bluuebunny/crossref_metadata_2025 huggingface dataset:
Obstetric and neonatal outcomes of the pregnancies complicated with thrombocytopenia
Authors: Kumari Pratima , Bhangale Saurabh V. , Patil Asmita N.
Published: October 2019

Background: Thrombocytopenia is second most common hematological abnormality in pregnancy after anemia (Incidence 8-10%). The aim of this study is to observe the obstetric and neonatal outcomes of pregnancies complicated with thrombocytopenia and to compare its maternal and fetal outcomes.Methods: The prospective observational study was conducted at tertiary care institute over period of one and half year and 100 cases of thrombocytopenia in present pregnancy were included after fulfilling inclusion and exclusion criteria and obtaining written informed valid consent. Complete history, physical examination and relevant investigations of the patient were documented. Patients were followed up to delivery and outcomes (obstetric, maternal, fetal, neonatal) were studied. The data obtained for all the patients was analyzed with SPSS (SPSS Inc, Chicago) software packages. Statistical comparisons were performed with Pearson’s Chi- square where appropriate with p-value of <0.05 considered statistically significant.Results: Most common cause of thrombocytopenia in pregnancy was gestational thrombocytopenia in (25%) cases followed by preeclampsia (20%). Most cases (94%) were diagnosed in antepartum period out of which most (58%) at >37 weeks of gestation. Most (53%) had moderate thrombocytopenia. Incidence of maternal complications was statically significant (P-value 0.038) with most common complication being caesarian section site oozing (9%) followed by placental abruption (4%). There was no statistical significance in degree of thrombocytopenia and need for blood and blood product transfusion (P-value 0.67). Only (2%) neonates of thrombocytopenic mothers had thrombocytopenia and both required treatment.Conclusions: Most common cause of thrombocytopenia in pregnancy was gestational thrombocytopenia with uneventful pregnancy and perinatal outcomes. Few severe cases associated with medical or systematic causes leads to serious catastrophic events which can be avoided by increasing antenatal surveillance and appropriate management by multidisciplinary team of obstetrician, hematologist, anesthesiologist, neonatologist and physician.
Clinical profile and fetal outcome in women with preterm labor pains
Authors: Gupta Shweta , Juneja Sunil K. , Salhan Himanti , Sandhu Parminder
Published: October 2019

Background: Preterm labor is a potential cause of preterm birth. Certain demographic and presenting features in pregnant women may correlate to the severity of the problem and progression to delivery. The aim of the study was to find out the clinical profile and fetal outcome in women with preterm labor pains in a tertiary care hospital of North India.Methods: 83 women with preterm labor were included in the study. Antenatal corticosteroids and tocolytic therapy were given. Women who delivered preterm comprised of Group A and who delivered at term were Group B. Clinical profile and fetal outcome was compared and statistically analyzed.Results: 39 (47.0%) women had preterm delivery (Group A) and 44 (53.0%) women delivered at term (Group B). 23.1% women in group A and 4.5% in group B had a previous preterm birth (p=0.021). 16 (41%) women in group A and 4 (9.1%) in group B had a positive microbial growth on high vaginal swab (p=0.001). The odds of having a preterm birth with cervical length of <2 cm was calculated to be 5.281 (p=0.000). A statistically significant difference was observed in the mean birth weight, Apgar score and nursery admissions in both the groups (p=0.000).Conclusions: A prior history of preterm birth, a positive growth on high vaginal swab and a cervical length of less than 2 cm were found to be significantly associated with preterm birth.
Magnitude of thyroid dysfunction among antenatal women attending tertiary care centre
Authors: Shanmugham Deepa , Saravanan Deepak Kannan , Shah Priyanka
Published: October 2019

Background: Thyroid disorders constitute one of the most common endocrine disorders in pregnancy. However, there is no universal guidelines to screen every Pregnant Woman for Thyroid dysfunction in India. This study was conducted to evaluate the magnitude of thyroid dysfunction among ante natal mothers in a tertiary care centre.Methods: This was a cross sectional observational study conducted on ante natal mothers for a period of 6 months. All consecutive ante natal mothers in their first trimester were included in this study. Exclusion criteria was pre-gestational thyroid dysfunction, hypertension and diabetes mellitus. After obstetric examination and investigation, thyroid function test (Free T4 and TSH) was done in all patients.Results: Mean age of the patients enrolled was 26.2±3.54 years. Mean gestational age at which they underwent screening was 9±2 weeks. The mean BMI of the study patients was 21.7±4. The prevalence of hypothyroidism in antenatal mothers was 14.5%. 5 patients (5.5%) had hyperthyroidism. The calculated mean TSH value was 4.26 mIU/L.Conclusions: Universal screening for thyroid dysfunction during pregnancy should be made mandatory in India due to high prevalence, in order to prevent maternal and foetal complications.
Evaluation of caesarean section practices according to Robson's 10-group classification at a level two maternity ward in Conakry, Guinea
Authors: Leno Daniel W. A. , Bah Mamoudou E. , Moumbagna Jerry C. , Millimouno Tamba M. , Lamah David , Delamou Alexandre , Sy Telly
Published: October 2019

