bluuebunny/crossref_metadata_2025 huggingface dataset:
Ultrasound and Doppler evaluation of salivary gland pathology
Authors: Patange Neeraj A. , Phatak Suresh V.
Published: December 2016

Background: Lesions of salivary gland are very commonly encountered in clinical practice. Only by Clinical examination alone it is difficult to differentiate between them and know its exact cause and etiology. It would definitely benefit the patient as well as the doctor if they could get an idea of the exact type of lesion affecting the salivary gland. Hence, this study was undertaken to demonstrate as how high resolution ultrasound imaging and use of colour Doppler can be useful in evaluation of salivary gland lesions.Methods: Duration of study was1yearwith sample size of 30 patients. This study has been conducted in the department of Radiodiagnosis JNMC, Sawangi, Wardha all cases irrespective of age and sex referred to the department were evaluated. Aloka Prosound Alpha 7 USG machine with a high resolution probe linear transducer was used. The lesions were evaluated by high resolution real time ultrasound and colour Doppler.Results: Most of the patients were in the age group 41-50years and had male preponderance. Most presented with unilateral swelling which was tender and firm in consistency. Amongst the study group saladenitis was most frequent finding followed by pleomorphic adenoma and carcinoma. Pleomorphic adenoma was most common neoplasm having predilection for the parotid gland. Saladenitis was most common in submandibular gland. The commonest histopathological finding was pleomorphic adenoma.Conclusions: The study concludes that High resolution ultrasound can differentiate various salivary gland lesions. Addition with colour Doppler ultrasound can increase its diagnostic accuracy. High resolution ultrasound with colour Doppler sonography should be first line of imaging modality in suspected cases of salivary gland lesions.
A cross-sectional study of post-vaccination anti-HBs titer and knowledge of hepatitis B infection amongst medical students in a metropolitan city
Authors: Acchammachary Ashmaki A. , Ubale Milind , Belurkar Deepali D. , Bhave Poorva P. , Malgaonkar Aniruddha Arjun , Kartikeyan Sundaram
Published: December 2016

Background: Medical students are at risk of acquiring hepatitis B virus infection due to occupational contact with patients’ blood or other body fluids. This study was conducted to determine knowledge of hepatitis B virus infection and anti-HBS antibody titer amongst medical students.Methods: This cross-sectional observational study was conducted on medical students who satisfied the intake criteria and gave written informed consent to participate in the study. After Institutional Ethics Committee clearance, written informed consent was obtained and a structured, pre-validated questionnaire (pre-test) was administered to the participants. After an educational session, an identical questionnaire was administered (post-test). For determining anti-HBs titer (vaccinated participants) and HBsAg (non-vaccinated participants), blood was aseptically collected by cubital venepuncture. HBsAg and anti-HBs antibody levels were determined by immuno-chromatographic assay and enzyme-linked immunosorbent assay, respectively.Results: 140 healthy, HBsAg-negative medical students (79 males; 61 females) participated in the present study. There was increased median correct response in the post-test with increased minimum and first quartile. 91 (65%) who were vaccinated against Hepatitis B were enrolled for anti-HBs titer estimation. There was no significant gender difference in mean antibody titer. 19 (20.9%) had inadequate levels of anti-HBS antibodies. 50% seroconversion was seen after single dose of hepatitis B vaccine.Conclusions: It is essential to delve into the logistic aspects of evaluating all medical students for hepatitis B infection, procuring and offering free vaccination and assessing anti-HBS titer of vaccinated individuals.
Effectiveness of the new polyfunctional infusion solution of blood substitutes on the activity of lipid peroxidation and antioxidant protection of heart in acute fatal blood loss
Authors: Ruziev Umid , Karimov Khamid , Shevchenko Larisa , Alimov Timur
Published: December 2016

Background: One of the important directions of modern medicine is improving treatment of extreme conditions, the mortality rate of which is still very high, which is often associated with insufficient effectiveness of modern blood substitutes. Purpose of the study was to investigate the efficacy of a new multifunctional blood substitute in acute fatal blood loss on the activity of lipid peroxidation (LPO) and antioxidant system (AOS) of the heart, which showed its high antioxidant efficiency.Methods: Experiment was carried out on 60 rats weighing 180-200 g, clinical death was caused under etaminal anesthesia by acute blood loss from the carotid artery. After bleeding rats were given injection of infusions. Animals were divided into following groups: group I – before blood loss (intact), group II - clinical death, group III (control) – acute fatal blood loss after infusion of saline solution, group IV (comparison) - after acute lethal blood loss with infusion of reo-sorbilact, and group V (main, experimented) - after acute lethal blood loss with the new infusion of multifunctional blood substitute.Results: The level of MDA in clinical death (in group II) had increased by almost 2.0 times, as well as diene ketones, indicators of antioxidant activity decreased. The enzyme activity of GR in heart was 1.2 times lower, GPO - 1.5 times, SOD-2.0 times, catalase-4.4 times. In group III where animals after clinical death were revived with saline solution, AD increased to 45.6±0.4 mm Hg after 1 hour, and CBV increased to 44.8±0.4 ml/kg, the values of these parameters in the intact animals of the first group were 40.2% and 76.6%, respectively. After infusion of saline glomerular filtration rate was 0.61±0.02 ml/min, and diuresis of 0.21±0.02 ml/min compared with the values of these parameters in the intact animals was 46.9% and 65.6%, respectively. Life expectancy of animals after infusion of physiological saline was 12.3±1.2 hours, 30% of the animals survived. After infusion of reosorbilact in group IV, the survival rate was 40%, and after the infusion of a new multifunctional blood substitute in group IV -70%, which is 30% higherConclusions: The infusion of a new multifunctional blood substitute during acute fatal blood loss leads to a more effective delay of LPO processes and restoration of AOS in heart, in comparison with the use of reosorbilact. The use of a new multifunctional blood substitute during acute lethal hemorrhage in rats, compared with infusion of reosorbilact, leads to a more pronounced recovery of hemodynamic parameters, biochemical parameters of blood and ABS.
Comparative study of acupressure wristband versus palonosetron for prophylaxis of postoperative nausea and vomiting in elective laparoscopic cholecystectomy under general anaesthesia
Authors: Naik Suchismita , Kujur Shweta , Debbarma Miltan , Debbarma Miltan , Murthy Madhumita G.
Published: December 2016

