treatment can affect the child in terms of delayed cognitive milestones. NSCH (newborn screening for congenital hypothyroidism) has been universally accepted and it is one of the most cost effective screening programs in the field of preventive medicine and public health.Methods: A cross sectional study was conducted in Sri Venkata Sai Medical College and Hospital from 28th August to 28th February 2019 (1.5 years), this study was done on 73 newborns (70 deliveries, three mothers gave birth to twins). All data was collected prospectively. Mothers with known thyroid disease or on thyroid medication were excluded from the study. Under sterile aseptic conditions blood sample is collected from the umbilical cord soon after delivery.Results: In the present study Cord blood TSH level of >20 mIU/L was present in 10% (7) of neonates. When the blood TSH levels were repeated (on day 3) among those with high cord blood TSH levels (>20), the blood TSH levels was also high (>20) in 6 (85.7%) neonates and low (<20) in 1 (14.2%). In Neonates with cord blood TSH >20, 6 neonates also had Low T4 (T4<7) levels (85.7%) and 1 neonate (14.2%) had T4 >7. In the present study 6 neonates (85.7%) had Congenital Hypothyroidism. The present study finds that Cord blood TSH as a diagnostic tool has Sensitivity of 100% and specificity of 98.5% in diagnosing congenital hypothyroidism.Conclusions: The current study concludes that Cord blood TSH is a sensitive and specific marker to predict the presence of congenital hypothyroidism in neonates.
Detection of red cell alloantibodies in thalassaemia patients
Authors: Sahu Ansuman , Parida Pankaj , Mahapatra Smita , Sahoo Binay Bhusan
Published: January 2020

Background: β-thalassaemia patients receive regular blood transfusion to thrive. Due to antigen disparity between the blood donors and these patients they develop red cell alloantibodies due to alloimmunization.  The objective of this study is to predict the frequency of red cell alloimmunization amongst β-thalassaemia major patients receiving regular blood transfusion.Methods: This study including 106 patients with β-thalassaemia was conducted in the department of Transfusion Medicine, S. C. B. Medical College, Cuttack for a period of 12 months. Alloantibodies to different red cell blood group antigens in multi-transfused thalassaemia patients were detected using the glass bead technology for blood group serology in the present study.Results: Out of 106 β-thalassaemia major patients included in the study, 7.5% of patients developed alloantibodies, all being clinically significant. The alloantibodies were anti-E, anti c, anti e and anti-D. The rate of incidence of these alloantibodies was 3.8%, 1.9%, 0.9% and 0.9% respectively.  There was a significant association between alloantibody formation with number of transfused packed red cells (Mann-Whitney Test: p value = 0.035) and age at first transfusion (p value = 0.001). The factors having no association with alloimmunization to red cell antigens are age and gender.Conclusions: Alloimmunization to various erythrocyte blood group antigens is a common problem in multi-transfused β-thalassaemia patients. There is an association between number of transfused packed red cells and age at first transfusion with alloantibody formation in the study.
Acquired generalized lipodystrophy type 2-lawrence syndrome: a rare case report
Authors: K. Dhanalakshmi , S. Mohinish , B. Dakshayani , K. Mallesh
Published: January 2020

Lawrence syndrome (Acquired Generalized Lipodystrophy) is a rare disorder, characterized by various dermatological and systemic manifestations such as lipodystrophy, hypertriglyceridemia, hepatomegaly, acanthosis nigricans and acromegaloid features. Because of its rare occurrence we are reporting a case with similar manifestations in a 10 years old child.
Functioning adrenocortical carcinoma causing virilisation: a case report
Authors: Sarma Vivek Parameswara , Menon Sunil S.
Published: January 2020

Adrenocortical carticnoma (ACC) is an uncommon tumor with an incidence of 1-2 cases/million/year. It has two peak incidences; the first one in the first decade and the second one in the fourth decade. Most patients present with features of steroid hormone excess or abdominal mass effects, but about 15% of ACC are diagnosed incidentally. It is hormonally functional in 80 - 100% patients and the predisposing lesions include congenital adrenal hyperplasia and adenoma. ACC has significant syndromic and genetic association. Surgery offers the best chance of cure, especially in localized disease. Here, we present the case of virilization in a young female child secondary to a functioning ACC. The child had classical hormonal and imaging features of functioning ACC and underwent resection of the tumor (Adrenalectomy) with good outcome.
A rare case of ischaemic stroke following cervical spine manipulation in an adolescent girl
Authors: Paul Ashitha Judith , Kumar Radha
Published: January 2020

