bluuebunny/crossref_metadata_2025 huggingface dataset:
Lokomotor Sistem Kısıtlılıklarında Fonksiyonel Bozukluk Oranı Cetveli Oluşturma Çalışması
Authors: Seviçin Sedat
Published: April 2021

Objective: In this study, to emphasize the importance of evaluating locomotor system limitations in terms of functional impairment or loss of function in injury, traffic accident and occupational accident reports and to contribute to the development and updating of the existing Guidelines for wounding offenses. The aim of the study is to develop a new scale that evaluates the loss of the organ as a percentage of its function in locomotor system limitations.
Methods: The patients who applied to the forensic medicine department and were evaluated for the impairment of the locomotor system due to injury were considered as impaired or lost their function. Using the scale we developed and compared with the report results made by our department. 
Results: 70 cases included in our study were re-evaluated according to the new scale. It was seen that different results occurred in 5 cases (7.1%). When these cases were examined according to the new scale, it was seen in the evaluation that in 3 cases the limitations were very close to the 10% limit of loss in terms of organ.
Conclusions: A new scale was created by using the scale of disability in order to have standardized objective criteria when evaluating the locomotor system limitations and to facilitate the physicians, which are frequently encountered in forensic medical practices. Therefore, due to limitations in organs the percentage of functional impairment was found to be more important, especially at borderline levels of functional impairment (%10) and a standardized scale should be used.
Las decisiones de adecuación en las transferencias internacionales de datos. El caso del flujo de datos entre la Unión Europea y Estados Unidos
Authors: Sobrino García Itziar
Published: April 2021

Este trabajo tiene como objetivo analizar los elementos que han llevado a la invalidación del actual Privacy Shield, el acuerdo entre la Unión Europea y Estados Unidos para las transferencias transfronterizas de datos, como consecuencia de la sentencia Schrems II. Para ello, este artículo se enfoca en establecer el concepto de nivel adecuado y decisión de adecuación a través del análisis legal y revisión de la literatura. Una vez estudiados, se examinan tras una breve contextualización del acuerdo que lo precedió, las lagunas o problemas iniciales del Privacy Shield, así como la argumentación dada por el Tribunal de Justicia de la Unión Europea para su invalidación.
¿Hacia una reformulación de la inviolabilidad del domicilio?
Authors: Zoco Zabala Cristina
Published: April 2021

En este trabajo se analiza el objeto protegido en la norma de derecho fundamental (art. 18.2 CE) y en la jurisprudencia del Tribunal Constitucional, así como su adecuación a los diferentes escenarios —pasados y presentes— en los que se despliega. Se verifica que el objeto protegido es la inviolabilidad del espacio físico, con independencia del carácter más o menos íntimo o privado de lo que acontece o anida en él. Asimismo, se evidencia una jurisprudencia constitucional más vinculada al destino del espacio físico —desarrollo de vida íntima o privada— que a su cualidad de inviolable. Se propone reformular el objeto iusfundamental con el fin de garantizar una protección que alcance todos los espacios definidos como inviolables, con independencia de su destino o la existencia efectiva de vida íntima o privada en ellos.
Value-Added, Energy and Technology-Capital in Central Java Industries
Authors: Wahyudi Setyo Tri , Darmawan Darmawan
Published: April 2021

Nowadays, many industries do not depend on labor intensive, but have transformed to rely on intensive technology. Industry is considered potential strategy to raise value-added for its effort to alter raw or intermediate goods to finished goods. In this study, value-added approach is used to measure the role of technology - capital and energy. A lot of work has been done analyzing restricted variables in single study, but there is still a significant gap where research did not determine differences between measures. This paper aims to discuss the similarities of many technology – capital and energy related variables in Central Java Industries and analyzes their profile change to regional value-added from 2007 to 2017.  Data related to technology – capital and energy are collected from Statistics Indonesia (Badan Pusat Statistik). The variables are examined using exploration factor analysis, multiple linear regression, and cluster analysis. The result shows that the energy consumption has the greatest effect on value-added rising during the study period, while technology - capital does not. Hence, policymaker should maintain the availability of energy for industries. Then, except for Kudus Regency and Semarang Municipality, policymaker should pay attention to the growth of value-added of the entire regions.
Analisis Perbandingan Unjuk Kerja Motor Bensin Dengan Penambahan Groundstrap dengan Material Tembaga Dan Perak Pada Kabel Koil Busi
Authors: Wijaya Hardian Putra , Dantes Kadek Rihendra , Wiratmaja I Gede
Published: April 2021

This research aimed to (1) Determining the differences in power and torque to use of a coil standard, a copper, and silver wire ground strap variation coils. (2) Determining the color characteristics of the sparks' size generated from the use of standard coils, variation coils of copper, and silver ground strap. This research used an experimental method. The data analysis technique used descriptive analysis, namely, observing and recording the test results and then concluding in tables and graphs. The test results show that an increase in power, and torque is generated in this test. The highest results were obtained using a silver ground strap variation coil with a power of 11.3 hp and torque of 12.05 Nm. In this case, the percentages are 7.6% and 7.8% from the lowest results of the standard coil. There are different colors, sizes, and characters obtained in the test of sparks. The dark blue-purplish sparks color is obtained from the silver wire ground strap variation coil, which can increase motor performance in a motorcycle. These results suggest that the ground strap on the spark plug coil wire can provide an increment in engine performance.
Unjuk Kinerja Alat Pasteurisasi pada Proses Pasteurisasi Madu: Studi Kasus PT Kembang Joyo Sriwijaya
Authors: Wibowo Sasongko Aji , Lastriyanto Anang , Erwan Erwan , Jaya Firman , Batoro Jati
Published: April 2021