Background: Postoperative nausea and vomiting (PONV) is common complication after general anesthesia and surgery. This randomized double-blind study was designed to compare the effects of acupressure wrist bands and palonosetron for the prevention of post-operative nausea and vomiting (PONV) in laparoscopic cholecystectomy under general anaesthesia.Methods: Sixty ASA I and II patients undergoing elective laparoscopic surgeries under general anaesthesia were divided into two groups. In Group A patients, acupressure wrist bands were applied on p6 point on both hands half an hour before induction. Group P patients received inj. palonosetron 0.075 m.g. i.v. just before induction. Anaesthesia technique was standardized. Post-operatively patients were monitored for nausea, retching or vomiting upto 24 hours. If patients vomited more than once, they were given inj. Metoclopramide 10mg as rescue antiemetic. Efficacy of drugs was compared using Chi square test. ‘p’ value of <0.05 is considered significant.Results: The incidence of PONV and requirement of rescue antiemetic were lower in palonosetron group than acupressure wrist band group.Conclusions: Palonosetron is more effective than acupressure wrist band for prophylaxis of post- operative nausea and vomiting in the patients undergoing laparoscopic cholecystectomy under general anaesthesia, but acupressure wrist band can also be used as an alternative non-pharmacological method.
Diagnostic accuracy of fine-needle aspiration cytology in diagnosis of thyroid nodules
Authors: Damle Gopal Krishna , Daharwal Ajit Vikram
Published: December 2016

Background: Thyroid nodules are a common clinical problem Epidemiologic studies have shown the prevalence of palpable thyroid nodules to be approximately 5% in women and 1% in men living in iodine- sufficient parts of the world. The prevalence of thyroid nodules ranges from 4% to 10% in the general adult population and from 0.2% to 1.2% in children. Currently, many investigations including diagnostic imaging studies, serologic and cytogenetic tests as well as histopathological techniques are available to evaluate to evaluate thyroid nodules out. Of all these investigations, fine needle aspiration cytology (FNAC) has become the diagnostic tool of choice for the initial evaluation of solitary thyroid nodule.Methods: A present prospective study was conducted in department of ENT, Dr. BRAM hospital, Pt. JNM Medical College, Raipur, Chhattisgarh, India during study period November 2011 to October 2012. Patients with thyroid nodule were selected for the study. After taking a detailed clinical history, all cases were underwent a thorough ENT and head and neck examination. The clinical findings were recorded. Thyroid function tests and other necessary investigations were also done. Then the patients were referred for fine needle aspiration cytology to the department of Pathology. Depending on the nature of the lesion, decision had taken regarding need for surgery and the extent of surgery. All fine needle aspiration cytology (FNAC) reports were correlated with histopathology diagnosis.Results: Male and female ratio was 1:3.5. Preoperatively FNAC done in 54 cases out of which 36 (66.66%) results were goiter followed by 4 (7.40%) hurthle cell thyroiditis and 2 (3.87%) chronic thyroditis Among 54 cases 1.85% results were follicular neoplasia followed by 3 (5.55%). Fine needle aspiration cytology was 87.5% sensitive in detection of neoplastic lesion and 95.65% sensation of neoplastic lesion and 95.65% specific. Accuracy was 94.44%.Conclusions: Fine needle aspiration cytology is a simple, rapid, inexpensive, well tolerated and harmless method of evaluation mass lesions of the neck especially when there is a close cooperation between the clinician and cytopathologist.
A comparative study between abdominal plain radiography and ultrasonography in non-traumatic acute abdominal emergencies in tertiary care hospital
Authors: Gathwal Chiranjeev Kumar , Gathwal Monika B. , Garg Shreya , Kumari Yogita , Singh Kulvinder
Published: December 2016