Background: The frequency of caesarean sections (CS) increased dramatically in the world over the last twenty years. The objective of this study was to evaluate caesarean section practices based on Robson classification in an urban referral hospital in Conakry, GuineaMethods: We conducted a cross-sectional study of 2,266 birthing records collected at the maternity ward of the Coronthie Communal Medical Center in Conakry, from January 1st to December 31st 2016. We included in the study all women who had a caesarean section and whose medical records were complete. Robson's classification was used to classify women into 10 groups based on maternal and fetal characteristics. The relative size of each group, its gross caesarean section rate as well as its contribution to overall caesarean section rate and the main caesarean section indications were calculated.Results: In 2016, 769 caesarean sections were performed out of 2,266 deliveries, corresponding to a hospital section rate of 33.9%. Groups 5 (11.0%), 1 (4.8%), and 3 (4.3%) of the Robson classification were the most contributors to registered hospital caesarean section rate. The main indications for caesarean section were uterine scar in group 5 and acute fetal distress in groups 1 and 3.Conclusions: The systematic reference to the Robson classification could help to identify and avoid the relative indications of the caesarean section in urban Guinea. Besides, increasing induction of labor and strengthening providers’ capacities in emergency obstetric and newborn care services could contribute to reduce caesarean section rates in Guinea.
Expression of Cyclin D1 in normal and hyperplastic endometrium
Authors: Kundu Parveen R. , Sindhu Anjali , Kaur Swaran , Kulhria Amrita , Hooda Ritika
Published: October 2019

Background: Endometrial hyperplasia is characterised by increased gland to stroma ratio with varying degree of atypia. Cyclin D1 is a protein playing important role during the G1→S phase transition in the cell cycle. The present study evaluated the expression of Cyclin D1 in normal and hyperplastic endometrium.Methods: A cross sectional study was conducted over a period of 1 year. We evaluated and compared the expression of Cyclin D1 in 56 endometrial samples including 24 cases of simple hyperplasia, 12 cases of complex hyperplasia and 10 cases each of secretory and proliferative endometrium.Results: A substantial increase in expression of Cyclin D1 was seen in hyperplastic endometrium compared to normal endometrium. Moreover, complex hyperplasia showed the maximum positivity for Cyclin D1.Conclusions: Cyclin D1 may play a stimulatory role in the proliferation of endometrial glands and hence may be involved in endometrial tumorigenesis.
Impact of severe anemia during pregnancy on maternal outcome
Authors: Raj Smruthi C. , L. Kruthika M. , S. Vidhyasree
Published: October 2019

Background: Anemia is a global problem. Its prevalence in India is about 60%. Anemia directly or indirectly contributes to a significant proportion (40%) of maternal deaths in developing countries. The present study aimed to determine maternal outcome among pregnant women with severe anemia.Methods: This was a prospective study conducted in the department of obstetrics and gynecology, Mc Gann teaching district hospital, Shimoga, over a period six months i.e from January 2019 to June 2019. The study population included all pregnant women who were in their third trimester and with severe anemia (Hb%</=7g%) attending for routine care at our hospital. The interviews were conducted in regional language. The information collected was, social demographic characteristics, economic characteristics and reproductive health history. After the interviews, clinical examinations were conducted and clinical samples such as blood, urine and stool were collected to perform investigations.Results: A total of 94 study participants were included in the study. All study participants were belonged to the low socio-economic strata of the society. 68.1% of women in anemia group were from a rural background. Unbooked and referred cases constituted nearly 4/5th of all anemic subjects (84%). In study group, preponderance of illiteracy was reported and accounted for 60.64% followed by primary and secondary education 23.04% and 14.90% respectively. Common maternal complications noted in the severely anemic group was PPH (14.9%), post-partum febrile morbidity (5.3%), CCF (3.2%) and sepsis (4.2%) while in the control group only one woman had post-partum febrile morbidity.Conclusions: In our study, common maternal complications noted in the severely anemic group were post-partum hemorrhage, postpartum febrile morbidity, congestive cardiac failure and puerperal sepsis.
Long term follow-up study for abdominal sacrocolpopexy/sacrohysteropexy
Authors: Puri Sapna , Jaggi Rohini , Sunil Isha
Published: October 2019

Background: Pelvic organ prolapse is common in women and 7-9% undergo surgical repair. Abdominal sacrocolpopexy and sacrohysteropexy is the most durable operation for vault prolapse and Nulliparous prolapse respectively. The objectives of this study were to describe Anatomic and symptomatic outcomes up to 5 years after abdominal sacrocolpopexy or sacrohysteropexy.Methods: This study was conducted in ASCOMS hospital for a cohort of patients who underwent abdominal sacrocolpopexy (ASC) or sacrohysteropexy (ASH) in 2 years (2013-2015) and follow up done for a period of 5 years from 2015-2019. These patients were evaluated for subjective and objective outcomes following ASC and ASH. women completed questionnaires and were examined in gynaecology clinic. Prospective follow up study using standarised examination with pelvic organ prolapse quantification system (POP-Q) and questionnairesResults: In the present study, there was low incidence of intraoperative and postoperative complications as well as long term complications were significantly low. The anatomical cure rate and patient satisfaction rate was both 100%.Conclusions: Abdominal sacrocolpopexy for vault prolapse and sacrohysteropexy for Nulliparous prolapse is safe and effective method and is considered gold standard for treatment of Apical compartment prolapse.
Clinical significance of HPV-HC2 in diagnosis and prognosis of cervical lesions: a retrospective study
Authors: Hassanati Soule , Fang Qin , Fang Yuanyuan , Xing Yan
Published: October 2019