One of the post-harvest honey processing processes is the pasteurization process. Pasteurization is the initial stage of honey processing before evaporation. The high demand for honey in Indonesia requires that honey producing companies must use pasteurization tools with large capacities and do not damage the honey content. Honey will be damaged if the pasteurization temperature is more than 70oC. In addition, the pasteurization process is also still a problem in the honey industry. Therefore it is necessary to make pasteurization tools with automatic and fast temperature control in the pasteurization process. The purpose of this study was to observe the rate of heat penetration into pasteurized honey material and the amount of honey weight pasteurized, then also measured changes in water content, viscosity, degree Brix, and density of density. From the results of measurements of heat penetration rates in pasteurization and conventional pasteurization devices, the difference in time duration on stoves 1, 2, and 3 to increase the initial temperature of 35 oC to 65oC respectively were 45, 45, and 42 minutes with a total of 101 honey, 22 kg while in conventional equipment takes 50 minutes to heat honey as much as 46,780 kg. Gas consumption on stove 1 was 0.291 g/(kgoC), stove 2 was 0.281 g/(kgoC), stove 3 was 0.285 g / (kgoC), whereas gas consumption on conventional stove was 0.272 g/(kgoC). The results of measurements of water content, viscosity, Brix, and density of density before and after pasteurization were as follows 21.99%, 4.835 poise, 63 obrix, 1.356 kg/m3, and 19.82%, 5.453 poise, 64 obrix, 1.358 kg/m3.
The correlation of Singh index and cortical thickness index toward bone mineral density in women older than 60 years old with femoral neck fracture
Authors: Purboyo Dwijo , Ridia K. G. Mulyadi , Aryana I. G. N. Wien , Astawa Putu , Dusak I. Wayan Suryanto , Dharmayuda Cokorda Gde Oka , Subawa I. Wayan
Published: April 2021

Background: Femoral neck fracture is one of the most common fractures in elderly. Proximal femur fracture in elderly patients is considered a severe morbidity which has a negative impact on the life expectancy and quality of life. Aim of this study was to find the correlation of cortical thickness index (CTI) and SI toward bone density (BMD) in female patients over 60 years of age with femoral neck fracture.Methods: This is an observational cross-sectional study. Subjects were selected from Sanglah general hospital outpatient department, Denpasar, Bali during the period October 2020 to January 2021 by inclusion requirements and then randomized into two groups. Data were taken through history taking, physical examination as well as supporting investigations such as contralateral hip joint radiograph and BMD measurements. Statistical analysis was done from those data.Results: It has been obtained that there was a positive correlation of Singh index (SI) and CTI toward BMD. The correlation coefficient (r) between SI and BMD was 0.874 (p=0.000). The r between CTI and BMD was 0.854 (p=0.000). Both variables were significant.Conclusions: There were significantly strong correlations between SI and BMD (r=0.874, p=0.00), also CTI and BMD (r=0.854, p=0.00) in female patients over 60 years of age with femoral neck fracture.
Perception about COVID-19 vaccine among patients at the federal medical centre, Yenagoa, South-South Nigeria
Authors: Oriji Peter Chibuzor , Allagoa Dennis O. , Obagah Lukman , Tekenah Ebiye S. E. , Ohaeri Onyekachi S. , Atemie Gordon
Published: April 2021

Background: The severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) is the causative organism of the coronavirus disease 2019 (COVID-19), which is a respiratory disease that was first identified in December, 2019 in Wuhan, China. Objective was to determine the perception of the COVID-19 among patients at the Federal Medical Centre, Yenagoa, Bayelsa State, Nigeria.Methods: This study was carried out at the Federal Medical Centre, Yenagoa between 4th January and 15th February, 2021. It was a descriptive cross-sectional study. The study population consisted of 1,000 consecutive patients that presented to the various out-patients departments of the hospital. Written informed consent was obtained. The data were collected with a predesigned questionnaire, and were analysed using statistical software (SPSS for windows® version 23, SPSS Inc.; Chicago, USA).Results: Out of 1,000 participants, only a quarter of the participants (24.6%) indicated willingness to take the COVID-19 vaccine when available in Nigeria. About one-tenth of the participants have had loss of sense of taste and smell (11.7%), and think they possibly may have been infected with the COVID-19 (10.8%) in the recent past. Among those that were unwilling to take the COVID-19 vaccine, 14.2%, 9.0% and 7.5% thought that hydroxychloroquine, azithromycin and septrin respectively, are safe alternatives to the vaccine.Conclusions: Although it is known that hypothetical choices may not always reflect real life decision, it is important for policy makers and stakeholders to pay more attention on health education and campaign, targeted at addressing the misconception about COVID-19 vaccine.
Functional outcome of galeazzi fracture dislocation treated by open reduction and internal fixation with dynamic compression plate
Authors: Kumar Manoj , Kumar Amit , Gupta Sanjeev , Mahajan Neeraj , Lone Zubair A. , Ahmed Maneer
Published: April 2021

