bluuebunny/crossref_metadata_2025 huggingface dataset:
Diaphragmatic Hernia in an isolated severe head injury patient: An accidental finding
Authors:   Assistant Professor (Trauma), Singh Yashpal ,   Department of Anaesthesia, IMS, BHU, Varanasi-221005, India, Yadav Ghanshyam ,   Assistant Professor (Trauma); Department of Anaesthesia, IMS, BHU, Varanasi-221005, India, Kumar Rahul ,   Assistant Professor (Trauma); Department of Anaesthesia, IMS, BHU, Varanasi-221005, India, Jain Gaurav ,   Assistant Professor (Trauma); Department of Anaesthesia, IMS, BHU, Varanasi-221005, India
Published: March 2022

Blunt traumatic rupture of diaphragm is uncommon in an isolated severe head injury patient and usually seen in polytrauma patients. Due to poor neurological status, diagnosis is often difficult and leads to increase in morbidity and mortality. We report a case of diaphragmatic hernia in a 25 year old male having isolated severe head injury sustained in a road traffic accident, diagnosed two days later on routine chest X-ray. Ryle’s tube shadow in left lower lung field that give raise to suspicion of diaphragmatic hernia and CT scan confirms the diagnosis. A high index of suspicion is required for early diagnosis and minimizes the morbidity and mortality associated with it.
Pattern Visual Evoked Potential in Non Diabetic offspring‘s of Type II Diabetes
Authors:   Associate Professor and HOD Department of NeuroPhysiology, Government Villupuram Medical College, Villupuram, Tamilnadu-605602, India, Achuthan Anitha , Ramesh Janani ,   Assistant Professor; Department of NeuroPhysiology, Government Villupuram Medical College, Villupuram, Tamilnadu-605602, India
Published: March 2022

Metabolic abnormalities in diabetes mellitus involves ganglionic and preganglionic elements in the entire retina and macular region causing visual disturbances. Subclinical central nervous system (CNS) dysfunctions have been reliably detected by visual evoked potentials in patients with uncomplicated diabetes and normal brain Computed tomography (CT) scan. The offspring of diabetic parents have a higher risk of diabetes and a possibility of diabetic retinopathy. The study aims at evaluating visual evoked potential in asymptomatic, non-diabetic offspring of diabetic parents. A total of 150 individuals in each group (case and controls) were enrolled after Written and informed consent. Institutional ethical Committee approval was obtained. Visual evoked potential (VEP) recordings were done using the standard procedure given in Recommended Standards for VEP, Guidelines 9B. The statistical analysis revealed significant difference in controls and offspring of diabetic parents in terms of P100 latency in both left and right eye (P<0.05). The offspring of diabetic parents may be screened with VEP, as, prolongation of P100 latency a direct sign of retinal damage and demyelination could add the risk to the fact that they may be in a pre-diabetic stage without clinical manifestation, but there may be subclinical optic pathway involvement which mandates active intervention to reduce the co-morbidly associated with diabetes.
Correction of preoperative anemia in women with menorrhagia: IV iron sucrose versus oral iron
Authors:   Associate Professor Department of Obstetrics and Gynecology, Surat Municipal Institute of Medical Education and Research (SMIMER), Surat, Gujarat-395010, India, Shah Jitesh M. , Mehta Meghana N. ,   Assistant Professor Department of Obstetrics and Gynecology, Surat Municipal Institute of Medical Education and Research (SMIMER), Surat, Gujarat-395010, India, Kongnathi Satyanarayan A. ,   Assistant Professor Department of Obstetrics and Gynecology, Surat Municipal Institute of Medical Education and Research (SMIMER), Surat, Gujarat-395010, India, Vachhani Ashvin D. ,   Associate Professor; Department of Obstetrics and Gynecology, Surat Municipal Institute of Medical Education and Research (SMIMER), Surat, Gujarat-395010, India
Published: March 2022

Objective: To compare the safety and efficacy of iron sucrose over oral iron for the correction of preoperative anemia in women with menorrhagia. Methods: Women with menorrhagia having Hemoglobin (Hb) level less than 10 gm/dl and features of iron deficiency were included in the study. Women matching the inclusion and exclusion criteria, allocated to group A (IV iron sucrose) or group B (oral iron). IV iron sucrose was administered as 100 mg (2 ampoules) in 100 ml normal saline by slow IV infusion. The women in the group B received ferrous sulphate as oral iron in the dose of one tablet (200 mg salt) three times a day. Repeat laboratory estimations were done after four weeks. Results were analyzed by paired t test using SPSS 15 and Microsoft excel. Results: Before treatment, mean Hemoglobin level (mean ± SD) was similar in both groups (7.18 ± 1.18 gm/dl in group A and 7.18 ± 1.02 gm/dl in group B). After treatment, rise of Hb level was more in group A (10.70 ± 0.73 gm/dl) than group B (9.64 ± 0.70 gm/dl). After treatment, the desired Hb level of 10 gm/dl or more were achieved in 96% of women in group A while only in 56% of women in group B. Conclusion: Preoperative intravenous iron sucrose administration is more effective than oral iron and is as safe as oral iron therapy in the correction of preoperative anemia due to menorrhagia.
A study of circulating sialic acid levels in pregnancy
Authors:   Ex Professor & Head, Department of Biochemistry, B.J Medical College & Civil Hospital, Ahmedabad, Gujarat380016, India, Chhabra R J , Singh Shweta ,   Associate Professor, Department of Biochemistry, SIMS, Hapur, Ghaziabad, UP-245304, India, Mangukiya Ketan ,   Assistant professor, Department of Biochemistry, Parul Institute of Medical Science and Research(PIMSR), Vadodara, Gujarat-391760, India, Gorasiya Jignesh ,   Assistant Professor, Department of Biochemistry, PDU Govt Medical College and Civil Hospital, Rajkot, Gujarat360007, India
Published: March 2022