Stroke in children is associated with a multitude of risk factors compared to risk factors of adult stroke such as hypertension, diabetes or atherosclerosis. A 15-year adolescent girl presented with acute onset weakness involving right upper and lower limb. She complained of neck pain and fever 2 days before the onset of hemiparesis for which her parents took her to traditional healer who performed neck manipulation after which she developed vomiting, tingling numbness and weakness of right upper and lower limb. There was no history of preceding headache, ear discharge or any other contributory history. Clinical examination revealed Glasgow Come Scale 12/15, power of grade 2/5 in right upper limb and 3/5 in right lower limb, exaggerated deep reflexes, extensor plantar reflex, right sided ptosis and right sided upper motor neuron facial palsy. CT scan brain showed right cerebellar and occipital infarct with posterior inferior cerebellar artery territory involvement. MRI Brain and MR Angiogram showed wedge shaped infarct involving right posterior inferior cerebellum, inferior vermis, ventral aspect of superior medulla, paracentral pons, right cerebral peduncle, tectum of both halves of midbrain with no internal hemorrhage and no vessel abnormality and right vertebral artery was not visualized. Her coagulation profile and cardiac work up were normal. She was treated with antiplatelet drugs, anticoagulants and physiotherapy following which the child gradually improved over a period of one month. In this case, with a positive history of neck manipulation authors can conclude that the etiology of young stroke wasinduced byneck manipulation. This case has been reported to increase awareness about the ill effects of neck manipulation and counsel parents against performing such procedures for children. Early recognition of pediatric stroke is critical for immediate diagnosis, imaging and treatment with better outcomes.
Neonatal presentation of Joubert syndrome
Authors: Choudhary Rahul , Sachdeva Garima , Katoch Gaurav , Choudhary Sanjeev
Published: January 2020

Joubert syndrome is a rare genetic disorder with autosomal recessive or rarely X-linked recessive inheritance. Authors are reporting a case of a newborn girl with Joubert syndrome who presented with respiratory distress, hypotonia, hyporeflexia, abnormal eye movements, and facial dysmorphism. Brain MRI revealed vermian hypoplasia, “molar tooth sign” with “bat wing appearance” of the fourth ventricle, deepened interpeduncular fossa, and elongated superior cerebellar peduncles. The clinical diagnosis of this syndrome is difficult due to its variable presentation and non-specific presentation. Magnetic Resonance Imaging (MRI) has an important role in the diagnosis of Joubert syndrome. This not only helps in early diagnosis but also helps in appropriate counseling and proper rehabilitation of the baby.
Severe haemoptysis in a 5 year old child with Kartagener’s syndrome: case report
Authors: S. Mohinish , K. Mallesh , K. Prashanth H. , R. Ravichandra K.
Published: January 2020

Kartagener`s syndrome, a rare autosomal recessive disorder is a type of Primary Ciliary Dyskinesia (PCD) associated situs inversus, bronchiectasis, sinusitis and male infertility. We present a case of a 5-year-old girl who came with features of bilateral glue ear, recurrent sinusitis, recurrent hemoptysis and dextrocardia. She was diagnosed to have Kartagener`s syndrome and was evaluated for recurrent hemoptysis.
Serum magnesium levels in attention deficit hyperactive disorder in 6-17 years age group: a study in tertiary care center
Authors: Varahala Ajay Mohan , Gajula Ravi , K. V. Subba Rao
Published: January 2020

Background: Attention-deficit/hyperactivity disorder (ADHD) is the most common neurobehavioral disorder of childhood and one of among the most prevalent chronic health conditions affecting school-age children. Magnesium is a crucial mineral and appropriate levels in the body are essential for normal cognitive function and mental health. Seventy-two to 96% of those diagnosed with ADHD have been found to be significantly deficient in magnesium. Studies have shown that in these patients, supplementation with magnesium improves attention and working memory and decreases anxiety, depression and emotional dysregulation. Objective of the study was to measure the serum levels of magnesium in children with attention deficit hyperactive disorder and to assess the relation between serum Magnesium levels and Attention deficit hyperactive disorder (ADHD).Methods: The study was conducted at Niloufer Institute of Child Health, which is tertiary care referral hospital and a teaching institute, affiliated under the esteemed Osmania Medical College, Hyderabad. Ethical committee clearance was taken before conducting the study, 50 cases of ADHD are selected from the outpatient department of the Psychiatry clinic for children and adolescents. And 50 controls are also selected for this study. Serum magnesium levels are assessed in both groups.Results: In ADHD group children with serum Magnesium level <1.5 meq/L are 24% whereas in control group it is 6%. When subgroups were analyzed, 25% of hyperactive ADHD group, 18.75% of inattentive ADHD group and 27.27% of combined ADHD group had serum magnesium levels of less than 1.5 meq/l.Conclusions: The study suggest that there is deficiency of magnesium in ADHD children when compared to healthy controls. Further, the study also recommends that further research is needed to help to identify the etiology, impact, and possible therapeutic implications of magnesium status in ADHD.
Association of cord blood and maternal lipid profile
Authors: Zohra Noor Fathima S. , Prabhu Anitha S. , Rao Smitha B. , Saldanha Prakash R. M.
Published: January 2020

Background: Cardiovascular diseases (CVDs) are the leading cause of mortality and morbidity with dyslipidemia as an important contributing risk factor. Objective of the study was to determine whether there is an association between maternal lipid profile and the cord blood lipid profile of their newborns.Methods: This was a hospital-based Cross-sectional study on 60 mothers and their respective newborns (30 term and 30 preterm) conducted in Yenepoya medical college hospital from August to November 2019. Umbilical cord blood samples from the newborns were collected after birth and the mother's venous blood was collected in the fasting state (8hrs of fasting) before delivery. The levels of total cholesterol, triglycerides, HDL, LDL and VLDL were determined in mothers and their newborns by an enzymatic colorimetric method. Data obtained was analyzed by the SSPS software 23.0 version and Pearson's correlation was done.Results: There was a significant correlation between the mean concentration of maternal Triglycerides and the Triglycerides and HDL levels of neonates (p-value <0.05).Conclusions: There was a significant association of cord blood and maternal lipid profile, hence changes in maternal lipid levels might influence the lipid levels in the cord blood of newborns.
Parents perception on pattern and effects of usage of electronic devices among school going children
Authors: Kuriakose Roshan , N. Prasad Nayak , Saldanha Prakash
Published: January 2020