Background: Acute abdomen is a loose term frequently used to describe the acute abdominal pain in a subgroup of patients who are seriously ill developing suddenly, over a period of several hours or few days.Methods: It was a prospective comparative study between abdominal plain radiography and ultrasonography in non-traumatic acute abdominal emergencies in Tertiary Care Hospital.Results: All the included patients (140) were imaged with abdominal X-rays series (AAS) and Ultrasonography (US) by different blinded radiologists without conveying results to either. Final diagnosis was made on the basis of clinical findings / laboratory or biochemical findings /radiological evaluation /therapeutic response / operative findings / histopathological examination. The entire data was collected, recorded and statistically analyzed as per objectives. GIT system was most commonly involved, in 75/140 cases (53.57%). Most common diagnoses were acute appendicitis, KUB calculus disease and acute cholecystitis seen in 32/140 (22.86%), 24/140 (17.14%) and 21 (15%) cases respectively. US supersedes Provisional clinical diagnosis and Radiographic evaluation in diagnosing acute abdominal conditions with Sensitivity, Positive Predictive Value, False positive rate, False Negative rate and Diagnostic Accuracy as 90.71, 100, 0 ,9.28 and 90.71 percent respectively.Conclusions: We concluded that Plain X rays can be used as screening modality in the diagnosis of acute abdominal emergencies; however ultrasound examination is cheaper, non-invasive, quick, reliable and highly accurate modality in diagnosing the exact cause of pain and its origin in a patient presenting with an acute abdomen and thus helps the physician or surgeon to plan the timely management.
Combined endoscopic intervention (ligation+sclerotherapy) compared with TIPS for prevention of bleeding from gastro-esophageal varices in patients with liver cirrhosis
Authors: Matkuliev Utkirbek
Published: December 2016

Background: Liver cirrhosis (LC) and portal hypertension (PH) is one of the most serious problems of modern surgical hepatology. The most common complication of liver cirrhosis is bleeding from varicose veins of esophagus and stomach. Today experts have several ways to prevent rebleeding from varices: pharmacotherapy, endoscopic intervention, transjugular intrahepatic portosystemic shunt (TIPS), a surgical portocaval bypass. Purpose of this study was to compare effectiveness of transjugular intrahepatic portosystemic shunts (TIPS) and combined endoscopic therapy the management of bleeding in cirrhotic patients.Methods: We observed 96 consecutive patients with portal hypertension who were treated in 2nd clinic of Tashkent Medical Academy (2014-2015). Bleeding was in history of 17 (17.7%) patients. The duration of the bleeding averaged 9.7±4.3 hours. Ascites was observed in 54.5 % of patients. Patients were divided two major groups. First group included 72 patients who was performed endoscopic intervention. Second group consisted of 24 patients who underwent TIPS in emergency cases.Results: Seventy-two patients were assigned to variceal ligation and Sclerotherapy, other 24 patients to TIPS. In the ligation combined Sclerotherapy group, a second treatment was performed 8–10 days after the initial endoscopy. Deterioration of portal gastropathy was observed in 9 (9.4%) cases after EL and 24 (25.0%) after ES (p <0.05). The mean portal system pressure prior to TIPS placement was 53.67±4.21 mm Hg, which decreased to 25.10±4.06 mmHg after the first shunt tract was established (P <0.001). The mean portal system pressure prior to the second TIPS was 43.68±3.98 mm Hg and decreased to 25.14±4.67 mm Hg after the procedures (P <0.001).Conclusions: TIPS can become dysfunctional if stenosis develops in the shunt or the hepatic vein above the shunt. Screening allows detection of stenosis before portal hypertensive–related complications recur. Revision of stenotic shunts can be easily accomplished in most cases. Techniques for screening and revision will be discussed. This is one of the most effective methods to control patients with liver cirrhosis.
Bacterial colonization of stethoscope used in the tertiary care teaching hospital: a potential source of nosocomial infection
Authors: D. Jeyakumari , S. Nagajothi , R. Praveen Kumar , G. Ilayaperumal , S. Vigneshwaran
Published: December 2016

Background: Hospital acquired infections (HAI) are a major problem in each hospital. HAI remains a significant hazard for hospitalized patients and health care workers are potential sources of these infections. Health care workers can transmit pathogens through their hands and contaminated medical devices such as stethoscopes, Blood pressure cuff etc. Hence we intended to determine the level of bacterial contamination of stethoscopes using in present hospital.Methods: Total of 50 stethoscopes were sampled before and after cleaning with 70% isopropyl alcohol by using sterile swab soaked in sterile saline. Samples were processed as per standard microbiological procedures.Results: Out of 50 stethoscopes, 30 (60%) stethoscopes were showing significant bacterial colonization, 7 (14%) showed insignificant colonization, and in 13 (26%) stethoscopes no growth was observed. The bacteria isolated were Methicillin Resistant Staphylococcus aurues (MRSA) (14%), Methicillin Sensitive Staphylococcus aureus (MSSA) (12%), Coagulase Negative Staphylococcus (CNS) (14%), Klebsiella species (20%).Conclusions: Our study concluded that stethoscopes used by health care workers were colonized by both pathogens and non-pathogenic microorganisms. Strict protocol of cleaning the stethoscopes in between the patients will eliminate the colonization and there by spread of infections.
Knowledge, attitude and practice of pharmacovigilance among medical professionals at a tertiary care hospital in Mumbai, Maharashtra, India
Authors: Katekhaye Vijay M. , Kadhe Neha G. , John James , Pawar Sudhir R.
Published: December 2016