Background: The sialic acid level is significantly higher in full term cord firbrinogen than in controls and higher in premature than term samples and degree of hypersialation of fetal fibrinogen is a function of gestational age,prenatal diagnosis and confirmation of infantile sialic acid storage disease have been carried out by amniocentesis. Aims & Objectives: To correlate the physiological stress occurring during different trimesters of pregnancy with circulating level of serum sialic acid. Methodology: In this study 30 blood samples were collected from healthy pregnant women in each trimester of pregnancy of age group between 18-35 years along with age and sex matched non pregnant control group. The blood samples was collected from all participants and analyzed for Serum sialic acid ,total protein, albumin and Blood sugar. Results: The mean concentration of serum sialic acid (Micmol/dl) in non pregnant control was estimated to be 119.1±4.68 as compared to 138.8± 4.57,155.76± 5.1, 171.18± 6.7 in first, second and third trimester of pregnancy respectively. Conclusion: The level of total sialic acid is found to be elevated as the pregnancy advances. This increase in maternal circulating serum TSA levels can be attributed to the immunological and metabolic adjustments that the pregnant women undergoes to bring about successful pregnancy.
Psychological stress among un-organized building construction workers in Gandhinagar, Gujarat, India
Authors:   Third MBBS (part-1) Student, Bhatt Riddhi R. ,   GMERS Medical College, Gandhinagar, Gujarat-382012, India, Desai Gaurav J. ,   Assistant Professor Department of Community Medicine, GMERS Medical College, Gandhinagar, Gujarat-382012, India, Verma Pramod B. ,   Professor & Head; Department of Community Medicine, GMERS Medical College, Gandhinagar, Gujarat-382012, India
Published: March 2022

Background: Workers who are stressed are more likely to be unhealthy, poorly motivated, less productive and less safe at work. Job stress is believed to be one of the causes of absenteeism, low workers morale, high rate of accident and poor turnover rates. Aims and Objectives: To study the socio-demographic aspect of unorganized workers and Psychological stress among them. Study Design: Cross-sectional. Study Setting: Construction sites in Gandhinagar, Gujarat. Materials and Methods: For data collection researchers were used instrument “The Stress Inventory Scale designed and developed by Gerard Hargreaves from the stress Management: The Essential Guide to Thinking and Working Smarter” for the measures of results in the present study., Statistics: For continuous variables range, mean and standard deviation will be calculated and for categorical variables proportion and percentage will be obtained. To know the association between dependent and independent variable chi-square or z-test will be applied accordingly. Results: Almost 85% participants have high stress and 2% participants have extreme high stress unmarried participants had more significant high stress [48/82, 58.5%, X2 = 5.81, p <0.05] than married participants. Study did not found significant association of stress level with age, sex and literacy level. Conclusion: Study found that most of construction worker were suffering from stress. Insomnia, headache and sleeping problems were the result of stress. stress can be reduce by applying the concept of level of prevention through ergonomics, work design, organizational development, workers training & counseling, pre-placement & periodic examination, enhanced occupational health services.
A case study of assessment of CA-125 levels in the rural population of Kanpur
Authors:   Assistant Professor, Anand Pallavi ,   Department of Biochemistry, Rama Medical College, Hospital & Research Centre, Kanpur209217, India, Choudhury Ipsita ,   Assistant Professor; Department of Biochemistry, Rama Medical College, Hospital & Research Centre, Kanpur209217, India
Published: March 2022

The aim of this study was to assess the incidence of ovarian cancer in the industrial hub of Uttar Pradesh. A total of 50 samples were collected and estimated for CA-125 by Sandwich Method. CA-125 [Cancer antigen 125 or carbohydrate antigen 125 or Mucin 16] is a high molecular mass glycoprotein recognized by the monoclonal antibody OC 125 and encoded by MUC 16 gene. It contains 24% carbohydrate and it is expressed by epithelial ovarian tumours. CA-125 is the most frequently used biomarker for ovarian cancer detection. The study was done to create awareness among the female industrial workers of the rural population of Kanpur.
Comparison of epidural Butorphenol-ropivacaineand Fentanyl-ropivacaine for labour analgesia-Randomized Double Blind Study
Authors:   Assistant Professor, Prakash Shashi ,   Department of Anaesthesia, Institute of Medical Sciences, BHU, Varanasi-221005, India, Meena Rajesh ,   Assistant Professor; Department of Anaesthesia, Institute of Medical Sciences, BHU, Varanasi-221005, India, Singh Yashpal ,   Assistant Professor; Department of Anaesthesia, Institute of Medical Sciences, BHU, Varanasi-221005, India, Loha Sandeep ,   Assistant Professor; Department of Anaesthesia, Institute of Medical Sciences, BHU, Varanasi-221005, India, Ranjan Pratibha ,   Junior Resident; Department of Anaesthesia, Institute of Medical Sciences, BHU, Varanasi-221005, India, Singh Kalpana ,   Senior Resident; Department of Obstetrics and Gynaecology, Institute of Medical Sciences, BHU, Varanasi-221005, India
Published: March 2022

