bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of the efficacy, safety, acceptability and fetomaternal outcomes of combination of mifepristone and foley’s catheter with foley’s catheter alone in induction of labour in term pregnancies with previous lower segment caesarean section
Authors: Thind Nancy , Sood Pranav , Sood Rajeev , Syal Geetika Gupta
Published: September 2020

Background: Objective of the study was to compare the efficacy, safety, acceptability, fetomaternal outcomes of combination of mifepristone and Foley’s catheter with Foley’s catheter alone in induction of labor in term pregnancies with previous Lower segment caesarean section (LSCS).Methods: This was a prospective study of 36 women induced with mifepristone and foley’s catheter and 36 women induced with foley’s catheter alone at 37 weeks to 41+6 weeks with previous LSCS.Results: Mean bishop score on admission in combined group (2.44) was comparable with that of foley’s alone group (2.91, p=0.888). Mean Bishop score (BS) after foley’s expulsion in group A and group B was 7.46 and 6.33 respectively, which was statistically significant (p<0.001). In group A 69.5% of women delivered vaginally compared to 52.2% in group B which was comparable (p=0.230). Mean induction to delivery interval was significantly short in combination group (15.5±1.3 hours versus 20.8±1.07 hours, p=0.003). 50% women in group A required oxytocin for induction/ augmentation of labour as compared to 77.8% in group B (p=0.02). Failed induction was statistically higher in group B (p<0.05). No difference was found with regards scar dehiscence, scar rupture, Postpartum hemorrhage (PPH), wound infection, puerperal pyrexia, Meconium stained liquor (MSL), fetal distress, mean birth weight, 1 and 5 minutes Appearance, pulse, grimace, activity, and respiration (APGAR) score, neonatal outcome, hospital stay.Conclusions: Priming with mifepristone before insertion of foley’s catheter results in significant change in BS signifying that combination promotes early cervical ripening as compared to foley’s catheter alone. Mifepristone plays significant role in cervical ripening, reduces induction to delivery interval, oxytocin requirement and failed induction.
Comparison of analgesic efficacy of intramuscular tramadol and pethidine in labour
Authors: Vinaya G. , Surekha S. M. , Chiniwal Shivaganga
Published: September 2020

Background: Labour pain is among the most severe pain experienced by women. It is unpleasant and distressing to the parturient. The objective of the study was to evaluate and compare the analgesic efficacy and adverse effects of intramuscular tramadol and pethidine in labour. Methods: The prospective study conducted in SDM College of Medical Sciences and Hospital, Department of OBG, from December 2013 to November 2014. The study was a study of the parturients admitted in the labour theatre. Written and informed consent was taken from all the patients enrolled in the study. One hundred parturient at term in active labour were randomly assigned to one of the two groups to receive intramuscularly either tramadol 100 mg or pethidine 75 mg. Results: Results were comparable in terms of maternal age, maternal weight and neonatal weight. Proportion of cases with satisfactory to good pain relief was 74% in the tramadol group and 78% in the pethidine group. Nausea and/or vomiting (12% versus 8%), fatigue (6% versus 4%) and drowsiness (8% versus 4%) were significantly high in the pethidine group than the tramadol group(p<0.05). The drugs used did not appear to influence the mode of delivery. Proportion of cases with non-reassuring foetal heart rate was high in the pethidine group. Meconium stained liquor was equally seen in both the groups and there were no incidence of neonatal respiratory depression in any of the groups.Conclusion: Tramadol is an equally effective labour analgesic as pethidine with less maternal and perinatal side effects.
An audit of the decision to delivery interval in emergency caesarean section and its effect on neonatal outcome
Authors: G. Anuradha , V. Nirupama , George Shirley
Published: September 2020