Background: Many adverse drug reactions (ADRs), interactions and specific toxicities are known once drug is exposed to a larger population. Spontaneous reporting adverse events (AEs) are fundamental to a robust pharmacovigilance (PhV). Increasing physician awareness about the pharmacovigilance and ADR reporting can significantly contribute the safety of medicines. Objective of the study was to assess the knowledge, attitude and practices related to PhV among medical professionals at a tertiary care teaching hospital.Methods: Postgraduate students (PGs) and medical teachers at a Medical College and tertiary care hospital were evaluated for their knowledge, attitude and practice of pharmacovigilance with the help of a structured questionnaire. Suggestions for improving the effectiveness of the pharmacovigilance practices were also sought.Results: One-hundred and fifty doctors [91 (60.7%) PGs and 59 (39.3%) medical teachers] participated. Overall, 48.7% were males. 96% believed that PhV is important in medical practice but only 79.3% knew the definition of pharmacovigilance. Only 24.7% were aware of the existing nationwide pharmacovigilance program whereas the international collaborating center was known to 26% of the participants. 96% believed that it is the duty of a treating physician to report an ADR while 36.7% felt that ADR reporting should be the responsibility of a separate team. Surprisingly, 54% felt that financial aid should be provided for ADR reporting. 42.7% have not reported any ADR whilst only 16% have reported more than 10 ADRs in their career. To create an ADR database (79.3%) was the common expectation from the PhV center. 98.7% suggested continued medical education (CME) and trainings to improve the effectiveness of PhV in Indian setting.Conclusions: Regardless of a fair attitude towards PhV, the practice of ADR reporting is poor probably because of lack of sufficient knowledge about PhV. Motivating the physicians through CMEs and trainings so as to improve and strengthen the pharmacovigilance practices is the current need in India.
Morbidity pattern and psychosocial problems of elderly in a rural population of Uttar Pradesh, India: a cross-sectional study
Authors: Seth Rajesh Kumar
Published: December 2016

Background: Ageing is a universal process and it affects every individual, family, community and society. It is a normal, progressive and irreversible process. Ageing is generally defined as a process of deterioration in the functional capacity of an individual that results from structural changes, with advancement of age. Population ageing is a global phenomenon. Aim of the study was to study the morbidity profile and their psychosocial problems of the elderly in a rural population in the state of Uttar Pradesh, India.Methods: This was a cross-sectional community based descriptive study. People of either sex, more than 60 yrs of age residing in the field practice areas of department of community medicine constituted the study population. Socio-demographic information like name, age, sex, religion, education, occupation etc. and other information like housing, ventilation, overcrowding were collected in semi-structured and pretested proforma, after obtaining informed consent. The multi-stage sampling methodology was adopted for the selection of study unit.Results: A total of 272 elderly with 173 male and 99 females were interviewed in this study. About one fourth of the elderly belonged to age 60-61 years (25.7%). More than half of the elderly had a fall within last 12 months (66.2%). Not much difference was observed in the percentage of fall within 12 months in male (64.7%) and females (68.7%). The majority of the males (64.7%) and females (81.8%) had pain in joints as the presenting symptom. The second most common symptom was found to be weakness. Only 45.6% of the elderly were satisfied with their life. There was similar percentage of male (45.7%) and female (45.5%) elderly who were satisfied with their life. However, 51.8% felt empty in their life and 45.2% preferred to stay in the house.Conclusions: The need for the hour is to set up special health services for geriatric population in accordance with the common existing problems. Providing screening services as well as curative, rehabilitative services and convalescent homes to provide long term care is also a priority.
Bacterial colonization associated with prolonged catheterization: Who is at risk?
Authors: Sayal Pallavi , Sandhu Raminder , Singh Kanwardeep , Devi Pushpa
Published: December 2016

Background: CAUTI (Catheter-associated urinary tract infection) is the most common adverse event associated with indwelling urinary catheter use. Despite innate mechanisms of intact urinary tracts, uropathogens are capable of colonizing and persisting in this environmental niche. This prospective observational study was done to evaluate age and gender as independent risk factor associated with acquisition of infection..Methods: Study was done on 339 non-repetitive urine samples from catheterized patients. Semi-quantitative bacterial culture was performed and isolates were identified by standard biochemical tests.Results: In present study 82.00% (278/339) significant bacteriuria was observed. No predilection of infection to any particular gender was observed, patients of both genders were affected, males being marginally more 201/239 (84.10%) than females 77/100 (77.00%). Females with significant bacteriuria were more asymptomatic 50/77 (70.12%) where as men had symptomatic CAUTI 115/201 (57.21%). Distribution of culture results were studied with respect to age, maximum number of significant bacteriuria was observed among age group >60 years 95/104 (91.34%). Further, it was analyzed that elderly females (93.33%) were more prone to CAUTI then males (90.54%). Gram negative bacteria (GNB) were predominant isolates 215/278 (77.33%) and among GNB, Escherichia coli was most common isolate 85/278 (30.57%).Conclusions: Thus, we observed significant bacteriuria is common among catheterized patients but predisposition to UTI results from several factors. Though in this study no predilection of infection was observed to any particular gender but prevalence varies widely with age and more among elderly.
Comparative analysis of radiocephalic versus brachiocephalic native arteriovenous fistula for hemodialysis in end stage renal disease
Authors: Khadatkar Aniket , Mahakalkar Chandrashekhar , Pradhan Tanu , Bora Akshay
Published: December 2016