Background: To evaluate the human papillomavirus HC2 different range detection values and their clinical significance in prediction of CIN lesions grades as well as their role in the follow-up outcome after treatment.Methods: Using the hybrid capture 2 to detect and measure the HPV and the viral load quantity, we enrolled a total of 527 HPV positive women. All patients underwent thin prep liquid-based cytology test (TCT) and only 325 underwent colposcopy guided biopsy due to abnormal cytology results. All cytology and biopsy results were collected and analyzed according to the HPV viral load. Among these patients 108 patients were followed during 2years post-operatives and their prognosis results were collected and analyzed.Results: The proportion and severity of cytological abnormalities was positively correlated with the HPV-HC2 viral load (P<0.05). There was a positive correlation between cervical biopsy results and the HPV viral load P <0.05). The more the HPV-HC2 viral load was, the higher CIN2-3 grade percentage was getting. However no statically significant correlation was found between the HPV-HC2 viral load and the follow up outcomes after treatment (P>0.05).Conclusions: High HPV-HC2 viral load is significantly associated with the severity of cervical lesions (CIN), however it does not predict any further prognosis on follow-up after treatment.
Recurrent hematometra with endometriosis in an adolescent girl: a case report
Authors: Agrawal Sarita , Sahu Rajshree , Thakur Pushpawati , Singh Vinita , Chandramohan Pawan B.
Published: October 2019

Hematometra is a collection or retention of blood in the uterine cavity. This condition is most commonly associated with congenital uterine anomalies that result from abnormal formation, fusion or resorption of Mullerian ducts during fetal life or may be due to prior surgical procedures, causing an obstruction of the genitourinary outflow tract. We report an unusual case of hematometra with endometriosis secondary to cervical stenosis. This is a rare and important case report due to the complexity of diagnosis as cervical stenosis was not presented as primary amenorrhoea as its usual presentation. This case was successfully managed by Hysteroscopic cervical dilatation under USG guidance followed by transcervical insertion of a catheter to prevent recurrent stenosis.
A case report on broad ligament fibroid mistaken as pregnancy
Authors: Dulewad Shirish , Chandak Pooja
Published: October 2019

Leiomyoma is the commonest benign uterine condition arising from smooth muscles. Extra uterine leiomyoma is rare. The incidence of broad ligament fibroid is less than 1%. Because of its rarity broad ligament fibroid poses specific diagnostic difficulties causing an error in making the final diagnosis and therefore the management. Here we report a case of rare broad ligament fibroid got neglected sadly in this modern era, where the facilities like USG which can easily diagnose this rare entity are readily available. Presented as ANC with no labor pains and accidentally diagnosed as a case of huge broad ligament fibroid. Managed surgically by myomectomy with conservation of uterus and bilateral internal iliac artery ligation for minimizing bleeding.
Mifepristone as pre-induction cervical ripening agent: a review article
Authors: . Nikita , Ghose Seetesh , Rathod Setu
Published: October 2019

Induction of labour after the period of viability by any methods medical, surgical or combined, for the purpose of vaginal delivery. The success of induction, to a great extent, depend upon pre-induction cervical status i.e. cervical ripening. So, ripening of cervix prior to induction i.e. pre-induction cervical ripening is one of the important steps for successful induction of labour. There are different methods for cervical ripening like prostaglandins (PGE). However, use of prostaglandins (PGE) and oxytocin as labour inducing agent has its own adverse effects on maternal and perinatal outcome. So, constant efforts are made for the less use of uterotonins. The present review aims to study the efficacy of oral Mifepristone for improvement in Bishop’s score, requirement of additional uterotonics, induction delivery interval, mode of delivery and neonatal outcome. Electronic databases were searched by using keywords ‘Mifepristone, RU486, PGE2 gel, Cervical ripening, Bishop’s score and Induction of labour’ and eleven articles were found from 2009 to 2018 which fulfils our study criteria and thus they were taken for review. Based on all the studies, Mifepristone appears to be effective cervical ripening in comparison to other agents with significant improvement in Bishop’s score, higher vaginal delivery rate, shorter induction delivery interval and good neonatal outcome.
Study on non-verbal communication knowledge among doctors of non-clinical and para clinical departments of Government Vellore medical college hospital, Vellore, Tamil Nadu, India
Authors: J. Balaji , P. Parthiban
Published: October 2019

Background: Many Studies and Research Articles in our medical field focuses on Verbal Communication component. The Non-Verbal Component has been neglected in many circumstances. But Medical science endorses that Non-Verbal component plays a major role in the communication process in all set ups whether it is in the classrooms, Examination Hall, Outpatient Room or Wards or Intensive Care Units. The objective of this study is to access the knowledge and Awareness of NVC Component among Doctors of Non-Clinical and Para Clinical Departments of GVMCH - Vellore, Tamil Nadu, India.Methods: This Cross-Sectional Study was conducted among 45 Doctors across 7 Departments of Government Medical College Vellore. Mean, Median, Mode and Standard Deviation were used for quantitative Data and Pearson Chi Square Test and Logistic regression was used for qualitative Data using Trial Version of SPSS 22.Results: The mean Score was 7.2±2.8 with Mean scoring percentile of 28.8 ±11.5. There was Pearson’s Chi Square significance for Variables like External Resources related to NVC, Books related to NVC, UG and PG pursued at, Exposure to Workshops or CME s related to NVC, and age Group < 35. But on running Logistic Regression we got statistical significance for variables like External resources related to NVC, UG studied at same state, Age Group >35 years.Conclusions: Variables like External resources, UG studied at same state, Age Group >35 years Showed Statistical significance in knowledge on Non-Verbal communication in this Study set up.
Validity of mannheim peritonitis index in predicting outcome of patients with perforative peritonitis in a tertiary care centre Kerala, India
Authors: Mathew Alex , John Joby , Sasikumar Asha
Published: October 2019