Background: Over usage of electronic gadgets has a serious impact on physical activity of children leading to obesity, depression, anxiety, poor scholastic performance, strain on the eyes and triggering factor for  neck and back pain (due to spondylitis).It is very important to know how to control the screen time of children by parents.Methods: Here, 75 parents were subjected to questionnaire study which contained questions on the information on usage of electronic devices among children and the adverse effects noticed. Results were analyzed using Microsoft excel software.Results: Almost all the 75 cases had access to television, 64 had access to smart phones, 24 had access to IPAD/Tablet, 8 had access to laptop and 4 had access to gaming console. It was found that 45 % were depressed / anxious when gadgets were withdrawn from them. 21 kids had no idea what to do when gadgets were not available. 54 kids had no interest in outdoor playing and 38 children were found to have decreased interaction with other family members.Conclusions: Exposure to gadgets in paediatrics population leads to poor scholastic performance, obesity, depression, decreased interaction with family and many other problems. So, it is very important to have control on child’s day to day activities and have constant vigilance on their gadget usage.
Relation between central aortic pulse pressure and coronary artery disease: a coronary angiographic study in a tertiary care center
Authors: Subramanyam K. , Suranagi Manohar J. , Subramani K. S. , Rangaraj R.
Published: January 2020

Background: Aortic pulse pressure is a significant marker of cardiovascular morbidity independently of mean blood pressure and pulse pressure of 60 mm Hg should be considered as the threshold at risk both in normotensives and hypertensives. Coronary perfusion is dependent on diastolic blood pressure and patients with CAD may be susceptible to the adverse effects of low diastolic blood pressure. This study conducted to examine the relation between central aortic pulse pressure and the prevalence and extent of CAD.Methods: A cross sectional, hospital-based study conducted in Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, among patients undergoing diagnostic coronary angiography.Results: Risk factors like Diabetes, Hypertension, Dyslipidemia and smoking rates were significantly higher in patients with PP of >60 mmHg (p<0.01). In the first group, the ratio of having normal coronaries is higher 61.9% vs 38% and diseased coronaries was lower when compared to the other group 38% vs 98%. In patients with aortic pulse pressure >60 mmHg, 4 patients had left main coronary artery (LMCA) disease, 20 patients had single vessel disease, 11 patients had two vessel disease and 20 patients had triple vessel disease.Conclusions: In this study it was demonstrated aortic pulse pressure of more than 60 mm Hg is associated with significant CAD.
Screening and quantitative estimation of factor VIII inhibitors by Nijmegen-Bethesda assay in hemophilia a patient of Southern Odisha, India
Authors: Nayak Jayanti , Kar Sonali , Kar Monali
Published: January 2020

Background: The current treatment of haemophilia is replacement of factor VIII or IX which is effective till development of inhibitor against factors. There has been no study on factor VIII inhibitors in Southern Odisha using Nijmegen–Bethesda assay. This study was planned with objectives to screen factor VIII inhibitors in hemophilia-A patients, to do quantitative estimation of it using Nijmegen-Bethesda assay and to explore factors associated with development of inhibitors.  Methods: This cross-sectional study was carried out from September 2016 to August 2018 in Department of pathology, MKCG medical college, Berhampur. Haemophilia-A patients coming to MKCG medical college and registered Haemophilia-A cases under Haemophilia society of Berhampur were included. Patients denying consent and having multiple clotting factors deficiencies were excluded. 1.8ml blood was collected. Mixing study was done to screen factor VIII inhibitors and then in positive cases inhibitors level measured by Nijmegen-Bethesda method. All data were analysed using SPSS (version 16.0).Results: 70 cases of Hemophilia-A patients were studied. Majority (50%) were with severe hemophilia-A. 7 patients developed inhibitors where 3 were high and 4 were low responders. Inhibitor level ranged from 0.8 to 64 Nijmegen-Bethesda units. Patients with severe hemophilia A, more than 10 transfusions and who switched to receive recombinant FVIII from other blood products developed inhibitors which were significant.Conclusions: Severity of hemophilia, increase frequency of transfusion and switching of blood products significantly increases chances of inhibitor development and hence intensive inhibitor screening is needed in these cases. Quantification of inhibitor is needed to monitor treatment and to manage bleeding episodes effectively.
Identification of various Candida species isolated from patients with vulvovaginal candidiasis attending a tertiary care hospital in North India
Authors: Jahan Noor , Vishnoi Pratishtha , Gupta Bhavana , Srivastava Swati , Ahmad Siraj , Khatoon Razia
Published: January 2020