Background: Advancement in labour analgesia includes newer local anaesthetics with more selective sensory blockade which permit ambulation of parturient, various technological improvement and newer adjutant which facilitate reduced requirement of local anaesthetics and hence side effect. Objective: The objective of this study was to evaluate the efficacy butorphenol 0.5mg and fentanyl 25 mcg mixed with 0.1% ropivacaine for epidural labour analgesia. Material and Method: After Institutional Ethical approval and written informed consent, 60 full term parturient with spontaneous onset of labour randomly assigned to two equal groups of 30 each, to receive an epidural injection of 12 ml ropivacaine 0.1% with butorphenol 0.5ml (500 mcg) in group B1 and 12 ml of ropivacaine 0.1% with fentanyl 0.5ml (25 mcg) in group L2 as initial bolus dose. Further Top-up of 0.1% ropivacaine was given on patients demand. Duration of analgesia, sedation, hemodynamic parameters, oxygen saturation, Respiratory rate, foetal Apgar score and maternal side effect were compared. Results were analysed by oneway analysis of variance test, Fisher’s exact test or Chi Square test, whichever appropriate. Result: Demographic data and obstetrical characteristics were comparable between two groups. After initial epidural bolus, duration of analgesia was significantly more in group B (90.70±41.21) than in group R (62.80±34.12) (p<0.001). Hemodynamic parameters, VAS Score and side effects were comparable between two groups. Neonatal outcome (Apgar score) was also comparable between two groups. Conclusion: Epidural ropivacaine 0.1% with butorphenol or fentanyl results in satisfactory labour analgesia without any increase in side effects. Duration of analgesia was more in butorphenol group.
Is dengue virus neurotropic?
Authors:   Formerly Associate Professor, Department of Medicine, Army College of Medical Sciences, Delhi Cantt-110010, India, Khati Chitralekha S
Published: March 2022

Dengue viral infection is on the rise in tropical urban and semi-urban parts of the world. WHO fact sheet- N°117 updated in May 2015 estimates 390 million dengue infections per year and that 3900 million people, in 128 countries, are at risk. The WHO case definition of severe dengue includes organ impairment, but does not describe neurological manifestations as a separate entity. Earliest reports on neurological manifestations came from Indonesia 35 to 40 years back. Abundant literature is available on diverse neurological manifestations in dengue from India and other parts of the world. Encephalopathy, aseptic meningitis, papilledema, stroke, intracranial and sub- arachnoid haemorrhage (ICH/ SAH), Acute Disseminated Encephalomyelitis (ADEM), opsoclonus- myoclonus syndrome, myelitis cranial nerve palsies, polyneuropathies, Guillain-Barre syndrome (GBS), polymyositis, and hypokalemic paralysis are all reported. Long-term sequelae recorded are Parkinsonism, dystonias, cognitive changes, behavioural disorders, depression, amnesia, dementia and psychosis. The neurological manifestations in dengue can be grouped into 3 categories – (I) those related to the neuro-myotropic effects of the virus (II) those related to the systemic complications of dengue infection like vascular leakage, hemoconcentration, haemorrhage and dyselectrolytemia; and (III) Post- infectious manifestations like ADEM, encephalomyelitis, myelitis, optic neuritis, GBS and mono and polyneuropathies. Dengue virus belongs to the flaviviridae family, several members of which have proven neurotropism and propensity for the sub- cortical nucleii. CNS invasion, either through neurotropism or vascular leakage is supported by inconsistent evidence including animal experiments. Presence of virus and IgM- dengue in the CSF of some encephalopathy cases suggests capability, but not invariability of CNS invasion. Glycosylation of the envelope protein, increased inflammatory cytokines disrupting the blood brain barrier (BBB) allowing free virus access to the CNS and non-specific cellular virus attachment factors are all implicated. Some authors recommend a high index of suspicion for dengue in CNS infections occurring in endemic countries. Three tetravalent live-attenuated vaccines are under development in phase II and phase III clinical trials, and 3 other vaccine candidates (based on subunit, DNA and purified inactivated virus platforms) are at earlier stages of clinical development. Their immunogenicity may be implicated in neurological manifestations in the future.
Total spinal blockade after Interscalene brachial plexus block- A rare but possible complication
Authors:   Assistant Professor, Department of Anesthesiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi. 221005, India, Loha S , Jena BR ,   Senior Resident, Professor, Department of Anesthesiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi. 221005, India, Singh AK ,   Senior Resident, Professor, Department of Anesthesiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi. 221005, India, Yadav G ,   Associate Professor, Department of Anesthesiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi. 221005, India
Published: March 2022

Interscalene block is a commonly done regional anesthesiatechnique for shoulder and upper arm surgery. It has been used regularly as it is simple and achieves good and satisfactory block, but still it is not completely devoid of complications. In our case we have given interscalene block to a 45 year old male patient of ASA grade-I. Immediately after injecting the local anesthetic drug the patient became unconscious and unresponsive due to total spinal blockade. The patient was resuscitated and shifted to ICU where the he regained his consciousness after few hours and shifted to the ward without any neurological deficit.
Prospective study of hypovitaminosis D in acute coronary syndrome
Authors:   Professor, Bamanikar AA ,   Department of Medicine, Dr. D Y Patil Medical College, Pune-411018, India, Vaishnav B. ,   Associate Professor; Department of Medicine, Dr. D Y Patil Medical College, Pune-411018, India, Dhobale SV ,   Lecturer; Department of Medicine, Dr. D Y Patil Medical College, Pune-411018, India, Rathore VS ,   Resident; Department of Medicine, Dr. D Y Patil Medical College, Pune-411018, India, Bamanikar SA ,   Professor; Department of Medicine, Dr. D Y Patil Medical College, Pune-411018, India
Published: March 2022