Background: Chronic kidney disease (CKD) is a long term condition caused by damage to both kidneys. The benefits of arteriovenous fistulas over other forms of chronic access are: Arteriovenous fistulas are associated with decreased morbidity and mortality among hemodialysis patients compared with arteriovenous grafts and central venous catheters. Objectives of the study were o choose the proper sites for formation of arteriovenous fistula, to find out the success rate at various sites and to study the complications of arteriovenous fistula.Methods: This prospective study was carried out on total 150 patients over the duration of two years. The fistulae were created using radial artery and cephalic vein side to side (Radiocephalic AVF) and brachial artery and cephalic vein side to side anastomosis (Brachiocephalic AVF). Doppler studies were done before and after every procedure to demonstrate the velocity, volume of blood flow, depth from the skin, diameter of vessels and to access the time of maturation of AVF. Patients were followed up to first dialysis by AVF to assess the overall outcomes and various complications.Results: Brachiocephalic AVF matured earlier than Radiocephalic AVF (mean maturation time Brachiocephalic 38.02 days and Radiocephalic 43.26 days) which was statistically significant. Brachiocephalic AVF matured earlier than Radiocephalic AVF with more flow rate. Complication rate was more at wrist (Radiocephalic AVF with 66.67% of overall complication) than at elbow (Brachiocephalic AVF with 33.33% of overall complication).Conclusions: We concluded that the Brachiocephalic AVF maturation time was significantly less than the maturation time of Radiocephalic AVF and rate of complication was less in Brachiocephalic AVF. The utility of pre-operative colour Doppler to select the vessels for AVF creation was found to be as an essential parameter of pre-operative work up.
Cerebral sinus venous thrombosis
Authors: Manorenj Sandhya , Barla Sudhaker
Published: December 2016

Background: Intracranial Sino venous occlusive disease is an infrequent condition and accounts only 0.5-1% of all strokes. Objective of the study was to know the prevalence, pattern and risk factors involved in patients of cerebral sinus venous thrombosis (CSVT).Methods: Hospital databases were searched retrospectively and patients diagnosed with CSVT from December 2014 to February 2016 were identified. Data on clinical presentation, risk factor, cerebral sinus involved, hospital stay and outcome were analyzed.Results: Fifteen patients (3.4%) were identified as CSVT out of a total acute stroke case of 430. Mean age of patients was 31 years and 11 (73.3%) were males. The presenting symptoms included headache (n=14), altered sensorium (n=1) and seizures (n=5); signs included hemi paresis (n=4), papilledema (n=8) and bilateral VI nerve palsy (n=3). Majority had aseptic CSVT (n=14), and one patient had septic CSVT associated with tuberculous meningitis (TBM). Radiological findings included brain parenchyma involvement (n=8), subdural hematoma (SDH) (n=1), subarachnoid haemorrhage (SAH) (n=1) and normal brain parenchyma (n=5). Multiple cerebral sinuses were involved in seven patients. Most common site of CSVT was observed in sigmoid sinus. Risk factors included hyperhomocystenemia (n=3), protein S deficiency (n=8), protein C deficiency (n=6) and antithrombin III deficiency (n=3) as primary hypercoagulable state. ANA positive was observed in one patient and four had history of alcohol use. All fifteen patients received low molecular weight heparin (LMWH) for 1 week along with bridging oral anticoagulant. None of the patients required intrasinus thrombolysis and decompression surgery. Average hospital stay was 9 days. All had modified Rankin scale (MRS) ≤ 2 at 6 months follow up.Conclusions: Prevalence of CSVT is higher than that reported from Asian studies. Younger age and male predominance was observed. Protein S deficiency was the major risk factor for CSVT.
Prevalence of transfusion transmitted infections amongst multiple blood transfused patients of β-thalassemia major in a tertiary care hospital
Authors: Mittal Kundan , Abrol Pankaj , Yadav Jaivinder
Published: December 2016

Background: The β-thalassemias are the most common autosomal recessive inherited hemoglobin disorder in the Indian subcontinent, with an uneven distribution among different endogenous populations. Present study was planned to estimate the prevalence of transfusion transmitted viral diseases in multiple transfused patients of β-thalassemia and factors affecting it.Methods: It was a Prospective observational study carried out at Thalassemia day care center of tertiary health care institute.Results: 211 patients were enrolled in the study. 151 were males and 60 females. Maximum numbers of children were in age group of 6- 10 years. 75 (35.5%) patients with HCV (Hepatitis C Virus) and 5 (2.36%) patients with Hepatitis B virus (HBV) infection were found at the end of study. No new HIV (Human Immunodeficiency Virus) infection was detected. There was significant association between prevalence of transfusion transmitted infections (TTI) with number of transfusions but no significant association detected with age, sex and blood group of the patientsConclusions: Thalassemia is a chronic transfusion dependent disease complicated by the effects of iron overload on various organs leading to increased morbidity and mortality. The risk of transmission of TTI in thalassemia increases with time as number of transfusions increase. Use of advanced technology in blood screening, voluntary donations, donor selection, asepsis during blood transfusion should be used to curtail the transmission.
An experimental study to evaluate and compare the analgesic activity of calcitriol with morphine in albino mice at a tertiary care teaching hospital in Maharashtra, India
Authors: David Abhinav , Goel Raj Kumar , Patel Prashant , Kunkolol Rahul , Nandal Dattatray H.
Published: December 2016