Background: Emergency caesarean section (CS) is divided into four categories based on the degree of urgency by RCOG and NICE guidelines. It is recommended that the decision to delivery interval (DDI) in emergency CS should be within 30 minutes in category 1 and within 75 minutes in category 2. Our Primary objective was to study the incidence and indications of emergency CS and audit the DDI in emergency CS at tertiary care hospital. Our secondary objective was to study the effect of DDI on neonatal outcome.Methods: Descriptive study was carried out among 409 women who underwent emergency CS from August 2018 to December 2018 at St. John's medical college hospital, Bangalore. Relevant data was collected by chart review. Emergency CS were categorised according to RCOG guidelines based on the degree of urgency and further classified based on DDI as <30 minutes, 30-75 minutes and >75 minutes.Results: We had 409 cases of emergency CS. Category 1 had 113 (27.63%) cases, category 2 had 126 (30.81%) cases and category 3 had 170 (41.56%) cases. DDI of <30 minutes was achieved in 19.5% in category 1, DDI of <75 minutes was achieved in 93.65% in category 2. Fetal distress was the leading cause of emergency CS in category 1 and 2. There was a high incidence of low APGAR in babies delivered in <30 minutes and lower APGAR was significantly associated with <30 minutes of DDI (p<0.0001).Conclusions: Fetal distress was the leading cause of emergency CS. DDI interval of <30 minutes was not always associated with good neonatal outcome; Category of CS has a significant effect on neonatal outcome.
Assessment of knowledge, attitudes and concerns to human papilloma virus vaccine among female nursing professionals in India
Authors: Rahman Hafizur , Khalda Ezzat
Published: September 2020

Background: To have a successful cervical cancer control programme in developing countries, nursing staff must be aware of the facts about the disease preventive methods and the prophylactic human papilloma virus (HPV) vaccine. The aims of the present study were to assess knowledge of, attitudes toward and concerns to HPV vaccine among female Sikkimese nursing staff in India.Methods: Between April 2012 and February 2013, a pre-designed, pretested, self administered multiple responses questionnaire survey was conducted among female Sikkimese nursing staff in India.Results: Overall, 77.4% nursing staff responded that they had ever heard of a HPV vaccine. Trainee nurses were significantly more aware of the vaccine than regular working nurses. Actual knowledge of the vaccine was poor. Recommended age of HPV vaccination was aware by only 38.7% and only 30% nurses knew number of doses of vaccine, while over 90% nursing staff were not aware of time schedule of the vaccine. According to summarized knowledge index only 13.5% nurses had actual knowledge of HPV vaccine. Sixty five percent nurses wanted to vaccinate themselves or to their daughters. Top three aspects of HPV vaccine that nursing staff were most concerned were effectiveness, effect duration and long term effects. Eighty four percent nurses wanted more education and training sessions about cervical cancer prevention and HPV vaccine.Conclusions: Nursing staff in India need to be updated urgently with continuing medical education about cervical cancer prevention and HPV vaccination.
Experience and yield of mass breast screening among working women in major cities of India: a mixed-method study
Authors: Bhutale Rakshita , V. Rajani , Bhashyakarla Varsha , Gunda Srinivas , Bhat Archana
Published: September 2020

Background: iBreastTM tool is simple, safe, a handy device which is designed for mass breast cancer screening tool in a community or hospital setting. This study determined the yield and basic characteristics of women attending the breast cancer screening programme. The study also determined the overall experience of women who underwent breast cancer screening using iBreastTM tool.Methods: This study was a multicentric, retrospective observational study conducted in Mumbai, Bangalore, Chennai and Hyderabad as a part of routine work-place breast cancer screening programme supported by Mfine. Screening was done by iBreastTM, which is a hand-held compression device. After proper clinical examination and iBreastTM scanning, results were confirmed by a consultant trained in interpretation of findings. The overall experience of the women who underwent screening was also determined using a questionnaire. Descriptive analysis was carried out by mean and standard deviation for quantitative variables, frequency and proportion for categorical variables. The qualitative assessment and thematic analysis of the qualitative data was done.Results: A total of 1080 eligible female employees were present in the approached IT companies and out of that 451 women (41.75%) had consented and participated in the screening program. The acceptance rate was highest in Bengaluru city (65%) followed by Mumbai (53%), Chennai (33%) and least in Hyderabad (18%). 31 participants documented positive findings had in the scan and were referred for further evaluation. The quantitative and qualitative data determined that iBreastTM scan was highly accepted by all participants. Customer service, screening location and overall experience was deemed good by the participants with an average score of 4.8.Conclusions: The iBreastTM has the potential to be a promising tool in providing effective diagnosis after breast examinations.
Analysis of caesarean sections according to Robson’s criteria at a tertiary care teaching hospital in central India
Authors: Wahane Aparna , Ghaisas Ashwini S.
Published: September 2020