Background: Perforation peritonitis is one of the most commonly encountered surgical emergencies in our country. The prognosis of secondary peritonitis remains poor despite development in diagnosis and management. Early identification of patients with severe peritonitis may help in selecting patients for aggressive surgical approach.Methods: The study was conducted in 128 cases of perforation peritonitis admitted and treated in the department of surgery in a tertiary care centre. Initial diagnosis was made on the basis of detailed history, clinical examination and presence of pneumoperitoneum on erect abdominal X-ray. Patients were first assessed using a predesigned Performa, then MPI score was calculated for each patient and the patients were followed-up till death or discharge from the hospital.Results: The ROC curve analysis shows area under the curve was 0.986 with a standard error of 0.008, 95% CI (0.971 to 1.001), p<0.0001. In our study authors found that for the MPI score of 26, sensitivity was 91.3% and specificity was 92.4%, with a positive likelihood ratio of 12.01 and a negative likelihood ratio of 0.09. Age of the patient, presence of organ failure, associated malignancy, generalised type of peritonitis and the original MPI Score has got a significant association with the final outcome (i.e. p value <0.05).Conclusions: MPI is an excellent prognostic index for peritonitis with high accuracy in individual prognosis that is cheap, cost effective, easily measurable and reproducible. The study accentuates that early diagnosis, appropriate resuscitation and prompt surgical intervention still remain the keystones in the management of perforation peritonitis.
Predictors of co-morbidities in chronic obstructive pulmonary disease patients at a tertiary care centre in north India
Authors: Narayan Kaushlendra Pratap , Verma S. K. , Kant Surya , Kushwaha R. A. S. , Kumar Santosh , Garg Rajiv , Srivastava Anand , Bajaj Darshan K. , Sonkar Satyendra
Published: October 2019

Background: Chronic obstructive pulmonary disease (COPD) is a common preventable and treatable disease that is characterised by persistent respiratory symptoms and airflow limitation. COPD is characterised by an intense inflammatory process in the airways, parenchyma, and pulmonary vasculature. It is possible in some cases that the inflammatory process may overflow into the systemic circulation, promoting a generalised inflammatory reaction. Patient with COPD often have concomitant chronic illness (co-morbidities). The aim of this study is to know the pattern of co-morbidities in COPD patients.Methods: This study was a cross sectional observational study conducted on 172 COPD patients (IPD and OPD) diagnosed on the basis of GOLD guideline 2017. Co morbidities were diagnosed as per standard defined criteria laid down in the respective guidelines.Results: 55.3% of the patients with COPD had co morbidities. 18/88(20.5%) patients presented with multiple co-morbidities. 49/88, 55.7% COPD patients were affected with cardiac (either only cardiac or had multiple organs affected besides cardiac), the commonest co-morbidity. Amongst cardiac, hypertension and congestive heart failure (CHF) was the commonest (n=19/49, 38.8% each) followed by CAD/CSA/IWMI/IHD/AF. Others were metabolic (n=14/88, 15.9%), GERD (n=13/88, 14.8%), Depression (n=11/88, 12.5%). Less prevalent co-morbidities were Osteoporosis (n=8/88, 9.1%), Lung cancer (n=6/88, 6.8%), Bronchiectasis (n=5/88, 5.6%) and OSA (n=3/88, 3.4%).Conclusions: Urban indwelling, advancing age and duration of illness, presentation with low mood, loss of pleasure/ interest, appetite disturbances and heart burn with relief on taking proton pump inhibitor can be predictors of co-morbidities in COPD patients. Chance of finding co-morbidities may be multifactorial. Thus, it is important to look out for co morbidities in each and every COPD patients.
Perception of medical students regarding breast feeding at Al Tibri Medical College and Hospital: a comparative study
Authors: Seema Nighat , Saboohi Erum , Kazi Umer , Hadi Abdul , Khan Hina , Channa Yasmeen , Tariq Anas
Published: October 2019

Background: Breast milk is an ideal feed for infants, and it is effective in ensuring child health and survival. The study was done to assess the perception regarding breastfeeding among medical students of basic and clinical sciences and to compare knowledge regarding feeding among basic sciences with clinical sciences students.Methods: This cross-sectional survey was done at Al-Tibri Medical College and Hospital over a period of 6 months from February 2019 till July 2109. A self-generated Questionnaire was used to assess the perception of 367 medical students regarding breast feeding from basic and clinical sciences of medical students. Result was statistically analyzed using SPSS version 22. Chi-square test was used to compare qualitative data, p-value <0.05 was considered significant.Results: A total of 367 students participated in the study with 159(43.3%) from basic medical sciences and 208(56.7%) from clinical sciences. Out of respondents, 54.5% were females. Internet was the main source of knowledge (47.3%) as shown in the graph, 74.1% were native. Generally, the majority of students from clinical group had a better perception regarding breastfeeding initiation and continuation along with infant and maternal benefit. Clinical science group had an edge on the basic science group with reference to their perception of breastfeeding in special circumstances.Conclusions: Medical universities are the main platform for future physicians, so knowledge regarding breast feeding promotion and practices should be given from this stage.
A prospective study of clinical manifestations of snake bite in government general hospital
Authors: Reddy Yadavendra C.
Published: October 2019