Background: Vitamin D plays vital role in physiological functions in humans through its active form Calcitriol (Vitamin D3). Vitamin D receptors are found in most tissues, attributing to its classic and non-classic actions. Calcitriol exerts important regulatory effects on the molecular pathways involved in inflammation and pain. The present study is done for experimental evaluation of analgesic action of Calcitriol using pain models in albino mice.Methods: In this prospective, experimental study, healthy Swiss albino mice were taken after permission from IAEC. Mice were divided into five groups as Control- treated with normal saline, Standard- treated with morphine and Test groups- treated with Calcitriol in dose of 15 µg /kg/mice, 30 µg /kg/mice and 60 µg/kg/mice respectively. Evaluation of analgesic activity was done using Hot plate and Tail flick analgesiometer.Results: All the 3 test doses of Calcitriol although showed prolongation of reaction time in Hot plate method up to 60 mins but the analgesic activity was not significant in comparison with the standard Morphine. With Tail flick method Calcitriol failed to show any analgesic efficacy at 15-30 μg/Kg but showed some analgesia at 60 μg/Kg which was more than control but not at all comparable with the standard Morphine for thermal pain.Conclusions: The analgesic activity of Calcitriol was exhibited at higher doses. This property needs to be further evaluated by planning extensive animal experimentation using different animal models.
Clinico-social parameters of diabetes among patientsutilizing emergency medical services
Authors: Prasad A. Rajhans , Priya Y. Kulkarni , Dhananjay S. Kelkar , Sameer A. Jog , Gouri Ranade , Sonal Utpat , Varsha Hande
Published: December 2016

Background: Diabetes mellitus (DM) is increasing in its potential in developing countries. Rise in diabetic patients calling emergency medical services (EMS) is expected. It calls for thorough assessment of patients with DM utilizing EMS. In the present study, was to assess magnitude of DM among patients utilizing EMS and its clinico-social parameters.Methods: It was hospital record based observational study of patients calling EMS delivered by a tertiary care hospital in Pune, Maharashtra, India during 1st January 2013 to 31st December 2014. Patients with incomplete records were excluded. A person with medical background was trained to extract required information from hospital records. Patients with previously diagnosed DM were considered those who were on diet, oral hypoglycemic agents or taking insulin therapy and newly diagnosed patients with DM were considered those with the value of glycemia on admission >200 mg/dl in first 24 hours. Data analysis was done using SPSS 15.0 software.Results: 45.8% (894/1951) were Patients with DM out of that 78.19% (699/894) were known to have DM while 28.81% (195/1951) were new cases of DM. 5.1% (100/1951) patients had uncontrolled DM. DM was significantly more in >60 years age group and in urban residents (p<0.001). Patients with DM were significantly more to have breathlessness, altered sensorium and dyspnoea as major purpose to call EMS (p<0.001, <0.001 and 0.045 respectively). Other co-morbidities in the form of Hypertension, other cardiovascular abnormalities, COPD, CKD and history of CVA were significantly more among Patients with DM (p<0.001, except for COPD, p=0.027).Conclusions: There was a high burden of patients with DM on EMS. EMS teams should be well trained to diagnose and manage such emergencies. Mass awareness of screening for DM and its proper management will help to decrease such burden.
Association of non-alcoholic fatty liver disease with anthropometric and metabolic parameters in type 2 diabetes: a retrospective analysis
Authors: Khan Shiraz S. , Kannu Nishad S. , Patil Sagar S. , Katekhaye Vijay M.
Published: December 2016

Background: Type 2 diabetes (T2D) is associated with increased prevalence of non-alcoholic fatty liver disease (NAFLD) which mediates increased insulin resistance and is associated with cardiovascular disease (CVD) risk factors. Aim of the study was to understand the association of NAFLD with anthropometric and metabolic parameters in T2DM.Methods: A retrospective observation of data obtained from a private diabetes care centre in non-alcoholic T2D patients was performed. Association of presence of NAFLD with anthropometric, metabolic (glycemic, lipid) parameters, and also blood pressure were assessed. Patients were duly informed that the data collected pertaining to their illness could be used for research purposes. No changes or interventions in the management of the illness were made as part of this study.Results: In total, 300 cases were included in analysis. NAFLD was seen in 38.0% of the cases. Patients with fatty liver were much older than those without fatty liver (P<0.0001). A significant association of NAFLD was seen with all anthropometric (P<0.05 for each) and lipid (p<0.05 for each) parameters and also systolic and diastolic blood pressure measurements (p<0.0001 for both). There was no significant association with glycemic levels in patients with NAFLD. Other factors which had significant association with fatty liver include duration of diabetes, duration of hypertension and a known history of hypertension and dyslipidaemia (p<0.0001 for each).Conclusions: NAFLD has significant association with cardio-metabolic risk factors and may be an independent risk factor for CV disease. Further prospective studies with effect of diabetes treatment and progression/regression of NAFLD and its association with CV outcomes in T2D are warranted.
Assessment of serum nitrate-nitrite ratio vis-a-vis insulin sensitivity and resistance in type 2 diabetics in a tertiary hospital in Eastern India
Authors: Deb Nayana , Chatterjee Sharmistha , Mukhopadhyay Mousumi , Majumder Biswajit , Bhattacharyya Swati
Published: December 2016