Background: Galeazzi fracture involves fracture of the distal 1/3rd of   radius shaft associated with dislocation of distal radioulnar joint. Open reduction and rigid internal fixation of radius is goal standard treatment. The aim of this study was done to evaluate the functional outcome of Galeazzi fracture dislocation managed by open reduction and internal fixation of radius.Methods: The study was conducted in department of orthopaedics Government Medical college Jammu from December 2018 to February 2021. 30 patients of Galeazzi fracture dislocation were managed with Open reduction and internal fixation of Radius with plating and were followed up to evaluate the results.Results: Age of the patients ranged between 23 years to 60 years with a mean range of 42 years. 22 cases were male (73.3%), 8 cases were females (26.6%). In 19 cases injury was in right side and in 11 cases injury was in left side. In most of the cases injury was due to due to RTA (80%) and in rest of cases injury was due to fall from height (20%).Conclusions: Anatomic restoration of length of the radius with rigid internal fixation is key to satisfactory results in Galeazzi fracture dislocations and K-wire fixation of distal radio ulnar joint is not necessary if anatomic reduction of the joint is obtained by indirect means such as open reduction and internal fixation of the radius and immobilization.
An observational study of clinical sequelae in COVID-19 at ESIC MCH Hyderabad
Authors: Chama Yadavendra Reddy , Chowdary Sangeetha
Published: April 2021

ABSTRACTBackground: covid 19 a deadly pandemic affecting people in 2020 not going to leave them without sequelae.This study is aimed at studying the sequelae in patients affected with covid 19.Methods: This Prospective Observational study was done from July 2020 to October 2020 in ESIC MCH Hyderabad.The patients admitted with covid 19 symptoms were treated and discharged.The patients on their follow up in OPD were asked about the symptoms persisting. Results: A total of 100 patients 60 males and 40 females presented during the study period.Most of the patients had fatigue 75[75%],myalgia 70[70%],dyspnea50[50%],throat pain 30[30%],edema 15[15%],dvt 10[10%],abdominal pain5[5%].Some of them developed DM due to use of steroids.                  Conclusions: It was observed from the study that this deadly pandemic could have everlasting effect on the affected people.though people recovered from the illness patients had complaints of fatigue,myalgias,dyspnea etc.Patients having lung complications aggravated leading to fibrosis.it was observed that patients with covid infection had predilection for kidney failure,heart failure.
An analytical observational study on the prognostic implication of postoperative serial serum lactate level for complications and predicting length of intensive therapy unit stay after major abdominal surgery
Authors: Mondal Moumita , Santra Sankari , Choudhuri Rajat , Das Amartya
Published: April 2021

Background: Post-operative microcirculatory alteration causes hypoperfusion, tissue hypoxia and organ dysfunction, resulting in significant morbidity and mortality. Increase in serum lactate level in response to tissue hypoxia may serve as a cost effective tool to assess status of all organ dysfunction being sensitive but not organ specific and may help in early prognostication. Aim of this study was to investigate the association of blood lactate levels during the first 24 hours after surgery with postoperative morbidity and mortality, with length of ITU stay and to correlate the lactate values at various time points with different postoperative complications (POC).Methods: 150 patients undergoing elective abdominal surgery were included. Blood lactate (mmol/lit) levels were measured immediately on admission to the Intensive Therapy Unit (ITU) and at 6, 12, and 24 hours of admission. The parameters of clinical outcome included were mortality, shock, Acute kidney injury (AKI), respiratory failure, wound dehiscence and length of ITU stay. Heart Rate, Mean Arterial Pressure, spo2, Temperature and Urine output were also measured.Results: There was statistically significant difference in the lactate levels measured at the above mentioned point of time (0, 6, 12 and 24h) in cases with death and without fatal outcome, with and without respiratory failure, with and without AKI, with and without shock and in cases with and without wound dehiscence (p<0.05). There was a statistically significant difference in urine output, duration of ITU stay and duration of intubation (p<0.05).Conclusions: Increased serum lactate levels were significantly associated with postoperative complications, mortality and length of ITU stay in patients undergoing major elective abdominal surgery.
Impact of serum vitamin D level on severity of asthma in children
Authors: Sachdeva Payasvi Baweja , Dutta Jusmita , Joshi Sheloj , Anand Shweta
Published: April 2021

Background: Asthma is the most common chronic respiratory disease among children characterized by reversible airway obstruction. Vitamin D plays an important role in many immune and allergic diseases and it may have a role in asthmatic patients, however this association yet remains uncertain. The present study was designed to assess the level of serum Vitamin D in patients with bronchial asthma and it’s correlation with disease severity.Methods: A prospective observational study was performed from April 2019 to February 2020 in the Paediatric OPD of LNMC and JK Hospital Bhopal. All 90 children with physician diagnosed bronchial asthma (mild, moderate and severe) aged 10 to 18 years of both genders who have come in the OPD (total enumeration sampling) during the above mentioned period were enrolled in to the study. The patients were grouped on the basis of Vitamin D sufficiency and Vitamin D levels were correlated with disease severity.Results: The study comprised 54 boys (60%) and 36 girls (40%) with mean age of 15.1±3.96. Out of 90 children enrolled, 46 had good control over asthma and 37 had uncontrolled asthma. As regards asthma control, 25-OH Vitamin D was lowest among patients with uncontrolled asthma.Conclusions: Vitamin D deficiency was highly prevalent in asthmatic patients and there was a direct and a significant relationship between serum Vitamin D levels, severity of asthma, control of asthma, serum IgE levels and blood eosinophils count. Thus, measuring serum levels of Vitamin D followed by supplementation could be considered in the routine assessment of patients with bronchial asthma.
Comprehensive study of thoracic trauma at tertiary health care centre: a retrospective observational study
Authors: Chauhan Ajay , Patel Yashasvi , Ranjan Nishant , Mehta Fateh S.
Published: April 2021