Background: Snake bite is an occupational and rural hazard because India has always been a land of exotic snakes. Although full burden of human suffering attributable to snake bite remains obscure, hundreds of thousands of people are known to be envenomed and tens of thousands are killed or maimed by snakes every year. This study is aimed at studying the clinical manifestations in snake bite at government general hospital.Methods: This Prospective Observational study was done from March 2019 to August 2019 in Government General Hospital Nalgonda. A total of 60 cases male and female admitted with snake bite were studied based on inclusion and exclusion criteria. All patients were done routine investigations, ECG was done to rule out cardiac anomalies. Patients below 12 years, pregnant women and patients with previous heart ailments were excluded from the study. The study was carried out in all patients fulfilling the inclusion and exclusion criteria.Results: A total of 60 patients 35 females and 25 males presented during the study period. Most of the patients presented with pain at the site 40(66%), Nausea 30(50%), Swelling 25(42%), Paraesthesia 25(42%), Bleeding 15(25%), Ptosis 15(25%), Sweating 10(17%), Cellulitis 10(17%) and dyspnoea 5(9%). Among the ECG manifestations- Tachycardia- 30(50%), Ischaemia 5(9%), Sinus arrythmia 2(4%), Myocardial Infarction-0.Conclusions: It was Observed from the study that the pt. had more of Haemolytic presentation than neuroparalytic presentation. Pain at the site was the most common presentation followed by nausea. Some patients developed neuroparalytic symptoms like cellulitis, and paraesthesia. Further it was observed that timely shifting to the Hospital and administration of Anti-Snake venom prevented major manifestations in the patients.
Role of cartridge-based nucleic acid amplification test to diagnose tuberculosis at tertiary care teaching hospital in Rajasthan, India
Authors: Mathur Rajendra Babu , Shukla Uma Shankar , Bindal Hemant Kumar
Published: October 2019

Background: Tuberculosis is one of the top 10 causes of death worldwide as per the Global TB report 2017, the estimated incidence of TB in India was approximately 28,00,000 cases accounting for about a quarter of the world’s TB cases (10 million). It is of utmost important to diagnose early and treat it to reduce disease transmission. GeneXpert MTB/RIF, an automated cartridge-based molecular technique detects Mycobacterium Tuberculosis and rifampicin resistance within two hours, has been recommended by WHO for rapid diagnosis of TB.Methods: Author conducted a retrospective study in the Department of TB and Chest, of tertiary care center at Jhalawar Medical College (JMC), Jhalawar to evaluate and analyze the role of CBNAAT to diagnose tuberculosis from 1st January 2018 to 31st December 2018. Author included all patients who came to department of TB and Chest of JMC, Jhalawar either new/ relapsed/ defaulters/ referred cases from ART/ ICTC center, Pediatric Department; Gynaecology and Obstetrics Department, peripheral Government Health Care Facilities and Private Hospitals of Jhalawar District catering about 15.5 lac population were subjected to both ZN staining/ Fluorescent microscopy and CBNAAT in the study period.Results: A total of 3078 samples (pulmonary 2739+EP 339) were tested for ZN staining / Fluorescent microscopy and CBNAAT during the study period. Mean age of the study population was 36.5±10.3 years. 1873 tested were negative and 1205 samples were positive for CBNAAT. Of these 1205 positive samples, 1174 were sputum/ BAL samples and 31 were extra pulmonary samples. Authors found rifampicin resistance rate of 6.98% (82/1174) in pulmonary tuberculosis cases, 3 rifampicin resistance cases were detected in extra pulmonary samples. CBNAAT could identify 255 cases (14.01%) that were smear negative. Author found TB-HIV coinfection rate of 18.75%.Conclusions: Author found CBNAAT to be an important diagnostic modality especially in smear negative patients for early diagnosis and treatment. Author could detect Mycobacterium Tuberculosis in 14.01% of patients with negative smear microscopy for AFB. In PLHIV, CBNAAT detected Mycobacterium Tuberculosis in 18.75% (12/64) of patients. Author found rifampicin resistance rate of 6.98% (82/1174) in pulmonary tuberculosis cases.
A study of the complications among the patients undergoing retroperitoneal and transperitoneal laparoscopic nephrectomy for pyonephrosis
Authors: Patil Milind , Baria Manish , Parmar Ankita
Published: October 2019