Background: Vulvovaginal Candidiasis (VVC) is a condition diagnosed in a large proportion of women presenting with complaints of abnormal vaginal discharge. The risk of VVC is high in women with diabetes mellitus, pregnancy, using oral contraceptives or broad-spectrum antibiotics and those having Human Immunodeficiency Virus infection.Objective of the present study was to identify the various species of Candida isolated from patients with Vulvovaginal Candidiasis.Methods: A cross-sectional study was done from January to June 2018. A total of 69 clinically suspected VVC cases were included in the study whose high vaginal swabs were collected and subjected to direct microscopy and cultured on Sabouraud Dextrose Agar (SDA). Creamy white pigmented colonies on SDA were confirmed as Candida by doing Gram’s staining. Speciation of positive cultures was confirmed by conventional methods like Corn Meal agar culture, Germ tube test (GTT), Candida CHROM Agar Medium (CAM), sugar assimilation and fermentation test.Results: Out of 69 clinically suspected VVC cases included in the study, only 14 cultures were positive for Candida species. All the 14 isolates were found to be Non-albicans Candida (NAC). Most common species isolated were Candida glabrata 7(50%), followed by Candida tropicalis 3(21.4%), Candida lusitaniae 3(21.4%), and Candida parapsilosis 1 (7.1%).Conclusions: Candida albicans was known to be the most common causative agent of VVC as it was isolated in 90% cases. However, this study showed that all isolates from VVC were Non-albicans Candida. Therefore, species identification should be done in all microbiology laboratories for accurate diagnosis of VVC.
A prospective evaluation of correlation between cholinesterase level and severity of organophosphorus poisoning
Authors: Phanindra M. Deepak , Satyanarayana P. V. V. , Acharya Anand
Published: January 2020

Background: Organophosphorus compounds are anticholinesterases by inhibiting cholinesterase it protects acetyl chorine from hydrolysis. So, acetylcholine accumulates at the synapses, and all the clinical manifestation are due to that. So, this study has been designed to establish the reactive between level of serum and prognosis of op poisoning patients.Methods: Patient with history of organophosphorus poisoning admitted into the emergency department with following exclusion and inclusion criteria were included in this study. All patients were managed as per standard treatment protocol of op poisoning. Various parameters like demography of the patients, sign and symptoms, severity of intoxication, clinical and lab parameter manoring, Serum cholinesterase was measured every alternate day.Results: 22(47.84%) patients have mild symptom out of that 20 patient’s serum cholinesterase was more than 2000 IU/L, and 2(4.3%) patients serum cholinesterase was between 1000-2000 IU/L. In eighteen patient’s severity as per POP scale was moderate, out of that 2(4.3%) patients have serum cholinesterase was below 1000 IU/L, 8 having serum cholinesterase between 1000 to 2000 IU/L, and remaining eight having serum cholinesterase above 2000 IU/L.Conclusions: Serum cholinesterase was less in patient with high severity score or low serum concentration of cholinesterase was associated with high severity score. Serum cholinesterase was improved as days passes.
Study of patients with suicidal ideation with sleep disorders and depression in Karnataka population
Authors: Kumar Jayant , R. Rekha
Published: January 2020

Background: 85, adult patients aged between 17 to 65 years of both sexes were studied with   to know the etiology of suicidal ideation.Methods: Applying methodical instruments like sleep habits questionnaires and Black scale for suicidal ideation to rule out etiology and types of suicidal ideation.Results: Total 13(15.2%) had active suicidal ideation, 23(27%) specific plans for suicide 20(23.5%) had passive suicidal ideation, 29(34%) patients had previous history of suicidal attempts. Majority of the patients were under treatment of hypnotics and antidepressants’, 11(12.9%) were on clonozepine 12(14.1%) were on lorazepam 9(10.5%) were on chlordiazepoxide, Antidepressants, 8(9.41%) were on sertalin, 14(16.4%) desvenlafaxine, 15(17.6%) Amitriptyline, 16(18.8%) were on duloxetine.Conclusions: This pragmatic study highlights the suicidal ideation with sleep disorders and depression, will be quite helpful to psychiatrist, psycho-social worker to treat the patients efficiently
A cross sectional study: to determine the prevalence and risk factors of non-fatty alcoholic liver diseases among diabetics-I and II
Authors: Navuduri Geetha , . Asma
Published: January 2020

Background: Non Alcoholic Fatty Liver Disease (NAFLD) is an important health problem globally as well as in India. The present was taken to determine the prevalence of NAFLD among diabetics attending a tertiary care hospital in Telangana.Methods: A total of 75 subjects who were all diabetics were taken. The diagnosis of NAFLD was done using Ultra sonogram. Preliminary information along with duration of diabetes, Waist Hip Ratio, Body Mass Index, Triglycerides and Cholesterol was collected and analyzed.Results: The prevalence of NAFLD among diabetics was 41.3%. Majority of the subjects belonged to age group of 41-60 years. The prevalence of NAFLD among females was 35.99%. Among patients who had Non-alcoholic fatty liver disease 74.19% had Waist Hip ratio >1. Almost 90.3% had higher levels of triglycerides (>180 mg/dl).Conclusions: The prevalence of NAFLD among diabetics was comparatively high. Early diagnosis, treatment, awareness and education is needed to reduce the burden of NAFLD.
Impact of antibiotic stewardship program on usage of higher range of antibiotics in patients of intensive care units in a tertiary care hospital, India
Authors: Bhattacharjee Mounamukhar , Nag Vijaya Lakshmi , Goyal Jagdish Prasad , Tak Vibhor
Published: January 2020