Background: The rate of caesarean section (CS) has been skyrocketed globally over the past three decades which makes it utmost essential to be reanalyzed. Hence, the Robson’s classification of international standards has become a need of an hour. This study aimed to analyze the trend of caesarean sections at a tertiary care teaching hospital, by using Robson’s criteria.Methods: This cross-sectional observational study was conducted at Government Medical College in Akola. The data was collected for the women delivered by CS during November 2017 to April 2019 and proportions in various groups as per Robson’s criteria were calculated.Results: The overall CS rate for the study period at our hospital was 63.89%. Robson Group 1 (24.5%) had the greatest representation in the study population followed by Group 5 (21.27%) and 3 (14.18%). While Groups 6 (10.13%) and 9 (0.63%) had the least representation. Group 5 was found to be the highest absolute contributor (20.5%) to overall CS rates followed by Group 1 (16.08%). Group 9 had a least possible share in the study population, but it had 100% CS rate.Conclusions: Robson’s classification must be implemented in all delivery units to avoid unnecessary caesarean sections. Every effort should be made to provide caesarean sections to women in need, rather than striving to achieve a specific rate and Robson’s criteria is a step forward in the same direction.
To study the feto-maternal outcome in cases with previous surgical intervention for first trimester abortion on subsequent pregnancy and to compare with cases without history of previous abortion
Authors: Tanwar Kritika , Sarkar Bani , Chauhan Anjali
Published: September 2020

Background: To study the Feto-maternal outcome in cases with previous surgical intervention for first trimester abortion on subsequent pregnancy and to compare with cases without history of previous abortion.Methods: A cross sectional observational study was conducted over a period of two years. Study included 80 consenting females at 28 weeks POG. Females with history of prior surgical abortion just before the present pregnancy were included as cases (n=40) and rest as controls (n=40). Detailed obstetric history was taken, subjects were then followed till delivery and feto-maternal outcomes such as period of gestation, mode of delivery birth weight, Apgar score, increased NICU stay at the time of delivery were recorded and analyzed.Results: We observed that the women with history of induced surgical abortion were at increased risk of Pre term birth (52.5%, p value0.006), Cesarean section (40%, p value 0.012), Low birth weight (47.5%, p value <0.001), increased NICU stay (32.5%, p value 0.027) compared to primi-gravida controls.Conclusions: We concluded that women with previous history of induced surgical abortions were at increased risk of preterm birth, very preterm birth and low birth weight babies, NICU stay in the subsequent pregnancies. The risk of caesarean was found to be increased in women with previous induced abortions exposing the women to the morbidity associated with the C-section. Hence patient with prior history of surgical first trimester abortion needs more vigilant monitoring during antenatal period in subsequent pregnancy.
A study on maternal factors affecting low birth weight in institutional deliveries
Authors: A. Chaithra , Chiniwar Mahantappa A. , Menasinkai Sharada B.
Published: September 2020

Background: Low birth weight is defined as birth weight below 2500 mg. WHO states prevalence of LBW is 26%. LBW babies are more prone for neonatal morbidity and mortality. 1) To assess various factors like maternal age, height, education, socioeconomic status on the birth weight of the baby. 2) To assess obstetric factors like parity, gestational age, antenatal care, anemia, hypertension on the birth weight of the newborn.Methods: A hospital bound cross sectional study done at the tertiary care centre. Study was done for a period of 2 months from 1st June to 30th July 2019 in Adichunchanagiri Institute of Medical Sciences and Research Hospital a rural medical college in Karnataka. Maternal data were collected and baby weight was recorded soon after birth on weighing scale.Results: There were 65 births during the study period. There were 13 babies weighing less than 2500 gm. Prevalence of LBW was 20%. 43.47% mothers were aged between 18 to 25 years and 7.14% were more than 25 years. 30.4% mother’s height was between 140 to 150 cm and 14.2% were more than 150 cm. Regarding maternal education, 15.3% degree, 24.1% PUC, 15% High school and 33.3% were primary school level. Regarding socioeconomic status 22.2% low, 25% lower middle, 18.7% middle class, 18.7% belonged to upper middle class. Regarding gestational age 50% were <37 weeks, 15.5% between 37-42 weeks, 10% were 42 weeks.73.8% women had normal BP, 21.5% were prehypertensive, 4.6% had PIH.Conclusions: Low birth weight is one of the important factors in infant morbidity and mortality. Maternal health was important factor in delivery of low birth babies. Maternal height, sex of baby, mode of delivery has no role in low birth weight babies.
Efficacy and safety of prostaglandins vs double balloon catheter in inducing labor: a meta-analysis
Authors: Chong Jia S. , Chew York L. , Fernando Ayendra , Nalliah Sivalingam
Published: September 2020