Background: Hypovitaminosis D has emerged as one of risk factors in coronary atherosclerosis either independently or in association with other factors though the causal relationship is not established. Aims: We aimed at finding out the prevalence of vitamin D deficiency in patients with acute coronary syndrome and to study if any association exists between them. Methods: This was a prospective study carried out on 50 hospitalized patients from urban habitations with acute coronary syndrome at Dr. D Y Patil Medical College, hospital Pune (India) during Oct 2012 to Sept 2013. The vitamin D status and other risk factors were studied in these cases and compared with normal control group having 50 subjects without any co-morbidity. Results: 58 % males showed hypovitaminosis D. Vitamin D levels were significantly low (OR3. [8;0.97-15.21];95%CI) in cases with hypertension (65.79%) and 60.53% cases with diabetes mellitus (OR4.6[1.02-19.8] 95%CI). BMI more (Mean 26.9 ± SD 4.95) in cases with low vitamin D levels; but weakly significant (p=0.061). Postprandial hyperglycemia and hypercholesterolemia were inversely associated with vitamin D levels. Acute coronary syndrome had weakly significant association (p=0.091) with hypovitaminosis D in our patients. Conclusion: Vitamin D deficiency was weakly associated with acute coronary syndrome.
Accuracy of serology IGM anti CMV and clinical manifestations as an alternative diagnostic of cytomegalovirus neonatal hepatitis
Authors:   Department of Paediatrics, Faculty of Medicine, Airlangga University, Surabaya, Indonesia, Setyoboedi Bagus , Angelika Dina ,   Department of Paediatrics, Faculty of Medicine, Airlangga University, Surabaya, Indonesia, Arief Sjamsul ,   Department of Paediatrics, Faculty of Medicine, Airlangga University, Surabaya, Indonesia
Published: March 2022

Background: Main problem in cytomegalovirus (CMV) neonatal hepatitis diagnostic approach in developing country is the lack of virology examination. Serology is the most affordable examinations. Methods: This cross-sectional study was done at Dr. Soetomo Hospital, December 2011-April 2012. Inclusion criteria were jaundice, hepatomegaly, elevated direct bilirubin >2 mg/dLif total bilirubin <5 mg/dLor >20% if total bilirubin >5 mg/dL, and elevated aminotransferases >1.5 normal within first 3 months. The immunocompromised patient was excluded. McNemar and Kappa analyzed statistics. Results: From 30 enrolled-patients, 12 subjects were positive PCR CMV. The AUC was 0.968 (95% confidence interval 0.915-1.020; p<0.0001). The cut-off of IgM anti-CMV with best sensitivity (sn) and specificity (sp) value was 0.8 (sn 100%, sp 83.3%), 1.0 (sn 91.7%, sp 88.9%), 1.1 (sn 83.3%, sp 88.9%), 1.2 (sn 83.3%, sp 88.9%), dan 1.3 (sn 83.3%, sp 94.4%). Conclusions: The anti-CMV IgM serology examination has a high accuracy in the diagnosis of CMV neonatal hepatitis in a patient with clinical signs of jaundice, hepatomegaly, the increasing of direct bilirubin, and an increase in aminotransferase enzyme, with a cut-off value of 1.3 index units. The anti-CMV IgM serology examination can be applied in lieu of PCR for alternative diagnosis of CMV neonatal hepatitis.
Recurrent and resistant duodenal ulcer revealing Thromboangiitis obliterans
Authors:   Associate Professor, Department of Internal Medicine, Military Hospital of Gabes, Gabes-6000, Tunisia, Bouomrani Salem , Belgacem Nessrine ,   Senior Resident, Department of Internal Medicine, Military Hospital of Gabes, Gabes-6000, Tunisia, Lassoued Najla ,   Senior Resident, Department of Internal Medicine, Military Hospital of Gabes, Gabes-6000, Tunisia, Baïli Hassène ,   Senior Resident, Department of Internal Medicine, Military Hospital of Gabes, Gabes-6000, Tunisia, Beji Maher ,   Professor, Department of Internal Medicine, Military Hospital of Gabes, Gabes-6000, Tunisia
Published: March 2022

Thromboangiitis obliterans or Leo Burger’s disease is a rare systemic vasculitis in young and typically heavy smoker male, whose diagnosis is a real challenge for the clinician. Digestive manifestations are rare and unusual in this disease and the inaugural intestinal involvement is extremely found. We report an original case of relapsing and resistant duodenal ulcer revealing a Leo Buerger’s disease in a 42 year old man.
Diagnostic accuracy of fine needle aspiration cytology, triple test and tru-cut biopsy in the detection of breast lesion
Authors:   Assistant Professor, Dept of Pathology, Sikkim Manipal Institute of Medical Sciences, Gangtok, Sikkim, India, Laishram Sabina
Published: March 2022

INTRODUCTION Palpable breast masses require a thorough clinical breast examination, imaging, and tissue sampling for a definitive diagsnosis to rule out malignancy. Mammography screens in same or contralateral breast can also detect malignant lesions in older women.Ultrasonography is particularly valuable in detecting cystic masses, and may be used to guide biopsy techniques. Invasive procedures such as core-needle biopsy allow histologic diagnosis, hormone-receptor testing, and differentiation between in situ and invasive disease. Breast masses have a variety of etiologies, benign and malignant. Fibroadenoma is the most common benign breast mass while invasive ductal carcinoma is the most common malignancy. In this review, an attempt is made to examine the role of FNAC, triple test & Tru-cut biopsy in the detection of breast lesions.
Influence of glycemia on admission for the intensive critical care patient outcome
Authors:   Medical Intensive Care and Toxicology, Hopital Universitaire Joseph Ravoahangy Andrianavalona (HUJRA), Antananarivo, Madagascar, Rasoamampianina LE , Rafanomezantsoa TA ,   Medical Intensive Care and Toxicology, Hopital Universitaire Joseph Ravoahangy Andrianavalona (HUJRA), Antananarivo, Madagascar, Randriamanantany Z.A. ,   Medical Intensive Care and Toxicology, Hopital Universitaire Joseph Ravoahangy Andrianavalona (HUJRA), Antananarivo, Madagascar, Riel AM ,   Medical Intensive Care and Toxicology, Hopital Universitaire Joseph Ravoahangy Andrianavalona (HUJRA), Antananarivo, Madagascar
Published: March 2022