Background: The aim of the study was to monitor the changes in antimicrobial use after implementation of Antibiotic Stewardship Programmed (ASP) and pattern of use of antimicrobials in the respective ICU’s.Methods: The study was conducted in three ICU’s Adult ICU(AICU), Paediatric ICU (PICU), Neonatal ICU (NICU) -Six bedded each) over a period of six months from September 2018 to February 2019 in a tertiary care hospital. Antibiotics monitored over total 155 patients and antibiotics selected for the study are β-lactam inhibitors, Carbapenem derivatives and ColistinResults: Out of total 155 patients 51% were males and the definitive therapy (Implementation of antibiotics according to the antibiotic policy of the hospital) in the respective ICU’s showed increase from 66.7% to 83.3% after implementation of ASP activity in that particular duration. Antibiotic consumption showed fluctuation in the whole duration of the study (p value <0.05).Conclusions: Analysis of the study shows a positive impact on implementation of ASP programme in intensive care units, brought an effective increase in appropriate use of antimicrobials.
Study of vitamin B12 deficiency in chronic kidney disease
Authors: Dandge Vinod Ananda , Variya Dhruv
Published: January 2020

Background: Chronic Kidney Disease (CKD) is a growing health burden and important cause of morality and morbidity worldwide as well as India. Anaemia a feature of CKD, is multifactorial, one of the most important factor responsible for the development of left ventricular hypertrophy, diastolic and later systolic dysfunction and cardiovascular disease, which is the single most important contributor to the mortality in CKD. Severe Chronic Kidney Disease has an adverse effect on haematopoiesisis. Lack of erythropoietin, Iron deficiency anaemia and shortened red cell life span, Nutritional deficiency or deranged metabolism of vitamins is the major factors contributing to anaemia in CRF. Patients with CKD show megaloblastosis on examination of the bone marrow. Suggestive of Vitamin B12 and folic acid deficiency might Be Additional Factors Contributing to inadequate Haematopoiesis in uremia. Patients with CKD are at higher risk for nutritional deficiencies due to medication interactions, dietary restrictions and malnutrition. The dialysis procedure itself may cause loss of vitamin B12, Folic acid and there deficiency.Methods: Sample size of 80 cases of CKD patients aged between 18-80 year admitted in SMIMER Hospital were included in study. Serum vitamin B12 Level was checked, correlation B12 deficiency with duration of CKD was observed.Results: It was observed that, 47 cases of CKD had vitamin B12 deficiency. The mean duration of CKD is more in B12deficient group as compared to Normal Group and also finds the higher proportion of vitamin B12 deficiency in CKD patients.Conclusions: Serum vitamin B12 level testing should be recommended routinely in patients with CKD and All the treating Nephrologists should anticipate the deficiency of vitamin B12 in CKD patients.
Study of serum vitamin D2 and calcium in young and middle aged healthy male smokers in rural tertiary care center
Authors: Paladugu Lalitha , V. Anjaneya P. , Mureboina Jayasree , Tummala Anusha C.
Published: January 2020

Background: Smoking is an essential determinant of various diseases. The study is aimed to understand the influence of smoking on serum vitamin D2/D3 levels and serum calcium levels in healthy young/middle-aged men.Methods: Prospective observational study was done among young and middle-aged healthy male smokers in a rural territory care center. Two hundred patients were studied and analyzed, who fulfill the inclusion and exclusion criteria.Results:  The prevalence of vitamin D deficiency (25(OH)D <20 ng/ml) was 50.3%. Only 8.8% of the participants had vitamin D sufficiency (25 hydroxyvitamin D ≥30 ng/ml). There is a  strong correlation between 25(OH)D and smoking in the participants (p<0.001). 25 hydroxyvitamin D level was lower by approximately 4.3 ng/ml (p<0.001) in a smoker compared to a non-smoker among the total participants, this value increased to 9.2 ng/ml in the 40-50y subgroup (p=0.003). A multinomial logistic regression model demonstrated that a young smoker (20-29y) had a 58% increased likelihood of having vitamin D deficiency compared to a non-smoker of the same age group (p=0.041). Irrespective of age and chronicity of smoking, there was a significantly increased level of serum calcium and significant vitamin D2/D3 deficiency in smokers.Conclusion: A high prevalence of vitamin D deficiency was identified in young and middle-aged male smokers, which is not likely to be explained by other confounding lifestyle factors. The depression of the vitamin D-PTH system seen among smokers may represent another potential mechanism for the harmful effects of smoking on the skeleton.
Prevalence of hepatitis C among pregnant females attending antenatal clinic at a tertiary care hospital in Lucknow, Uttar Pradesh, India
Authors: Jahan Noor , Chaudhary Nitin , Nigar Asma , Ahmad Siraj , Khatoon Razia , Kumar Anil
Published: January 2020