Background: Thoracic injuries account for a substantial proportion of all injury-related admissions, morbidity and mortality in all tertiary health care centres. The study was conducted to do comprehensive study of chest trauma at a tertiary health care centre.Methods: In this retrospective study we included all polytrauma patients with chest trauma admitted to Geetanjali medical college and hospital, Udaipur for a period of 2 years, from January 2017 until January 2019. Clinical details of the patients were recorded from their case sheets and were analyzed with reference to their age, sex, mode of injury, type of injury, severity of injury, treatment modalities, complications and final outcome.Results: Prevalence of chest trauma was 16.61% out of total cases of polytrauma. Males were predominantly involved (79.61%). Majority were in the age group of 21-30 years. Road traffic accidents (RTA) was the most common mode of injury (68.93%). A total of 53.40% patients required inter costal tube drainage (ICTD). About 17.47% of patients developed complications during treatment in the hospital.Conclusions: Chest trauma occurs in a significant number of polytrauma patients and majority of victims are males of 21-30 years of age. Majority of these patients were treatable with simple procedures like tube thoracostomy or ICU based treatment.
Feasibility of laparoscopic repair of peptic ulcer perforation
Authors: Sisodiya Sanjay , Patel Badri Prasad
Published: April 2021

Background: Perforation is a common complication of peptic ulcer disease and presents as Perforation peritonitis. It has the highest number of mortality among all complications (≈15%). In spite of modern progress in the management, it is still a life-threatening catastrophe. Emergency surgery for complicated cases required in 7% of hospitalized peptic ulcer disease patients. Factors such as >24 hours of history, concomitant disease, shock, post operated wound infections, all are associated with increase in mortality and morbidity.Methods: A Prospective, observational, single hospital base study done during the period from 2016 to 2020 in the Department of Surgery, Gandhi medical college Bhopal. Sample size was taken 63Results: 52 out 63 cases presented with perforation peritonitis included under study period, 11 cases were excluded due to death and absconding of cases. In rest 52 cases, 15 of them went through laparoscopic repair, 28.85% of the cases were shifted directly to ORG.Conclusions: Laparoscopic repair of peptic ulcer perforation is feasible if patient presents early to the hospital. All perforation peritonitis should give fair chance to repair laparoscopically if patient’s general condition and anesthetic permits. This is a good alternative for conventional open surgery with less post-operative pain, early return to normal activities, less hospital stays and few postoperative wound infections. Thus it can significantly decrease the economic burden.
Surgical perspective in pseudoaneurysm of peripheral arteries: a better limb salvage option
Authors: Sinha Lakshmi , Kumar Sanjeev , Ranjan Nishit , . Rituraj
Published: April 2021

Aneurysm involve all three layers of vessel wall. Psudoaneurysm also known as false aneurysm is a collection of blood that forms between the two outer layers of an artery. Femoral and popliteal artery aneurysms account for more than 90% of peripheral aneurysms, with popliteal artery aneurysms being the most common (70%). The estimated incidence of femoral and popliteal aneurysms is approximately 7/100,000 men and 1/100,000 women. Femoral aneurysms usually involve the common femoral artery but may occasionally extend or be limited to the superficial femoral artery (SFA) in the midthigh. Femoral and popliteal aneurysms are commonly associated with other aneurysms, with approximately 80% of patients having multiple aneurysms. Femoral and popliteal aneurysms show a high incidence of thromboembolic complications, which can result in limb loss. Pseudoaneurysm, if left untreated can result in deadly limb loss.
An ulcerated exophytic tumour over the gluteal area- eccrine porocarcinoma in an immunocompetent female
Authors: Kumar Ashok , Jagannath Spandana , Phulware Ravi H. , Mendiratta Vibhu
Published: April 2021

Porocarcinoma is a very rare type of skin cancer arising from the eccrine sweat glands and is poorly understood. The exact pathogenesis is unknown. Clinical features are non-specific. It may present as a painless, slow growing mass or nodule, ulcer, plaque, swelling, wart, papule or naevus that increases in size over years to decades and may ulcerate or bleed upon trauma. They occur equally in both sexes and are most commonly found in the lower extremity. Though metastasis is rare, they are considered aggressive with high mortality rate. Diagnosis requires standard histopathological studies. Immunohistochemistry is useful in difficult cases. Treated early, eccrine porocarcinoma is curable by wide excision. The author reports the case of an eccrine porocarcinoma in the lower extremity of an elderly lady and a summary of its clinical, radiological and histological findings is illustrated.
Two case reports of malignant melanoma rectum
Authors: Sathyan Jeena K. , Kamat Manmohan , Sharma Varsha , Shetye Shravani , Barman Seema
Published: April 2021