Introduction: The glycemic surveillance is important in intensive care unit in order to know the vital prognosis of each patient. Methods: We did a descriptive and analytical study during six months in the medical intensive care unit and toxicology at Joseph Ravoahangy Andrianavalona Academic Hospital. All admitted patients with high blood glucose level and the protocol done were concerned by this study. Objective: The aim of this study was to determine the outcomes for those patient with high blood glucose level during their stay in the unit. Results: Among 78 patients selected for this study: 22 (13%) of them died and 10 from those last received insulin therapy. The correlation between mortality rate and insulin use were non-significant. Conclusion: Hyperglycemia and insulin resistance are frequently seen while in intensive care unit and also associated with a high morbi-mortality rate.
Adult onset dermatomyositis associated with lipodystrophy and underlying calcinosis: Case report
Authors:   Associate Professor, Ministry of Health, Dubai, P.O. Box 65522, Unite Arab Emirates, Hannawi Suad , Salmi Issa Al ,   Associate Professor, Ministry of Health, Dubai, P.O. Box 65522, Unite Arab Emirates
Published: March 2022

Dermatomyositis is an idiopathic inflammatory myopathy, with skin manifestations. A less frequently recognized but clinically important complication of dermatomyositis is lipodystrophy (LD), and associated metabolic abnormalities that increasingly recognized as complications of juvenile dermatomyositis. Lipodystrophy is less frequently reported in adult onset dermatomyositis.In this paper we are presenting a case of adult onset dermatomyositis associated with lipodystrophy and underlying localized calcinosis; at the exact distribution of lipodystrophy.
Hypertensive encephalopathy as the initial manifestation of Cushing’s syndrome
Authors:   Department of Internal Medicine, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria, Iyagba Alagoma , Onwuchekwa Arthur ,   Department of Internal Medicine, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria
Published: March 2022

A 65-year old lady was rushed into the accident and emergency department with a two-day history sudden onset severe generalized throbbing headache associated with restlessness, irritability, irrational talk, projectile vomiting and loss of consciousness of three hours duration. On examination, she had moon face, buffalo hump, and truncal obesity with body mass index was 45.84kg/m2 . Her blood pressure was 190/120 mmHg. Serum cortisol done at 0800 hrs the next day was elevated with a value of 511 ng/ml. 1 mg overnight dexamethasone was 148 ng/ml. The diagnosis of hypertension secondary to Cushing’s syndrome should be strongly considered in any hypertensive obese patients regardless of age with typical ‘cushingoid facies’. An assessment of serum cortisol in such patients would be beneficial in diagnosing this condition and optimizing treatment outcomes.
Neuropsychiatric morbidity in HIV/ AIDS
Authors:   MD Psychiatry & Post-doctoral Fellowship in Addiction Medicine, Singtam District Hospital, Government of Sikkim, India, SatishRasaily  , Laishram Sabina ,   Assistant Professor, Department of Pathology, Sikkim Manipal Institute of Medical Sciences, Tadong, Sikkim, India
Published: March 2022

Human-immunodeficiency (HIV) virus is a neurotropic virus that enters the central nervous system by crossing blood brain barrier early in infection. HIV virus independently infects and destroys neuronal cells causing neuropsychiatric morbidity ranging from psychiatric illnesses to cognitive deficits. Several research studies have consistently reported higher prevalence of neuropsychiatric manifestations in patients with HIV/ AIDS. Further, there is an urgent need to sensitize health care providers regarding the relationship between HIV/ AIDS and neuropsychiatric morbidity to empower them to screen for psychiatric diseases.An early identification and treatment of psychiatric conditions in patients with HIV will help to improve compliance to anti-retroviral therapy, & coping with stress of living with HIV thereby improving quality of life. The review discusses prevalence of psychiatric morbidity in patients with HIV/ AIDS.
Stretching Exercise versus Local Corticosteroid Injection in Plantar Fasciitis: A Comparative Study
Authors: Gurung Sandeep , DC Gopal Sagar , Pant Biswas
Published: March 2022

Introduction: Plantar fasciitis is an inflammatory painful condition, one of the most common causes of heel pain. The cause of it is multifactorial; and different treatment modalities are available.
Aims:To compare the effectiveness between the stretching exercise and corticosteroid injection.
Methods:This study was conducted at Nepalgunj medical college, in the department of orthopedics from September 2019 to September 2020. Patients were equally divided into two groups. In Group A corticosteroid injection was given and in group B stretching exercise was advised. Patients were followed up at two weeks, 8weeks and 16weeks; pretreatment and post-treatment pain level was assessed by Visual Analog Scale (VAS) and Functional outcome was assessed by Foot and Ankle Ability Measure (FAAM) Scale.
Results: Both groups were comparable in relation to age and sex. There was significant decrease in pain and improvement of function in steroid group at two weeks and eight weeks follow up; whereas at 16weeks follow up plantar fascia stretching groups improved significantly.
Conclusion: For short term relief local corticosteroid injection is superior; but for long term relief in pain and improvement in function plantar fascia stretching exercise is better treatment option.
Perinatal Outcome in Term Pregnancy with Isolated Oligohydramnios: Retrospective Observational Study
Authors: Adhikari Ayushma , Gurung Tika Kumari , Adhikari Shree Prasad
Published: March 2022

Introduction: Isolated Oligohydramnios complicates 3 to 5% of pregnancy at term both in terms of fetal outcome and mode of delivery.