Background: Nowadays laparoscopy have gained wider acceptance in urology that leads to more reports on the potential complications. This study was conducted to evaluate the complications among the patients undergoing retroperitoneal and transperitoneal laparoscopic nephrectomy.Methods: Analysis was done retrospectively through review of a maintained database of 219 consecutive laparoscopic simple nephrectomies done for pyonephrosis from July 2001 to February 2013 at the department of urology Civil Hospital and B J Medical College Ahmedabad.Results: Total 219 simple nephrectomies performed between July 2001 to February 2013 for pyonephrosis. In 165 (75.3%) of patient’s procedure was through trans peritoneal route while retroperitoneal access was used in 54(24.6%) patients. In our study there were major complications in 12 patients with laparoscopic transperitoneal group and in 4 patients in laparoscopic retro peritoneal group. The minor complication rate in present study was 13.3% (22/165) in laparoscopic transperitoneal group and 11.1% (6/54) in laparoscopic retroperitoneal group.Conclusions: There were major complications in patients with laparoscopic transperitoneal group and in few patients in laparoscopic retro peritoneal group. In most other series it was seen that retroperitoneoscopic surgery may be associated with more complications, the findings are unfounded. Minor complications can be managed easily if there is low threshold for conversion to open surgery.
Comparison of standard short infusion versus prolonged infusion of Doxorubicin in relation to its cardiotoxicity in South Indian population
Authors: Jacob Roshan Koshy , Karpurmath Shashidhar V. , Nandennavar Manjunath , Angadi Veerendra
Published: October 2019

Background: Anthracycline is one of the commonly used chemotherapeutic agents in the treatment of malignancies and their efficacy is undermined by potential life-threatening cardiotoxicity.  The aim of this study is to compare the cardiotoxicity in patients receiving standard short infusion (15-30 minutes) versus prolonged infusion (6 hours) of doxorubicin in the study group.Methods: In this study 80 patients who were planned for treatment with Doxorubicin >200 mg/m2 were included in this study and they were randomly allotted to either of the treatment group. Each patient was assessed clinically (History, Pulse rate, Blood pressure) along with ECG ,ECHO prior to initiation of chemotherapy, after completion of 200 mg/m2 of Doxorubicin, 3 months and 6 months after chemotherapy.Results: There were 40 patients in each group, and they received a total of 384 cycles of Doxorubicin containing regimens according to respective protocols. The median number of cycles was four (range four to six cycles). The mean cumulative dose of doxorubicin was 271.5 mg/m2 in the group which received standard short infusion and 264 mg/m2 in the group which received the drug by prolonged infusion. However, none of the patients developed any cardiac symptoms during or after the planned chemotherapy nor was there a drop in ejection fraction on serial ECHO.Conclusions: There was no benefit of prolonged infusion of doxorubicin as compared to the standard rapid infusion in terms of doxorubicin induced cardiotoxicity. At present, standard rapid infusion is the best option.
Postoperative morbidity following Whipple’s procedure for periampullary carcinoma: a retrospective study spanning 5 years
Authors: V. Sharath Kumar , J. S. Ajith Prasad
Published: October 2019

Background: The morbidity rates for Whipple’s procedure has remained high even as mortality rates were coming down. This study was intended to assess postoperative morbidity rates in  a tertiary care centre and to compare it with other centres.Methods: Data was collected from various registers and medical records for this retrospective cohort study. All Whipple’s procedures for 5 years were included in the study. Statistical analysis was done using R statistical software and the results were tabulated.Results: There were 48 patients and half of them developed morbidity. Surgical site infection was the most common complication (18.8%) followed by pulmonary complications (12.5%) and bile leak (6.25%). Half of the patients having pulmonary complications died while nobody with surgical site infection or bile leak died.Conclusions: In this study the morbidity rates were comparable to other centres. Hypoalbuminemia is a significant predictor of morbidity. Surgical site infection was the most common morbidity. Pulmonary complications were the most common cause for death. Morbidity rate is comparable to other centres and Whipple’s procedure is a safe surgery in the tertiary centre where the study was conducted.
A comparative analysis of total haemoglobin level and red blood cells count in ABO blood groups of healthy adults
Authors: Mahapatra Bibhupada , Chinara Aurobinda , Purohit Prasanta
Published: October 2019

Background: The haemoglobin content and red blood cells counts in four different ABO blood groups in healthy adults remain conflicting with different results. The present study was undertaken to analyse the possible differences in the haemoglobin content and red blood cell counts in health adults in four ABO blood groups.Methods: This prospective study was undertaken in a tertiary health care facility. A total of 227 healthy students were finally included in this study for analysis. The study subjects were belonging to 18-22 years old of both genders. The haemoglobin content was measured by Sahli’s method and ABO blood group typing along with Rh D typing was carried out in all the students. The statistical analyses were carried out by using Graph-Pad Instat.Results: The mean age of the students was 19.91 years with 59.9% being males. Both haemoglobin level and red blood cells counts were significantly high in males compared to females. Blood groups A, B, AB and O was reported in 41(18.06%), 63(27.75%), 15(6.60%) and 108(47.58%) healthy students respectively.conclusion: There was no significant difference was observed in the mean haemoglobin level and red blood cells counts among the four ABO blood groups.
Measurements of the normal size of spleen and spleen to left kidney ratio among sudanese children up to five years age using ultrasonography
Authors: Suliman Awadia G. , Adam Mohammed A. , Ahmed Rihab Y. , Aburaida Raga A. , Ebrahim Ahmed A.
Published: October 2019