Malignant melanoma of the rectum is an extremely rare disease. It typically presents in the fifth or sixth decade predominantly in female sex. The first symptoms are nonspecific such as bleeding, anal mass or pain. A timely diagnosis of melanoma is made even more difficult due to lack of obvious pigmentation and histologically amelanotic. Anorectal malignant melanoma spread along submucosal planes and are often beyond complete resection at the time of diagnosis. Prognosis is very poor. We present a rare case of malignant melanoma of rectum in a 21-year-old male, who was diagnosed at advanced stage, and a case of malignant melanoma in a 50-year-old male, who underwent abdominoperineal resection with permanent colostomy. Anorectal malignant melanoma is difficult to diagnose and prognosis is poor.
A case report of portal vein thrombosis and common bile duct compression in the patient having pseudocyst of pancreas and its management by percutaneous trans-hepatic biliary drainage
Authors: Baldiwala Aafrin S. , Chandnani Rajesh G.
Published: April 2021

Pancreatitis is a systemic disease owing to release of inflammatory mediators and digestive enzymes. Acute pancreatitis is sudden inflammation of the pancreas. Alcohol and gallstones are main cause of acute pancreatitis. Chronic pancreatitis is the persistent inflammation and irreversible fibrosis associated with atrophy of pancreatic parenchyma. There are various complications associated with pancreatitis such as strictures, pancreatic necrosis, pseudo-cyst of pancreas, pancreato-cutaneous fistulas, venous thrombosis, arterial aneurysm in various arteries around pancreas etc. Common bile duct (CBD) strictures are a common complication in patients with advanced chronic pancreatitis and have a variable clinical presentation ranging from an incidental finding to overt jaundice and cholangitis. CBD strictures occur as a consequence of recurrent acute inflammatory episodes which may ultimately result in a periductal fibrotic stricture. CBD can be compressed as a result of extrinsic compression by large pseudocyst or aneurysm. The diagnosis is mostly made during investigations for abdominal pain but jaundice may be the initial clinical presentation. The jaundice is typically transient but may be recurrent with a small risk of secondary biliary cirrhosis in longstanding cases. Vascular complications in chronic pancreatitis are rare. Venous thrombosis is the most common complication of pancreatitis affecting venous system. It occurs as consequences of an inflammatory mass in head of pancreas, and splenic vein thrombosis occurs in association with chronic pancreatitis in 4-8% cases. Present case is a case of acute pancreatic collection in head of pancreas with aneurysmal small bleeding causing complete CBD compression and extensive venous thrombosis involving superior mesenteric vein, portal vein, splenic.
Complex fibroadenoma with focal ossification- an enigmatic finding in a less common tumor
Authors: Hota Subhransu Kumar , Giri Ranjana , Kabra Hardik , Chauhan Devika , Pradhan Prita , Pujari Pran Singh
Published: April 2021

Breast lumps have diverse causes including benign as well as malignant lesions. Fibroadenoma (FA) is a common cause of breast lump. Complex fibroadenomas, a particular subtype, pose diagnostic dilemmas due to confusing the radiological findings and hold higher incidence of transformation to malignancy. A 49 year old female presented with a painless lump in right breast for 2 years which appeared calcified on radiology. Excision biopsy was performed which grossly revealed an encapsulated grey-white firm to hard with cystic areas. Microscopically the sections showed a well encapsulated fibroepithelial tumor showing areas of sclerosing adenosis, hyalinization, cysts lined by cuboidal cells with eosinophilic secretions, areas of calcification and ossification. No evidence of lobular hyperplasia or in-situ carcinoma was seen. Patient was advised follow up. This case represents the unusual occurrence of complex fibroadenoma in a middle-aged female showing with ossification.
Gangrenous bowel ischemia-a complication of COVID-19: a case report
Authors: Swami Ganesh Ashok , Shinde Swapnil Kashinath , S. Halnikar Chandrashekha , Asawa Ganesh
Published: April 2021

The novel virus SARS-CoV2 responsible for ongoing pandemic of COVID-19 since March 2020 has not only been found to cause pneumonia but also involves multiple symptoms such as Gastroinstestinal system, central nervous system, cardiovascular system as a part of multi inflammatory syndrome, which has been increasingly recognized as a part of disease spectrum. COVID-19 associated coagulopathy has emerged as a major cause of high morbidity and mortality, one of which is result being ischemic bowel disease. So herein, we are going to present the first case of probable case of COVID-19 associated ischemic bowel disease in our institute.
Bacterial etiology and antimicrobial susceptibility pattern of neonatal sepsis at a tertiary care hospital in Nepal
Authors: Sharma Kiran , Sah Love Kumar , Pareek Prince , Shah Sanjay , Garegrat Reema
Published: April 2021