Aims: To study the perinatal outcome in isolated oligohydramnios (Amniotic Fluid Index≤8) and compare the outcome between Borderline (Amniotic Fluid Index=5.1-8 cm) and Severe (<5 cm) oligohydramnios.

Methods: Retrospective observational study of pregnancy outcome with isolated oligohydramnios (Amniotic Fluid Index≤8 cm) at term was carried out in Gandaki Medical College Teaching Hospital, Pokhara for one year from January 2019 to December 2019. Patients were divided into Borderline Oligohydramnios (Amniotic Fluid Index=5.1 to 8 cm) and Severe Oligohydramnios (Amniotic Fluid Index ≤5 cm). The two groups were compared in terms of fetal outcome like: meconium passage, low birth weight, low APGAR (Appearance, Pulse, Grimace, Activity and Respiration) score at 1 and 5 min, Neonatal Intensive Care Unit (NICU) admission and neonatal death. Similarly mode of delivery was also compared.

Results: There were total of 100 patients with isolated oligohydramnios. Of which 51(51%) were with Borderline Oligohydramnios and 49(49%) with Severe Oligohydramnios. The incidence of adverse perinatal outcome and caesarean delivery was high in patients with isolated oligohydramnios. When compared with the two groups there was significant difference in terms of meconium passage (11% vs 48.9%), low birth weight (5.8% vs 18%), low APGAR (Appearance, Pulse, Grimace, Activity and Respiration) score at 1 min (1.9% vs 14%), NICU (Neonatal Intensive Care Unit) admission (11% vs 67%) and Caesarean delivery (39% vs 79.5%).

Conclusion: Isolated oligohydramnios at term has been associated with an increased risk for caesarean delivery for fetal distress and adverse perinatal outcomes. Severe oligohydramnios is a sensitive predictor for the adverse perinatal outcome both in terms of fetal outcome and termination of pregnancy.
In vitro Evaluation of Tinidazole Bioadhesive Vaginal Gels
Authors: T.Salih Zainab
Published: March 2022

Many trials were made to prepare Tinidazole 2% as bioadhesive vaginal gels using different gel bases including hydroxypropyl methyl cellulose (3 and 4% w/w), methylcellulose (3 and 4%w/w) and    carboxymethylcellulose (2 and 3% w/w) .Swelling index of the polymers,pH , viscosity , bioadhesive force , and in-vitro drug release to the simulating vaginal fluid (S.V.F.) were investigated for all the prepared bioadhesive gels . The mechanism of drug release from the gel bases was also investigated.

The results revealed that C MC 3% gave the highest viscosity and bioadhesive strength with the lowest release rate while lowest viscosity and bioadhesive force was obtained with HPMC gel base with the highest release rate. The mechanism of drug release was affected by the type of gel base. Fickian diffusion was obtained with all gel bases.

Key words:  Tinidazole, bioadhesive polymers, gels
Urine Protein SDS-PAGE Reveals Different Profiles in Iraqi Children with Kala-azar
Authors: MK Al-Mulla Hummadi Yassir
Published: March 2022

Urine proteomics have been an area of interest and recently in Kala-azar as an alternative sample type for serum or plasma. Because of simplicity, noninvasiveness of collection and simpler matrix.  Many studies had detected an increased protein excretion in the urine of patients with active Kala-azar due to renal involvement particularly by an immunological related mechanism(s). This study have demonstrated the presence of three different protein profiles in Iraqi children (Patients: including 60 children aged 4-60 months) with defined Kala-azar using the conventional SDS-PAGE on urine samples. Urine protein profile in Kala-azar patients revealed three groups of banding patterns: group-1(33.4)% of the patients show the pattern of 5 bands with a MW. Ranged (512.861-158.489), groups-2, 3 were (55, 11.6) % of the patients showing 2 banding proteins with a MW. ranged (512.861-199.526) , (199.526-181.97) respectively. These findings may be correlated with other epidemiological studies that revealed the presence of different clinical presentations like fever, spleenomegally, hepatomegally, thrombocytopaenia, and different response to leishmania therapy. Furthermore, the presence of different protein patterns may also be related to the chronicity of infection and the degree of renal involvement.  The presence of a similar protein band between group-1 and 2 may be of diagnostic purpose and further studies on expanded number of patients are required to identify that kind of protein or other urine protein profiles. 

Key words: Protein band, protein pattern, sodium dodecyl sulphate-poly acrylamide gel electrophoresis (SDS-PAGE), urine proteome, visceral leishmaniasis.
Responding to the Evaluation Capacity Needs of the Early Childhood Field: Insights from a Mixed Methods Community-based Participatory Design
Authors: Gokiert Rebecca J. , Poth Cheryl N. , Kingsley Bethan , El Hassar Btissam , Mejia Teresa
Published: March 2022

Abstract: For this special issue, our article provides an illustrative example of data integration in a complex mixed methods design. It advances three mixed insights about the evaluation capacity needs of the early childhood field generated by using a mixed methods community-based participatory research (MMCBPR) design. We integrated quantitative findings from an evaluation capacity needs assessment tool with qualitative themes from community consultations. Findings highlight the pressing need for practices aimed at enhancing individual capacity through skills-based training, shifting organizational learning culture through resource investment, and cultivating interdependencies between organizational evaluation culture and individual evaluation capacity through engagement and collaborations.
Learning and Leading: Integrating Mixed Methods in a Collaborative Approach to Educational Evaluation
Authors: Searle Michelle , Drabenstott Matt , Kirkpatrick Lori , Smyth Rachael , Labonte Chantal
Published: March 2022