Background: Hepatitis C virus (HCV) is a major causative agent of parenterally acquired hepatitis. Vertical transmission of HCV occurs from mother to infant during pregnancy, delivery, or neonatal period. Hepatitis C infection among pregnant females can adversely affect both mother and fetus, leading to chronic infection in infants who later develop liver cirrhosis and hepatocellular carcinoma. Objective of the study was to evaluate the prevalence of hepatitis C among pregnant females attending antenatal clinic.Methods: A hospital based cross-sectional study was done over a period of six months from January to June 2019. A total of 550 pregnant females were included in the study who attended Antenatal Clinic for routine check-up and whose blood samples were sent to Microbiology Laboratory for screening of anti-HCV antibodies by Enzyme linked Immunosorbent Assay (ELISA) method.Results: Out of 550 pregnant females tested, 3 were found to be reactive to anti-HCV antibodies by ELISA; hence the prevalence was found to be 0.5%. All 3 seropositive females belonged to age group 26-35 years, were indoor patients (IPD) and belonged to lower socio-economic class. Majority of seropositive females belonged to urban areas (66.7%, 2/3) as compared to those from rural areas (33.3%, 1/3).Conclusions: Although, prevalence of hepatitis C was found to be less among pregnant females attending ANC of this institute, still routine screening of all pregnant females for anti-HCV antibodies is highly recommended, for timely detection of disease in mothers and prevention of its transmission to infants.
Tissue doppler imaging for estimation of left ventricular filling pressure in patients with systolic and diastolic heart failure: a comparative simultaneous doppler catheterization study
Authors: Suranagi Manohar J. , Subramanyam K. , Subramani K. S. , Srinivasa K. H.
Published: January 2020

Background: Noninvasive assessment of diastolic filling by Doppler echocardiography provides important information about left ventricular (LV) status in selected subsets of patients. This study was designed to assess whether the lateral mitral annular velocity as assessed by tissue Doppler imaging is associated with invasive measures of diastolic LV performance in patients with diastolic and systolic heart failure. Aim of the study was to compare the diagnostic accuracy of lateral mitral annular E/E′ as an estimate of LV filling pressure with invasive LVEDP measurement in subjects with systolic or purely diastolic heart failure.Methods: Total 100 patients were studied, 50 patients with diastolic heart failure and 50 patients with systolic heart failure in patients undergoing diagnostic coronary angiogram. Detailed 2D Echocardiography, Trans mitral Doppler and Tissue Doppler velocities of lateral mitral annulus was obtained. The ratio of peak mitral velocity (E) to lateral mitral annular velocity (E′) by TDI (E/E′) was calculated.Results: The ratio of E/E′ in diastolic group was 13.4±4.9 and in systolic group it was 13.7±5.2. The mean LVEDP in diastolic heart failure patients was 14.3±4.5 and 14.2±4.9 in systolic heart failure patients. The ratio of E/E′ showed a better correlation with LVEDP. E/E′ <8 accurately predicted normal LVEDP, and E/E′ >15 identified increased LVEDP ≥15mmHg.Conclusions: E/E′ is a reliable estimate of LV filling pressures in subjects with systolic and diastolic heart failure. In subjects with diastolic heart failure, E/E′ seems helpful to identify those with truly elevated LV filling pressures. In patients with diastolic heart failure and normal E/E′, a search for other causes of symptoms (pulmonary disease, obesity and so forth) may be warranted.
A case report on hydroquinone induced exogenous ochronosis
Authors: Sunkara Hari Priya , Kilaru Krishna Rajesh , Kumar Adusumilli Pramod , Ramineni Hari Babu , Krishna Puvvada Rahul
Published: January 2020

Exogenous ochronosis is an infrequent skin disorder characterised by bluish-black or grayish brown pigmentation on dermis. It is the most common condition caused due to long term application of Hydroquinone skin preparations for melasma, skin brightening, cholasma, acne induced pigmentation etc. This report refers to a case of 39-year-old female patient who presented to the hospital with chief complaints of progressive formation of dark lesions over face, neck since one and half-year. She had history of usage of hydroquinone (4%) cream for skin brightening for a period of three months. Based on clinical findings and history she was diagnosed to have acquired exogenous ochronosis and was treated with microdermabrasion, cosmelan peel, yellow peel, glutathione tablets, topical sunscreen and kojic acid cream. Patient noted 50% improvement in her condition after 4 months of treatment. It is believed that application of high concentrations of hydroquinone for a prolonged period causes exogenous ochronosis. This case report suggests that exogenous ochronosis can occur after three months of application.
Vitamin D: role of vitamin D in human health beyond skeleton
Authors: Singh Ambrish , Soni Ameet , Changani Mohit , Choksi Harsh
Published: January 2020

Deficiency of vitamin D is now considered as epidemic in Indian subcontinent, with a prevalence of 70-94% in the general population. Like in US, Indian dairy products are rarely fortified with vitamin D. Socioreligious and cultural practices followed in India do not facilitate adequate sun exposure, thereby negating potential benefits of plentiful sunshine resulting in vitamin D deficiency.  Deficiency is highly prevalent in both urban and rural settings. Vitamin D deficiency can lead to rickets, osteoporosis, cardiovascular diseases, diabetes, cancer and infections. In present review authors have revisited the details pertaining to vitamin D to increase the awareness on Vitamin D efficiency.
Assessment and accreditation of a medical college by national assessment and accreditation council: an overview
Authors: Doddaiah Sunilkumar , Bhat Deepa , Hathur Basavanagowdappa , Suma M. N. , V. Manjunath G. , Vishwanath Prashant
Published: January 2020