Background: Sepsis is the second major cause of mortality among neonates. Present study was done to identify the common organisms which cause early and late onset neonatal sepsis in neonates admitted in our department and their antibiotic sensitivity patterns.Methods: All neonates weighing more than 1500 gms and born to mothers with pre-existing infection, admitted to neonatal intensive care unit for suspected neonatal sepsis were included in the present study. They underwent blood culture and antibiotic sensitivity profiling.Results: 210 newborns were admitted to the NICU of our department for suspected neonatal sepsis. Longer duration of rupture of membranes was found to be significantly associated with growth of organisms. Amongst the cases with gram positive organisms, most were due to Coagulase-negative staphylococci (CoNS) (n=25), followed by Staphylococcus aureus (n=14), and, Enterococcus (n=4). Gram negative organisms isolated constituted 17 organisms. Amongst the cases with gram negative organisms, mostly were due to Klebsiella (n=10), followed by Pseudomonas (n=5) and E. coli (n=2). The most common organism causing early onset sepsis was CoNS, while Staphylococcus aureus was the most common organism causing late onset sepsis. CoNS was fully sensitive to Vancomycin and Amikacin. Staphylococcus aureus was fully sensitive to Amikacin, α-hemolytic. Streptococcus were sensitive to Amikacin, Vancomycin and Piperacillin and Tazobactum and Enterococcus was sensitive to Amikacin and Vancomycin.Conclusions: Antimicrobial surveillance of neonatal septicaemia is required to know the antibiotic sensitivity pattern and thus to formulate policies on use of antibiotics and to know the changing spectrum of antimicrobial sensitivity patterns.
Role of probiotics in clinical course and outcome of preterm neonates
Authors: G. Ram Mohan , Khan Majaz Ahmed , G. Seshagiri , V. Pavithra , C. Ramya
Published: April 2021

Background: In a quest to improve the outcome of preterm neonates and to reduce neonatal mortality a lot of research has been done in the field of neonatology; one such intervention is the use of probiotics. We evaluated the role of probiotics in reducing the incidence and severity of NEC, sepsis, hyperbilirubinemia and in improving enteral feeds in preterms.Methods: A prospective randomized control trial was conducted in preterm neonates <37 weeks of gestation from December 2017 to November 2019. They were randomized into test and control groups. The neonates in the test group were fed with probiotics with breast milk twice daily till they reach full feeds. Babies in the control group were fed with breast milk alone. Various parameters were compared between two groups like incidence of NEC, sepsis etc.Results: Sixty preterm neonates were enrolled, 30 in the test group and 30 in the control group. The demographic and clinical variables were similar in both groups. The incidence of NEC and sepsis in the test group is less compared to the control group. Duration of phototherapy was less in test group (1.10.3 days) compared to control group (1.90.9 days). Duration of hospital stay in test group was less (8.92.1 days) compared to the control group (11.43.7 days).Conclusions: Prophylactic probiotics have a beneficial role in prevention of NEC and sepsis, reducing duration of phototherapy and duration of hospital stay in preterm neonates.
Assessment of level of fatigue and level of parenting efficacy among mothers of hospitalized children
Authors: Mukhopadhyay Ananya , P. Vetriselvi , Ramamoorthy Jaikumar
Published: April 2021

Background: Fatigue is a vital concern among mothers of hospitalized children but it remains relatively unexplored. Parenting efficacy is parent’s competence in taking care of the children. The present study was aimed to assess the level of fatigue and parenting efficacy among mothers of hospitalized children and to identify the correlation between them.Methods: A cross-sectional study was carried out among 112 mothers of hospitalized children in paediatric medical ward of a tertiary care centre. Participants were recruited through convenient sampling. Socio-demographic proforma was used to collect the data concern with socio demographic details, Chalder’s fatigue scale was used to assess the level of fatigue and parenting sense of competence (PSOC) scale was used to assess the level of parenting efficacy of mothers. Distribution of demographic variables, level of fatigue and level of parenting efficacy were expressed in frequency and percentage. Correlation between the level of fatigue and level of parenting efficacy was assessed by Karl Pearson correlation coefficient.Results: Among 112 mothers 83.9% of them had moderate fatigue and only 42% had good parenting efficacy, Karl Pearson correlation had shown a negative correlation (r=-0.002). Age and occupation had shown significant association with level of fatigue (p=0.004,  p=0.019 respectively).Conclusions: In order to provide family centered care to the children, strategies should be implemented in all paediatric care units to reduce fatigue and to improve parenting efficacy among mothers of hospitalized children.
Clinical profile and outcomes among neonatal pneumonia patients admitted in a tertiary care hospital, Gujarat, India
Authors: Patadia Jigisha R. , Parmar Ankit , Shah Vijay B. , Bambharoliya Praful R.
Published: April 2021

Background: Neonates are highly vulnerable to infection due to factors like immaturity, immunologic deficiencies at time of birth and in-utero maternal infection. Neonatal pneumonia continues to remain important cause of mortality and morbidity in developing countries like India. The aim of this study was to study the clinical profile and outcome of neonatal pneumonia.Methods: This descriptive observational study was carried out at NICU of tertiary care hospital with level III nursery during August-October 2012. A total of 200 neonates admitted in NICU during the study period were included as per inclusion criteria. All neonates were observed on day of admission, on day of deterioration and day of discharge. Clinical parameters, investigation profile, probable aetiology, intervention required and outcome was noted.Results: Out of 200 neonates admitted during study period, 64 neonates were having neonatal pneumonia, making incidence of 32%. All symptomatic patients having respiratory distress were evaluated by taking blood samples for blood culture with antibiotic sensitivity, C-reactive protein, sepsis screen and X-ray chest. Onset of pneumonia was decided on basis of appearance of symptoms like early onset (<72hours) or late onset (>72 hours). Half of the patients had shown improvement after intervention but 16% deteriorated which required ventilatory support. Mortality was 32.81% and it was more in early onset (40%) than late onset (28.2%).Conclusions: There was no single parameter which can be used for diagnosis of neonatal pneumonia. Clinical features with chest X-ray with sepsis markers have to be considered in diagnosing pneumonia.
Peripheral tactile stimulation for intractable apnea of prematurity: a case report
Authors: Pothapregada Sriram , K. Umamaheswari , Ram Soumya
Published: April 2021