Abstract: This practice note describes the benefits of integrating mixed methods in a collaborative approach to evaluation with school districts and community partners in southwestern Ontario. We discuss the ways in which the integration of qualitative and quantitative data generated a multi-faceted perspective about a new mental health professional role as a complex educational phenomenon. The insights related to recognizing the role of context, supporting the use of mixed methods with stakeholders, and responding to evolving needs related to youth mental health and well-being in schools highlight the practical value of using mixed methods in a collaborative approach to evaluation.
DİJİTALLEŞEN MÜZİK SEKTÖRÜNDE ÇEVRİM İÇİ MÜZİK PLATFORMLARI: TRT DİNLE ÖRNEĞİ
Authors: BÖLÜKBAŞ Kenan
Published: March 2022

Teknolojinin gelişmesi ve beraberinde dijital platformların yaygınlık kazanmasıyla müzik sektöründe, dinleyici kitlesinde, müzikal içeriklerin üretim süreçlerinde birtakım değişim ve dönüşümler yaşanmaya başlamıştır. YouTube, Spotify, Fizy, Deezer gibi birçok dijital müzik dinleme platformu ortaya çıkmış ve her geçen gün daha fazla kullanıcı tarafından kullanılır hâle gelmiştir. Bu bağlamda dijital müzik sektöründeki gelişmelerin ve kullanıcıların farklılaşan müzik dinleme eğilimlerinin saptanması önem kazanmıştır.
Bu çalışmada, dijitalleşen müzik sektöründe çevrim içi müzik platformlarının durumu “TRT Dinle” uygulaması üzerinden değerlendirilmeye çalışılmıştır. Araştırmada, nicel araştırma yöntemlerinden biri olan anket tekniği, çevrim içi bir şekilde uygulanmıştır. Araştırmanın örneklemini, 13.12.2020-25.12.2020 tarihleri arasında kişisel Twitter hesabından ve WhatsApp uygulamasından paylaşılan ankete katılım gösteren 246 kişi oluşturmaktadır. İki bölümden oluşan anketin ikinci bölümü, şartlı önermeyle sadece “TRT Dinle” platformunu kullanan katılımcıların değerlendirilmelerine yönelik sorulardan oluşmaktadır. Anket sonuçları Google Formlar ve Google E-Tablolar üzerinden analiz edilerek bulgular elde edilmiş ve yorumlanmıştır.
Buna göre, TRT Dinle uygulamasının daha çok zengin ve özgün müzikal içerikleri ile ücretsiz olması nedeniyle tercih edildiği; sesli kitaplar, podcastler, eski radyo programları ve radyo tiyatrolarının ise müzikal içerikler kadar ilgi görmediği sonucuna varılmıştır. TRT Dinle, tüm bu nitelikleri ile rakiplerinden farklılaşmaktadır. Bu farklılıkların sayısal verilerle ortaya konulması açısından çalışmanın alanyazına katkı sunacağı düşünülmektedir.
OMİCRON’UN TANIMI, YAZIMI VE OKUNUŞUNA DAİR DÜŞÜNCELER
Authors: ERASLAN Ebubekir
Published: March 2022

Çin’de başlayıp tüm dünyaya yayılan korona virüsünün üzerinden üç seneye yakın bir zaman geçmiştir. Bu sürede insanlık hem korona virüsünden hem de onun varyantlarından derinden etkilenmiş, pek çok insan hayatını kaybetmiş ve kalıcı/geçici sağlık sorunları yaşamıştır.Korona virüsü ve onun varyantları konusunda Dünya Sağlık Örgütü başından beri kamuoyunu bilimsel olarak uyarmakta ve insanlığı derinden etkileyeceğini düşündüğü varyantları isimlendirmektedir. Dünya Sağlık Örgütünün, korona virüsünün varyantlarından birisi olarak tanımladığı beşinci büyük varyant; Kasım 2021’de Güney Afrika’da ortaya çıkmıştır. Bu varyant tüm dünyayı etkileyerek COVID-19’un en bulaşıcı ve dirençli son varyantı olarak küresel salgın hâline gelmiştir.Dünya Sağlık Örgütü, tespit ettiği büyük ve etkili varyantlara Yunan alfabesinin harflerini sırasıyla isim olarak vermektedir. Omicron adı da bu alfabenin on beşinci harfi olarak diğer dört büyük varyanttan sonra verilen son isimdir.Dünyada yeni bir terim hâline gelen Omicron varyantıyla ilgili olarak bir alanyazını oluşsa da Türkiye’de bu alanda henüz bir çalışma yok gibidir. Belki de bu yüzden olsa gerek Türkiye’de Omicron’un tanımı basılı ve elektronik sözlüklerde yapılmamış, yazım bilgisine değinilmemiş, okunuşuyla ilgili herhangi bir malumata erişilememiştir. Özellikle Omicron’un yazımı ve okunuşu, gizli anlaşmalar sistemine terk edilmiştir.Tüm dünyayı etkileyen küresel salgın hastalıklarda Türkiye’de ve dünyada dil uzmanlarının ve mikrobiyologların disiplinlerarası çalışarak kamuoyunda oluşabilecek yanlış/eksik tanım, yazım ve okunuşların önüne geçmesi gerekmektedir.
Uso de ozônio na terapêutica de mastite bovina: Relato de caso
Authors: Fuentes Arévalo Esther
Published: March 2022