Background: Insulin Resistance is of paramount importance in the pathophysiology of Type 2 Diabetes Mellitus along with endothelial dysfunction is mediated by Nitric Oxide (NO). Central to this endothelial dysfunction is the action of Insulin on the Nitric oxide synthase enzyme. Since NO cannot be measured because of its short half-life, metabolites of NO (namely nitrite and nitrate) are measured towards assessing their relationship along with different direct and surrogate markers of insulin resistance in patients of Diabetes Mellitus attending a tertiary care hospital in Eastern India. Aim of the study was to assess the level of Insulin resistance with the direct and surrogate markers of insulin resistance in patients of Diabetes Mellitus attending a tertiary care hospital in Eastern India.Methods: Blood samples from newly diagnosed Type 2 Diabetic patients were assayed for fasting and postprandial sugar and insulin, lipid profile and serum nitrate and nitrite and different anthropological parameters were measured. After that, HOMA-IR and QUICKI’ index were measured.Results: Values of anthropological parameters and the direct and surrogate markers of insulin resistance showed statistically significant difference between cases and controls. Bivariate analysis of post-prandial blood glucose showed strong co-relation with HOMA-IR while serum total nitrate-nitrite ratio showed a strong co-relation with QUICKI.Conclusions: Serum nitrate-nitrite ratio showed a strong co-relation with HOMA-IR and QUICKI. The significance of this study lies in the fact that measurement of the serum nitrate-nitrite may give an idea of the level of insulin resistance of a diabetic patient.
Radiographic imaging of metabolic bone disorders in consonance with biochemical parameters
Authors: Chandna Parveen , J. Pramod Setty , M. U. Jeevika , Kochar Praveen Kumar Tejmal , M. B. Siddesh
Published: December 2016

Background: Bone is a strong dynamic organ of the endoskeleton playing a vital role in structural integrity envisaging keeping proper shape and maintenance of the body, mineral reservoirs, blood production, coagulation and immunity. Metabolic bone diseases are a heterogeneous group of disorders that interrupt the normal homeostasis of bone formation and resorption. Bone regulates as well as acts as a host for hematopoiesis by providing niche for proliferation and differentiation of hematopoietic cell. Bone is a dynamic tissue but metabolically active as it is being constantly formed (modelling) and reformed (remodelling). Metabolic bone diseases comprise of a broad spectrum of inherited and acquired disorders characterized by abnormalities in calcium metabolism and bone cell physiology- that lead to an altered serum calcium concentration and skeletal failure.Methods: After taking a properly informed written consent and complete history, thorough clinical examination was done and these patients were subjected to radiographic imaging and biochemical analysis.Results: With regards to fracture relating to different skeletal structures frequency was more in vertebra (38%), the maximum to be reported in 38 cases followed by hip fractures (17%) in 17 cases. Pelvis fractures were reported as (11%) in 11 cases and tibia fractures were reported to be only (7%) in meagre population of 7 cases, while remaining skeletal organs had (27%) fractures with subject to realisation in other 27 cases.Conclusions: In all the osteoporotic cases irrespective to age of patients, values of serum calcium, serum alkaline phosphatase, serum phosphorus, serum potassium, serum sodium, serum calcidiol were within normal limits.
Prevalence of psychiatric co-morbidity among abused and neglected: a cross-sectional study among child, adolescents, and adult population
Authors: R. C. Bhuvana
Published: December 2016

Background: In the past few decades child abuse and neglects has been only highlighted as an area of concern and has only explained lifelong mental and physical consequences rather than estimating the prevalence rates also there were gaps in child age groups in most of the previous studies in the world, especially in India. Therefore, the present study was undertaken to estimate the prevalence of psychiatric co-morbidity among those who having history of abuse and neglects in a community population of all age groups and to compare the prevalence of psychiatric co-morbidity in among different age groups.Methods: A total of 600 participants, children, adolescents and caregivers like parents, of aged 1-65 years, from Shimoga districts, were screened by using CCMS for adults and parents to identify the cases. A chi-square test has used for statistics.Results: The overall prevalence rate of psychiatric co-morbidity among abuse and neglects were 29.9% (28.9% had schizophrenia and other psychotic disorders 27.9%, mood disorders 25.6%, anxiety disorders 29.2%, behavior disorders 43.5%, and substance use disorders 29.2%).Conclusions: Childhood maltreatment has strong associations with all classes of disorders at all life-course stages in all groups. The awareness of the serious long-term consequences of child maltreatment should encourage better identification of those at risk and the development of effective interventions to protect children from violence.
Radiographic imaging of metabolic bone disorders and their relative management
Authors: Chandna Parveen , Setty J. Pramod , M. U. Jeevika , Kochar Praveen Kumar T. , M. B. Siddesh
Published: December 2016