Apnea of prematurity (AOP) is an extremely common problem in preterm babies. Several invasive and non-invasive methods of treatment have been studied. We present a novel non-invasive method of managing intractable apnea in preterm neonates.
Acculturative status, age, and hypertension among African American women
Authors: Webb Fern J. , Jones Christina , Jones Ross , Morga Kristen , Bilello Lori , Khubchandani Jagdish
Published: April 2021

Background: Understanding culture’s impact on hypertension (HTN) is important since its prevalence in African American women (AAW) in the United States is among the highest. It is therefore important to know if younger AAW have similar acculturation status as older AAW when developing culturally relevant interventions.  The objective of this study was to examine the association between acculturation status and age, determining whether acculturation status and age are significantly associated with hypertension among AAW.Methods: Acculturation status, age, and HTN were analyzed using data from the listening to our voices study (LOVS), a population-based observational study of 294 AAW conducted throughout Florida. LOVS was promoted via African American women research assistants trained to inform and recruit AAW living in Ft. Lauderdale, Jacksonville, Miami, and Tampa.Results: Findings demonstrate that AAW held traditional values regardless of age. Moreover, AAW of younger ages had higher average acculturation scores compared with older AAW indicating stronger agreement with traditional values, practices and beliefs. Acculturation subscale scores were not associated with HTN. AAW with HTN scored higher on the traditional food subscale compared to AAW without HTN.Conclusions: These findings indicate the significance of considering the beliefs, values, and practices of AAW when developing health interventions. Health interventions developed should be tailored toward AAW of varying ages to incorporate activities relevant to their cultural beliefs, values and practices.
Efficacy of home visits by public health providers for high-risk pregnant women in Egypt
Authors: Elbahrawe Rasha S. , Saleh Lamiaa , Khalil Eman M. , Abbas Ahmed M. , Yahia Marwa , Ali Hamada A. A.
Published: April 2021

Background: Home visits programs aim to improve care management for high-risk pregnant women. Birth outcomes, such as preterm birth, low birth weight (LBW), and small for gestational age (SGA), are crucial indicators of child development and health. The present study evaluates the efficacy of home visits by public health providers for high-risk pregnant women in Egypt to prevent adverse pregnancy outcome.Methods: This is a cohort study using administrative data collected in obstetrics department, Faculty of Medicine, Beni-Suef University. All women with high risk pregnancy were followed by home visits by public health providers.Results: Birth outcomes were documented and evaluated. Women from the home-visit group had a heavier birth weight 2752.85±286.571, longer gestational age 38.36±1.257, less LBW infants 52 (18.6%), less preterm birth 22 (7.9%), and less SGA infants 27 (9.6%) compared to participants who did not receive the home-visit program.Conclusions: Our findings suggest that home visits by public health nurses for high-risk pregnant women in Egypt might be effective in preventing preterm birth, but not SGA. This study adds to the evidence of the effectiveness of population-based home-visit programs as a public healthcare measure.
Role of health care workers in the care and support of women living with HIV/AIDS experiencing intimate partner violence: the case of women attending care and treatment clinic in Singida region, Tanzania
Authors: Kosia Agnes L. , Nyamhanga Tumaini , Frumence Gasto , Kakoko Deodatus , Semakafu Ave Maria
Published: April 2021

Background: Intimate partner violence (IPV) is behaviour within intimate relationship that causes physical, sexual and psychological harm. Health care workers (HCW) have a big role to play for women living with HIV/AIDS (LWHA) who are experiencing IPV. The understanding and perception of IPV towards health care workers is very important in the provision of integrated holistic care.Methods: This was a qualitative study where data was collected through in-depth interviews and focus group discussions for 24 HCW, working at a care and treatment clinic and prevention of mother to child transmission of HIV/AIDS. Content analysis was used to analyse the data.Results: The study findings showed that HCW had their own meaning and understanding of IPV that was when a male partner does something wrong to his female partner which was associated with beating, use of abusive language and refusal to provide basic needs. HCW had various roles in caring and supporting women LWHA experiencing IPV. They provided emergency medical services, health education which helped them to cope with their HIV/AIDS disease, counselled on the importance of adhering to their antiretroviral treatment medications and referral services which helped them to address their IPV as women LWHA.Conclusions: The study concluded that HCW had a very important role to play in care and support of women LWHA. They needed more training on IPV so that they will be able to provide care and support to all women living with HIV/AIDS experiencing IPV and the community at large.
Medical laboratory professional’s week in Rwanda: a field report from the Simbi and Maraba communities
Authors: Pierre Gashema , Iradukunda Patrick Gad , Tumusiime Musafiri , Harelimana Jean De Dieu , Rutayisire Gad , Nyakatswau Stuart T. , Samjeh Oswald , Muhwezi Andrew , Mwikarago Ivan Emil , Muvunyi Claude Mambo , Gitema Fiston , Ndoricyimpaye Ella Larissa , Rugimbanya Pierre , Gatete Edgar , Rujeni Nadine , Dzinamarira Tafadzwa
Published: April 2021