Background: Knowledge of the normal range of spleen size in the population being examined is very important because there are many different pathological conditions that may alter in spleen size. Also, gender, height, weight and BMI of individual, affect the splenic length and could result in incorrect interpretation of splenic measurements, spleen to left kidney ratio is one of recent parameter mention in literature aid in diagnosis of splenomegaly in children.Methods: The study was a cross-sectional study conducted in Khartoum state at Al-Buluk and Gaafar Ibnauf Paediatric Tertiary Hospital during the period from March 2018 to August 2018. A total of 101 children (males and females) with aged ranged 1 month to 5 years included in study. A transabdominal scan was performed, and measurement of spleen and left kidney taken after an ethical verbal consent from their parents, then data analyzed by SPSS, Mean±SD. Deviation for study variables calculated then correlation between patients factors and ultrasound measurements done.Results: The study found that the mean measurements of the normal size of the spleen and spleen to left kidney ratio for children up to five years of age, Splenic length was 7.24±1.12 cm, width was 3.83±0.81 cm , thickness 2.91±0.55 cm and spleen to left kidney ratio was 1.04±0.0.70 ranged (0.86-1.23). The male have larger spleen than female with no statistically significant differences in spleen sizes between the sexes. There was a strong significant correlation between age, weight, height  spleen and left kidney length (p<0.01)respectively and a moderate association with BMI (p<0.05).Conclusions: Spleen and left kidneys was growing rapidly and similarly in infant up to one year of life 1 mm\1 mm for each month and then decreasing growth rate of kidney in relate to spleen for 1 mm growth of spleen kidney grow 0.8 mm in up to five years of age. There was strong significant positive correlation between spleen and left kidney measurement with age, height, weight of individual. The spleen to left kidney ratio for children up to five years ranged (0.86-1.23) with mean 1.04, so if the ratio less or more than this ranged it should be considered in clinical context for diagnosis of splenomegaly or shrunken spleen in children up to five years of age.
A chronic case of Madurella mycetoma involving left foot
Authors: Alim Alfia , Pati Binod K. , Sarfraz Asim , Das Sushmita
Published: October 2019

Mycetoma is a localized chronic, suppurative, and deforming granulomatous disorder of subcutaneous tissue, skin and bones. Mycetoma is endemic in tropical and subtropical areas, where it is a real public health issue. It is a rare and neglected disease in our country. Etiological classification divides it into eumycetoma caused by fungus, and actinomycetoma caused by bacteria. Since the treatment of these two etiologies is completely different, a definite diagnosis after microbiological and histopathological examination, though difficult, is important. The disease is notoriously difficult to treat. Eumycetoma may be unresponsive to standard antifungal therapy. Authors report a case of eumycetoma in a 38 year-old male from Bihar, with history of thorn prick 30 yrs back. Madurella mycetomatis was isolated from the granular discharge from sinuses and itraconazole was given followed by surgical debridement of the lesion. The patient recovered well and is still on follow up.
Emergence of antibiotic resistance in bacteria isolated from tubotympanic type of chronic suppurative otitis media in Chhattisgarh
Authors: Singh B. R. , Pradhan Sagarika , Murthy R. , Agrawal Ekta , Barapatre Rekha , Kumari Neha , Pandey Arti
Published: October 2019

Background: Chronic suppurative otitis media (CSOM) is a common chronic ear disease and a major health problem in developing countries causing deafness and life threatening complications like meningitis and brain abscess. Early and effective treatment based on the knowledge of causative organism and their antibiotic sensitivity is essential for immediate clinical recovery.

Methods: Total of 152 clinically diagnosed patients with CSOM safe were enrolled in the study and two swab of the discharge ear were obtained from each patient under aseptic precaution. Microbiological study was done according to standard operative guidelines.  

Results: Out of 152 patients 93 male and 59 were female, majority of the patient seen below 30 year of age. Most common organism found was Staphylococcus aureus (43.2%) and Pseudomonas aeruginosa (27.9%). Staphylococcus aureus was sensitive to vancomycin (98%) and linezolide (100%) and Pseudomonas aeruginosa was found highly sensitive to Imipenem cilastin (84.85%) and Imipenem (66.7%).

Conclusions: In our study gram positive Staphylococcus aureus (43.2%) and gram negative bacilli P. aeuroginosa (27.9%) was the most common organism was found and this P. aeruginosa were hospital acquired infections. We found out high resistant to Cefepime, ceftazidime, ciprofloxacin and levofloxacin and aztreonam.
Unusual symptoms of Thornwaldt’s cyst: a case report
Authors: Kaur Rajwant , Kumar Pawan
Published: October 2019

Thornwaldt’s cyst also known as bursa pharyngeal embryonalis which is formed by traction of notochord at the retropharyngeal wall at the site of contact. It is present in the midline, at the junction between nasopharyngeal vault and posterior pharyngeal wall. The bursa can extend upward and backward above the limit of superior constrictor muscle fibres. This bursa when infected becomes seat of inflammation and cyst formation occurred. The well-known Thornwaldt’s cyst occurs as a result of obstruction of orifice of the bursa and is different from cyst of Rathke’s pouch. Thornwaldt’s cyst is usually asymptomatic but more than 1-2 cm may become symptomatic. Symptoms that commonly seen are halitosis, nasal discharge, nasal obstruction, epistaxis, prevertebral spasm, and rarely occipital headache and obstruction of Eustachian tube can occur. The diagnosis usually incidental as a part of a nasal endoscopic examination or radiological and endoscopic examination which is used to diagnose the cyst. On examination it appears as smooth mass with a central dimple. In this case report young female present with difficulty in swallowing, occipital headache, halitosis and fever. Initially she was managed conservatively when the cyst was resolved then it was marspupizied by transoral approach, with uneventful postoperative period. Other approaches for excision or marsupialization in symptomatic cases are endoscopic or transpalatal using powdered instrumentation.
La transformación post-socialista y la cultura popular: reflejo de la transición en series televisivas de Serbia
Authors: Trifunović Vesna , Diković Jovana
Published: October 2019