Mastitis is defined as inflammation of the mammary gland and is characterized by causing significant alterations in the composition of milk and economic losses and endless perjuries to the dairy industry. For this reason, and in view of the growing demand for antibiotic-free and quality products for human consumption, alternatives are being sought for current broad-spectrum antibiotic-based mastitis treatments. Within this framework, this article aims to demonstrate through a case report the effectiveness of the use of ozonized solutions in the treatment of clinical mastitis in dairy cows. For which a cow that presented clinical mastitis in 2 quarts was treated, with an ozonated solution (10 ml of solution in total, 5 ml of ozonated sunflower oil plus 5 ml of ozonated physiological serum in a concentration of 12 mg/ml), this treatment was compared with a usual commercial antibiotic treatment (Masticine L). At the end of the treatments, a favorable change was perceived in terms of visible physical aspects in both treatments, the antibiotic having a better performance in this regard, however the treatment with ozonized solution had favorable effects in terms of milk composition, improving its quality and lowering treatment costs therefore the use of intramammary ozonated solutions is recommended for the treatment of clinical mastitis in dairy cows.
“Doenças da produção” como evidências nas perícias de bem-estar em bovinos leiteiros: Revisão
Authors: Amaral Jackson Barros do
Published: March 2022

This article aims to discuss, within the scope of domestic and international literature, the medical-legal and forensic basis for evidence of “production diseases” as an aid in the welfare inspections of dairy cattle. The involvement of the veterinarian in forensic expertise is not recent. In Brazil, veterinary expertise has evolved and is now being applied in issues related to animal health, public health, consumer, wildlife and environmental protection. The medicine of dairy cattle production encompasses technical-scientific knowledge in multiple areas of veterinary science and the milk production chain. In recent years, dairy cows have suffered constant pressure and genetic and management changes in order to maximize production. In this context, “production diseases” stand out, which are characterized by an inconsistent level of production that mainly compromise the quality of life of dairy cows and cause an economic impact. They are metabolic disorders characteristic of a group of farm animals caused by selection and management pressure, with nutritional imbalance in their biotransformation. When the metabolic disorder affects the individual, it is understood as a metabolic disease and when it affects the herd, it has been attributed the term “production disease.” The dairy cow transition period is comprised within the interval of three weeks before and after calving and during this period, 70% of the occurrence of these diseases prevails, in which drastic changes take place in the nutritional, metabolic, physiological and behavioral status, preparing the animal for a new pregnancy and partum. Of these diseases, the metabolic ones cause high morbidity and mortality and represent great importance in intensive systems with the application of modern technologies, requiring the use of rigorous prevention measures, especially in the pre- and post-partum periods. The clinical evaluation of herds as a production problem can be carried out through clinical examinations and clinical analyzes of the metabolic profile. The system of raising high-yielding cows when it does not meet nutritional and management requirements can trigger metabolic and infectious diseases, culling and even death, in addition to causing economic losses and compromising well-being and health. The well-being and occurrences of maltreatment due to negligence, malpractice and recklessness can be assessed by medical and veterinary expertise and generate important evidence in legal actions.
Mastite clínica decorrente de psedouciese em cadela: Relato de caso
Authors: Oliveira Neves Gustavo , Teixeira Neto Milton
Published: March 2022

The routine in the small animal clinic demands numerous illnesses, knowing about them leads to greater effectiveness of treatment success. The infectious and inflammatory process of the mammary glands is defined as mastitis, which causes changes in the glandular tissue, modifying physical and chemical aspects of the milk. The prognosis is mostly favourable and the treatment is based on broad-spectrum antibiotics, for the main infection, and for the secondary symptoms, non-steroidal anti-inflammatory, non-opioid analgesics. use of warm compresses, drainage of the affected glands, alleviate pain and can be used in a complementary way. In this sense, the present study aimed to evaluate a case of clinical mastitis in a female dog, due to an anterior pseudocyesis process. The work describes the case of a female dog, Poodle, weighing 8.5 kg, 9 years old and complaining of inflammation in the mammary glands. On clinical examination, inflammation of the mammary glands, pain on palpation, hyperaemia, presence of milky and bloody secretion, oedema, and blackened breast colour were observed. Treatment based on anti-inflammatory drugs and antibiotics provides greater ease due to the easy access to these medications, in addition to avoiding the use of hormones. Ovariohysterectomy as a therapeutic measure is the best form of prevention, especially for cases related to pseudopregnancy.
Identificação e diferenciação morfológica de microfilárias no sangue de cães do Espírito Santo
Authors: Vilhena Freire Martins Isabella
Published: March 2022

The filariasis are helminths that are common in domestic dogs but may also occur in cats, horses and some wild animals. The species involved with the parasitism bring the host to a case of microfilaremia, producing microfilariae that are very similar to each other, which makes the diagnosis difficult. This work aimed to clarify the morphologic differences between the microfilariae of the main filarial worms in dogs, specially Dirofilaria immitis e Acanthocheilonema reconditum. For the study, blood samples of dogs in Espírito Santo were collected by veterinarian laboratories previously diagnosed as positive using blood smear, and forwarded to the Parasitology Lab of the Veterinary Hospital of the Federal University of Espírito Santo. The samples were submitted to modified Knott test and analyzed on slide under optical microscope for morphometric characterization, based on its main morphological characteristics from head and tail and subsequent differentiation of the microfilaria species found. Seventy-two samples were analyzed, being 69.44% represented infection by D. immitis and 15.27% by A. reconditum, from which 12.5% were infected by both species. There was no evidence that would suggest other species of filarial worms.