Accreditation affirms provision of quality education, thus determines its graduate attributes. WFME, WHO and various bodies have been striving to ensure credibility of educational institutions through accreditation. NAAC is an Indian accrediting body providing framework for quality assurance to higher education institutions. Being an autonomous body under UGC, it  sets a standard of excellence to which they are bound to adhere. This article provides details regarding an insight into NAAC, its vision, objectives, core values and the process of accreditation. The details regarding various criteria, components, allotment of weightage to each of them are detailed in the manuscript. The requirements and needs towards preparedness for this accreditation process are simplified to make the readers to understand easily thus providing a bird’s eye view of entire process.
Implementation of a self-directed learning module for undergraduate medical students in biochemistry: sharing of an experience
Authors: Agrawal Poonam , Verma Niket
Published: January 2020

Self-directed learning SDL is a process where learners take the initiative for their own learning, become sensitive to personal learning needs, formulate the learning objectives, search for the resources and use them judiciously and finally evaluate the learning outcome.
A qualitative perinatal audit at a rural health facility in Eldoret, Kenya
Authors: Omwodo Kimbley
Published: January 2020

Background: Objectives of the study were to ascertain the pattern of occurrence of perinatal mortality by applying the World Health Organization (WHO), International Classification of Diseases, tenth revision (ICD-10) to deaths during the perinatal period, ICD perinatal mortality (ICD-PM), following the introduction of a qualitative perinatal audit process at a rural health facility in Kenya.Methods: A single centre retrospective analysis demonstrating the application of the WHO, ICD-PM. Data pertaining to perinatal deaths for the period from 1st May 2017 to 31st August 2018 was obtained from Plateau Mission Hospital perinatal audit records.Results: There were 22 perinatal deaths during the study period, 17 were included in the study. The overall perinatal death rate was 11 per 1000 births. Antepartum deaths were as a consequence of fetal growth related problems (33.3%), infection (33.3%) or unexplained (33.3%) with pregnancy-related hypertensive disorders (gestational hypertension, pre-eclampsia and eclampsia) being the most frequent medical condition associated with the mortalities. Neonatal deaths (47.1%) were the most frequent in the study and were a consequence of low birth weight and prematurity (25.0%), Convulsions and disorders of cerebral status (25.0%). The maternal condition in most of these cases being complications of placenta, cord and membranes. Acute intrapartum events and were least in this setting accounting for 17.4% of deaths.Conclusions: The ICD-PM is generalizable and its use in perinatal death classification emphasises focus on both mother and baby. Our study showed the majority of perinatal deaths occurred in the early neonatal period & affected mostly preterm infants.
Health care seeking behaviour of pulmonary tuberculosis patients in Jabalpur district, Madhya Pradesh
Authors: Sahu Rupesh , Verma Prashant , Kasar Pradeep K.
Published: January 2020

Background: Successful tuberculosis control requires specific behaviors from patients and health providers. Therefore, understanding behaviors is fundamental to design interventions to strengthen tuberculosis control programs, including communication interventions. The aim of this study was to assess the healthcare-seeking behavior of pulmonary tuberculosis (PTB) patients in Jabalpur district.Methods: Cross-sectional study was conducted among category I new sputum positive PTB patients identified from nine designated microscopy centres from November 2013 to October 2014. Calculated sample size of 135 with a multistage random sampling method was used. Student’s t-test and Chi-square test were used along with descriptive statistics.Results: Mean age of patients was 33.87 (14.3) years, males constituted 66.7%, 72.5% patients belonged to below class IV socioeconomic status. Cough was experienced by 91.1% subjects, followed by fever (69.6%). First action was consulting a health care provider (HCP) in 41.5% followed by self-medication (21.5%). It took two attempts for 76% of patients to reach a formal health care provider. Private health care providers were consulted as first choice among HCPs by 86.7% patients, initial diagnosis was made by them in 25.9% cases. Sixty-three percent of patients were not satisfied with care at government hospitals, 41.5% had not heard of tuberculosis before their diagnosis, 59.5% of patients got information about tuberculosis from their relatives suffering from it.Conclusions: Cough is the most common and earliest symptom responsible for seeking care in pulmonary tuberculosis. Government health facilities contribute maximum to diagnosis but private health facility is the first choice for initial consultation. Patients’ perception of suggestive symptoms needs to be changed.
Preference for male child among married adults in rural and urban field practice areas of Narayana Medical College, Nellore, Andhra Pradesh, India
Authors: Vardhan Y. Vishnu , Rao D. Srinivas
Published: January 2020

Background: Reduction of national fertility levels was directly proportional to the preference of male child in many families in India. We conducted this study on 214 married adults, in both sexes to find out whether this strong preference still exists in this decade or not, and if it does what could be the reasons.Methods: A community based cross-sectional study done by face to face interviews using a semi-structured questionnaire containing both qualitative and quantitative variables, among 214 married adults.Results: Upon analysing the results, we identified that higher son preference (61.23%) is seen in many rural families, and is strongly associated with low socio-economic status, literacy rate and caste. The reasons by which these families prefer male child were also broadly categorized and identified. Economic utility (78%) and old age security (61%) was found to be the major reasons most families has quoted in preferring a son.Conclusions: By improving the literacy rate and job opportunities in the community, fertility rate can be reduced, especially in rural areas where the other options are limited.
Prevalence of depression among the elderly in urban area of Perambalur district
Authors: Raveendran Nirmal S. , Ravi Abinaya , Britto Rock , Sankar Saranya , Ramachandran Sharathkumar , Balamurugan Santhosh , Panchanathan Bharathwaj
Published: January 2020