Background: Bone is a strong dynamic organ of the endoskeleton playing a vital role in structural integrity envisaging to keep proper shape and maintenance of the body, mineral reservoirs, blood production, coagulation and immunity. Metabolic bone diseases are a heterogeneous group of disorders that interrupt the normal homeostasis of bone formation and resorption. Bone regulates as well as acts as a host for hematopoiesis by providing niche for proliferation and differentiation of hematopoietic cell. Bone is a dynamic tissue but metabolically active as it is being constantly formed (modelling) and reformed (remodelling). Metabolic bone diseases comprise of a broad spectrum of inherited and acquired disorders characterized by abnormalities in calcium metabolism and bone cell physiology- that lead to an altered serum calcium concentration and skeletal failure.Methods: After taking a properly informed written consent and complete history, thorough clinical examination was done and these patients were subjected to radiographic imaging and biochemical analysis.Results: Serum alkaline phosphatase is a good marker in rickets and osteomalacia, ICTP in osteoporosis, pyridinoline, deoxypyridinoline in primary hyperparathyroidism, serum PICP in renal osteodystrophy.Conclusions: In cases of rickets and osteomalacia either decreased or normal values of serum calcium and serum phosphorus were obtained. But the cases pertaining to renal failure with rickets values of serum phosphorous were found to be raised. However, in all cases of rickets and osteomalacia values of serum alkaline phosphatase were also found to be raised.
Study relationship between multiple sclerosis and migraine
Authors: Ghoreyshi Esmaeil , Fattahzadeh-Ardalani Ghasem
Published: December 2016

Background: Each person experiences headaches in his/her life. Some studies have shown a significant relationship between Migraine and MS. In these patients there can be a variety of clinical symptoms such as muscle weakness, sensory loss, ataxia, optic neuritis. Optic neuritis in MS is a relatively common symptom that can cause blurred vision, headaches (especially frontal ones) and painful eye movements. Headache is a clinical symptom that makes people visit neurologists. There are several diagnoses for headaches including migraine. In this study, we evaluated the possibility of a significant relationship between migraine and MS.Methods: In this case-control study, 134 MS patients and 134 sex and age matched controls were selected randomly from all patients referred to hospital. Their information about MS and migraine was collected and analyzed by SPSS v.21.Results: The Mean age of cases in this study was 41.5±9.4 years. The gender of 73.13% of patients was female. In MS patients with chronic headaches, 36 people (42.9%) and in Controls 22 people (38.6%) had migraine. In this study it was found that people with MS, experience more migraine attacks compared to the controls (OR=3 and P=0.05). Further investigation showed that, unlike aura type, migraine without aura had a significant relation with the MS (OR=1.94 and P=0.04). Also, it seems that the number of migraine attacks in patients with MS is significantly more than the controls.Conclusions: Finally it seems that there is a positive association between MS and migraine. The relationship between migraine without aura and MS is obvious, but the relation between aura type and MS is not clear, yet.
HPV-DNA testing for detecting precancerous lesions of cervix: how effective?
Authors: Thakur Ruchi N.
Published: December 2016

Background: Human Papilloma Virus has been found to be associated with cervical squamous cell carcinoma. Studies and reviews indicate that HPV testing is more sensitive than Pap smear for identifying cervical cancer and its precursors in population screening. Hybrid capture 2 assays detect high oncogenic risk viruses and can be used as primary screening tool for women older than 30 years.Methods: A detailed history followed by a thorough clinical and gynecological examination was carried out for women attending the gynecological O.P.D. HPV-DNA (HCT) samples were collected using a cytobrush. Suspicious lesions of the cervix were further subjected to colposcopy directed loop electrosurgical excision procedure (LEEP) and sent for histopathological examination in formalin. The results of HPV-DNA (HCT) and histopatholgical report were then correlated.Results: In this study, one hundred and sixty women were screened for HPV-DNA. Thirty-two women were found to be positive for HPV-DNA. They were further subjected to colposcopy directed large loop electrosurgical procedure. The positive patients were found to have either low-grade or high-grade cervical intraepithelial neoplasia.Conclusions: The use of HPV-DNA test may make it a viable alternative to cytological screening especially as a less frequent screening.
Inter-rater reliability of wound care skills checklist in objective structured clinical examination
Authors: Abdillah Ina Laela , Nurjannah Intansari
Published: December 2016

Background: The wound care skills checklist in objective structured clinical examination (OSCE) should be valid and reliable. Thus, the reliability test of the wound care skills checklist is needed. Purpose of the study was to identify the reliability of the wound care skills checklist.Methods: This study is a descriptive non-experimental quantitative research with a cross-sectional study design. This study was conducted in the School of Nursing, Universitas Gadjah Mada, Indonesia. The number of respondents was 94 second-year students of this school of nursing. Inter-rater reliability was performed by 2 raters during OSCE. Kappa and Percent agreement (PA) were used to analyze the reliability of the checklist.Results: Inter-rater reliability of the wound care skills checklist is categorized as good based on kappa value (0.7613) and acceptable based on PA value (89.36%). The results of the twenty-two item checklist were divided into five categories. Sixteen of the twenty-two items on the wound care skills checklist are included in the first category in which kappa category (≥0.41) and PA (>70%) are acceptable. One item is in the second category which has unacceptable value of kappa and PA, one item is in the third category which has low kappa value (0.3974) and high PA (89.36%), one item is in the fourth category which has a kappa value of 0, and three items are in the fifth category which has negative kappa value.Conclusions: Inter-rater reliability of the wound care skills checklist OSCE in this nursing school can be categorized as good and acceptable.