Nuestra intención en este estudio es examinar de qué modo el nuevo fenómeno social y la orientación de valores, que ha sido consecuencia el proceso de transición(desde 1989 hasta hoy), están reflejados en la producción televisiva de series (telenovelas) domésticas en la sociedad serbia. En cuanto a la particularidad de la transformaciónpost-socialista que se ha desarrollado en dos fases en la sociedad serbia, se han escogidodos series televisivas para este análisis: Srećni ljudi (La Gente Afortunada) y Mile protivtranzicije (Milo vs. la transición). La primera pertenece al período de la primera transición(1989-2000), mientras la segunda se puede situar en el contexto de la llamada segundatransición (2000 - actualidad). La primera serie describe el inicio de la transformaciónsocial y económica, es decir, el colapso de las empresas públicas y estatales, la señalizaciónde su privatización y la aparición de los empresarios privados. La segunda, por otra parte,realiza una parodia de la extensa aglomeración de determinadas relaciones políticas y sociales que han cambiado y de los valores que representan los indicadores de la transición(establecimiento de la democracia liberal, la corrección política, la multiplicación de lasONG, la integración en la UE). La razón principal por la que se han escogido estas seriesde TV para el análisis es el hecho de que describen diversos aspectos de diferentes fases delperíodo completo de la transformación post-socialista. Enfocándonos en esto, creemosque podemos analizar cómo se reflejan y se presentan las consecuencias dominantes dediferentes fases de la transición en uno de los medios de comunicación más importantesde la cultura popular actual.
Brand 2020. El futuro de las marcas
Authors: Pol Andrea
Published: October 2019

Para las grandes empresas y las marcas líderes actuales, el año 2020 ya es el futuro cercano, en términos estratégicos y tendenciales. En vistas del nuevo decenio, consideramos que el valor gerencial determinante, a la hora de “gestar y gestionar una marca” con eficiencia, no es de carácter meramente cognitivo sino actitudinal; el rol del brand manager ha sufrido un inédito desplazamiento, desde el tradicional gerente de marca, hacia una especie de brand trend hunter –o cazador de tendencias de marca– que monitorea el mercado de manera creativa y holística. Abordamos la construcción de un mapa de escenarios tendenciales para las marcas 2020, a partir de un encadenamiento de fenómenos significativos y características  reveladoras de nuestro futuro cercano, en materia de branding.Para las grandes empresas y las marcas líderes actuales, el año 2020 ya es el futuro cercano, en términos estratégicos y tendenciales. En vistas del nuevo decenio, consideramos que el valor gerencial determinante, a la hora de “gestar y gestionar una marca” con eficiencia, no es de carácter meramente cognitivo sino actitudinal; el rol del brand manager ha sufrido un inédito desplazamiento, desde el tradicional gerente de marca, hacia una especie de brand trend hunter –o cazador de tendencias de marca– que monitorea el mercado de manera creativa y holística.Abordamos la construcción de un mapa de escenarios tendenciales para las marcas 2020, a partir de un encadenamiento de fenómenos significativos y características reveladoras de nuestro futuro cercano, en materia de branding.
La puesta en escena. Arte y representación
Authors: Stefanini Valeria
Published: October 2019

El problema de la representación y la relación de la fotografía con el objetofotografiado es material de estudio y reflexión de teóricos y artistas desde los orígenes dela fotografía como disciplina. Hoy el debate sigue siendo interesante. Para pensar en esteproblema hemos elegido un corpus de obras fotográficas que aborda la representación y lapuesta en escena de obras plásticas significativas de la historia del arte. Trabajaremos obrasde Julia Margaret Cameron, Cindy Sherman, Orlan y Nicola Costantino para graficar estaoperación de apropiación de formas, estilos y modelos.
Upstream / Downstream
Authors: Kirkbride Robert
Published: October 2019

En mi artículo para el Cuaderno 48, Velos y veladuras, exploramos las relacionesentre decoración e identidad, su relación con la condición humana de “poner unpie afuera” y “encajar”, y la capacidad del ornamento de transmitir historias a través deltiempo y alimentar la imaginación. Abundante o escaso, el ornamento permite a la menteinterpretar la narrativa, cultural y personal, y la lectura atenta de nuestros entornos ayudaa sintonizar las nuevas obras construidas con las preocupaciones contemporáneas yfuturas. Para este artículo, focalizo en un argumento secundario introducido en Velos yveladuras, donde explico que: “mientras que las mejoras sostenibles a menudo se centranen productos intermedios derivados de la producción, las lecturas cercanas se pueden realizaren sentido ascendente en la secuencia de fabricación, mejorando el bienestar de losfabricantes y la poética de un producto” (Kirkbride, 2013, p. 185). Este trabajo consideravarias escalas y modos de actividades previas, a partir de la tectónica de las cuencas hidrográficasy la gestión del sitio, a la conciencia de la historia y de la posición propia de unoen ella, y la reconceptualización de un producto por los flujos de su cadena de suministroy el ciclo de vida. Voy a recorrer los orígenes de esta idea –un paseo río arriba a través deuna cuenca con problemas durante una lluvia torrencial– y sigo sus influencias en variaslecciones prácticas y ejercicios basados en proyectos desarrollados en Parsons The NewSchool for Design.