Background: Depression at any age needs attention. Geriatric population being most vulnerable, are more prone to many morbidities, physically and mentally. Geriatric depression is one among them which needs prompt attention. The objectives of the present study were to estimate the prevalence of geriatric depression and association of depression with various sociodemographic factors.Methods: A cross sectional study carried out among 300 geriatric subjects. A structured interview schedule was used to collect data.Results: The prevalence of depression was found to be 44.4%. Female gender, marital status, family type was found to be positively associated with depression.Conclusions: Geriatric depression in our study is found to be on little higher side. Lifestyle modifications and support from family members are needed to improve the quality of life of these people.
A cross-sectional study on ante-natal depression in a tertiary health care hospital in Navi Mumbai
Authors: Joshi Sumedha M. , Ravi Shilpa , Velankar Deepa H.
Published: January 2020

Background: Depression is a common source of disability among women. Antenatal depression has been often overlooked and under diagnosed, throughout the world especially in the developing countries like India. This study was conducted to assess the mental health status of pregnant women attending the antenatal clinic in a tertiary health care hospital.Methods: A cross-sectional study was conducted over a period of three months among randomly selected pregnant women attending the antenatal clinic of a tertiary hospital. A total of 170 pregnant women formed the study subject. Data was collected using a pre-designed, pre-tested, semi-structured questionnaire and analysis was done using SPSS version 20.0.Results: Among the study population, the prevalence of depression was found to be 20.6%. Depression was significantly associated with the socio-economic status and education of the study subjects. Women with family discord were significantly more depressed than those with no discord. Unplanned pregnancy and preference of male child very significant factors for depression. Multiparity and bad obstetric history also showed a higher level of depression which was statistically significant.Conclusions: There is a significant prevalence of antenatal depression which needs screening and appropriate management. Maternal health policies must integrate maternal depression as a disorder of Public Health importance and interventions should target the pregnant women as early as possible.
Vaccination coverage of children in tribal Narmada district of Gujarat: a cross sectional study
Authors: Parmar Rahul , Prajapati Nirmal , Shringarpure Kalpita
Published: January 2020

Background: Vaccination being one of the cheapest and safest methods of primary prevention, indicators of maternal and child healthcare are crucial. Multi-indicator cluster survey was planned to check these objectives as set up in reproductive child health (RCH)-II and National Rural Health Mission (NRHM) plan. This study was initiated to determine the vaccination coverage among the children in tribal district in Gujarat and to determine factors associated with partial immunization and non-immunization.Methods: A community based cross-sectional study was done in tribal district Narmada in Gujarat for a period of four months from May 2011 to August 2011. The study population consisted of all children aged between 12-23 months. After using cluster sampling method, assessment of vaccination programme was obtained from 346 out of total 352 children scattered across 30 clusters. A pre-tested semi-structured questionnaire was administered by interview technique.Results: Highest coverage was seen in the first dose of diphtheria, pertussis, and tetanus (DPT) 95.7% (CI 92.3-99) followed by Bacillus Calmette-Guérin (BCG) 95.4% (CI 92-98.7) and first dose of oral poliovirus vaccines (OPV) 95.4% (CI 92-98.7). The proportion of fully immunized children was 77.7% (CI 69.4-86.1), whereas 2.9% (CI 0.0-6.1) children were not vaccinated at all. The drop-out rate was 8.76% from DPT1 to DPT3 and 16% for DPT1 to measles.Conclusions: Vaccination   coverage   was highest for DPT first dose followed by BCG. The drop- out rate was 8.76% from DPT1 to DPT3 and 16% for DPT1 to measles. Non-awareness regarding subsequent doses of vaccines was most common reason for partial or non-vaccination.
Prevalence of internet gaming disorder in India: a technological hazard among adolescents
Authors: Undavalli Vamsi Krishna , Rani Gobburi Sudha , Kumar Jonnalagadda Ravi
Published: January 2020

Background: Internet gaming disorder (IGD) refers to the problematic use of on-line or off-line video games.  Presently the prevalence of IGD among the adolescent group was between 1.3%  to 19.9% and males reported more prevalence than females. Aims of this study was to know the prevalence and the various factors associated with the development IGD among adolescents.Methods: Settings and Design was to a cross sectional study was conducted among students of High schools for a period of 3 months from July 2018 - September 2018. Four hundred adolescent students were included in the study. English version of the DSM–5 short (9-item) dichotomous scale with cut-off point of five or more criteria was used for diagnosing the IGD.Statistical analysis used descriptive statistics were represented with frequencies and percentages. Chi-square and Fisher Exact tests were applied to find significance difference. P<0.05 was considered as statistically significant.Results: An overall prevalence estimate of IGD was 3.50% among the school children and it is higher among male students (8.8%) than female students (0.8%) and it was found statistically significant with a p value of <0.001.Conclusions: The prevalence differences between Age groups, gender, class of the student and availability of smart phone with internet facility act as an important risk factors for the occurrence of IGD among adolescents.