Background: In response to the need for interventions that facilitate the accessibility of medical services in poor communities, an outreach activity was organized in semi-rural areas of Maraba and Simbi sectors located in Huye district, Southern province of Rwanda. The outreach was undertaken by health sciences students and involved the screening of hypertension, risk of diabetes, hepatitis, anemia, eye disease, and HIV.Methods: Clinical assessments and rapid laboratory diagnostic assays were used to screen invited residents from the two selected communities. An observation research was conducted from May 21 to 25 May, 2018, at Maraba and Simbi sector located in Huye district, Southern province, Rwanda. We employed a purposively sampling technique for participants' recruitment in the outreach. The outreach was conducted as part teaching program and community engagement, and was endorsed by college of medicine and health sciences and all the subjects voluntarily participated in this exercise; the ethical approval was not applicable for this outreach activity. Results: The total beneficiaries from those sectors were 1427 citizens of whom females predominated at 72%. During the screening, hypertension was found to be high at 47.8% among adults. Anemia which mostly presumes iron deficiency was observed at 32.5% among under 15 years old children and at 15% in pregnant women. The vision impairment and cataract were observed at 5.66 and 19.59%, respectively. The assessed viral infection indicated a rate of 0.56% for HIV, 1.03% for HBV, and 7.17% for HCV. High blood glucose was found in 10.4% of the screened population.Conclusions: The findings highlight a high burden of non-communicable diseases (NCDs) in rural communities and call for further investigations and interventions to align with the sustainable development goals (SDGs), particularly access to affordable health services. Furthermore, the success of this outreach highlights the potential contribution of health care trainees in achieving these goals and calls for integration of such interventions in the health education curriculum.
Optimization of SARS-CoV-2 laboratory testing in a rural healthcare facility in the United States
Authors: Bharathan Tanvi S. , Trale Austan J. , Bharathan Tashi , Dienes Nichol L. , Sansig Jackie , Wilson Steven , Bharathan Narayanaswamy
Published: April 2021

Background: The diagnostic testing for SARS-COV-2 (COVID-19) presented a profound challenge to the entire world, dominating the concern of most governments and public health systems, particularly rural community hospitals in the United States. Indiana University of Pennsylvania (IUP) in partnership with Indiana Regional Medical Center (IRMC) began on site, same-day COVID-19 testing in efforts to not only combat the challenges that health providers faced in rural Indiana community but also help to strengthen global diagnostic capacity.Methods: Clinical samples were collected as dry swabs from the nasopharyngeal (NP) regions and processed in phosphate buffer saline (PBS). The crude RNA was directly tested using real-time (RT) reverse transcription quantitative polymerase chain reaction (RT-qPCR) with PrimeDirect probe RT-qPCR Mix (Takara Bio USA) and optimized with probe-primer sets [Integrated DNA Technologies (IDT)].Results: Validation experiments with dry swabs from NP clinical samples showed no difference in the testing accuracy to those collected in viral transport medium or universal transport medium. Extraction of COVID-19 RNA in PBS reduced processing time of a batch of 50 NP clinical samples from 6 hours to an hour. This allowed for rapid diagnostic testing of nearly 200 clinical samples per day. Optimization of analytical variables helped to detect virus loads up to 2.0 copies/μl during routine diagnostic testing.Conclusions: During an infectious outbreak, the ideal response by public health authorities is rapid testing. The collaboration between IUP and IRMC attests to the importance of teamwork between local initiatives to detect and prevent further spread within a rural community.
Burundi: analysis of the 2016-2017 Burundian demographic and health survey
Authors: Prosper Masabarakiza , Charles Nsanzabera
Published: April 2021

Background: Access to antenatal care and postnatal care services has a great deal of impacts on major causes of high maternal, neonatal and child mortality rates. This study was aimed to identify factors affecting the use of antenatal care (ANC) and postnatal care (PNC) services.Methods: The study used data from the nationally representative 2016-2017 Burundi demographic and health survey (DHS). A total of 8,660 mothers who gave birth within five years preceding the 2016-2017 Burundi DHS were included in this study. Logistic regression statistical analyses were used to identify factors associated with the use of the first ANC visit, the use of 4 ANC services and the use of PNC services in Burundi.Results: Using logistic regression the determined factors such as birth order (AOR 1.64; 95% CI 1.51-1.73), place of delivery (AOR 0.63; 95% CI 0.54-0.76), mothers’ education (AOR 0.47; 95% CI 0.38-0.57) and husband’s education level (AOR 0.85; 95% CI 0.74-0.94) were associated with the use of early ANC. Factors such as birth order (AOR 1.79; 95% CI 1.67-2.30), the exposure to media(AOR 1.11; 95% CI 0.98-1.30), women’s education (AOR 0.58; 95% CI 0.46-0.73), residence(AOR 0.8; 95% CI 0.69-1.01) and the birth interval(AOR 1.45; 95% 1.32-2.00) were associated with the four ANC. Women’s education (AOR 0.59; 95% CI 0.40-0.70), and health insurance coverage (AOR 0.72; 95% CI 0.59-0.96) were associated with the receiving of PNC.Conclusions: Health promotion targeting women’s education, husbands’ education and behavioural change communication in rural areas are vital for increasing their awareness about the importance of antenatal services.