Background: To compare the efficacy and safety of double‐balloon catheter with prostaglandin E2 (PGE2) in induction of labor.Methods: We searched electronic sources from Medline, Scopus, PubMed, Science Direct and Cochrane Library Database of Systematic Reviews. Only randomized controlled trials and observational studies comparing the PGE2 agents with double-balloon catheter for cervical ripening and labour induction in women with unfavorable cervix were included in the analysis. The main outcomes included vaginal delivery rate within 24 hours and cesarean delivery rates. We calculated relative risks and mean differences using fixed effects and random‐effects models.Results: Prostaglandin was more favourable for vaginal delivery within 24 hours compared to double balloon catheter, but was not statistically significant (RR 1.17: 95% CI 0.96-1.42 p =0.12). The induction to delivery time yielded a non-significant result that again favors prostaglandin (SMD 0.02 CI:0.18,0.22, p = 0.86). There was no significant difference in the cesarean delivery rates between the two groups (RR 1.02: 95% CI 0.92-1.14, p = 0.68). Uterine hyperstimulation and Neonatal Intensive Care Unit (NICU) admissions were significantly higher with prostaglandin. (RR 0.09: CI 0.04, 0.22 p<0.00001 and RR 0.75 CI: 0.62,0.90 p=003).Conclusions: There is no significant difference in the success of induction of labour between use of PGE2 and double balloon catheter. Uterine hyperstimulation and NICU admissions were significantly higher in Prostaglandin group.
Ovarian mass in pregnancy: case series
Authors: Manvi M. R. , Deshpande Radhika
Published: September 2020

Ovarian masses in pregnancy are not uncommon. Ovarian masses during pregnancy should be accurately evaluated to identify the patients who need surgical interventions from those where it can be managed conservatively. Ultrasound and magnetic resonance imaging (MRI) are safe diagnostic tools during pregnancy. The overall incidence of ovarian tumours in pregnancy is 2.4-5.7%. Most masses are functional and asymptomatic and up to 70% resolve spontaneously in the second trimester. Both open surgery and laparoscopy can be performed considering the tumour diameter, gestational age and associated complications. A multidisciplinary approach is necessary in case of high suspicion of malignancy. This study evaluates the clinical features, course in pregnancy, management and pregnancy outcome in patients with ovarian masses diagnosed during pregnancy. This was a retrospective analysis of medical records of 6 patients diagnosed with ovarian mass during pregnancy in the department of Obstetrics and Gynaecology at Kanachur Institute of Medical Sciences, Mangalore from June 2019 to June 2020.
Placenta percreta: a rare presentation of obstetric emergency in second trimester
Authors: Chavan Niranjan , Mirza Hera , Venkateswaran Sneha , Changede Pradnya
Published: September 2020

Incidence of adherent placenta is on the rise nowadays due to various reasons. Placenta percreta is seen in 5-7% of cases with adherent placenta, patients with morbidly adherent placenta are at increased risk for major obstetric hemorrhage, usually in the third trimester. Here we present an unusual case of placenta percreta presenting with obstetric emergency after trauma to abdomen in the second trimester. Emergency exploratory laparotomy was done for abruptio placentae with scar dehiscence at 20 weeks period of gestation. Consent for obstetric hysterectomy, if needed, was also taken. Intraoperatively, the placenta was found to be adherent to posterior wall of bladder. Emergency obstetric hysterectomy with bilateral internal iliac ligation with cystoscopy with detrusorrhaphy was done. Patient had an uneventful recovery. Multidisciplinary management with obstetricians, urologists and intensivist is presented hereed.
A rare case of peritoneo-cutaneous fistula after cesarean section
Authors: Rana Anshul , Mohindroo Neha
Published: September 2020

Peritoneo-cutaneous fistula is usually a rare but known entity. Such a case has not been reported after cesarean sections. A 26-year female presented to our clinic in May 2019 with persistent sero-purulent discharge from sinus over abdominal skin. The patient had previously undergone a cesarean section in April 2018 for premature rupture of membranes and non-progress of labour. The surgery and puerperal period were uneventful. The patient presented with document high-grade fever in June 2018. In August 2018, a localized painful swelling was noted by the patient herself over the abdomen, contrast-enhanced computed tomography, which suggested 6.3×3.9×3 cm collection in the right adnexal region and a fistulous tract communicating with abdominal skin. For the same she underwent surgery, wide local excision of the fistulous tract around elliptical skin incision was done. The development of delayed peritoneo-cutaneous fistula has been seen as a complication of difficult cholecystectomy.
Twin reversed arterial perfusion in twin pregnancy
Authors: Devi L. Thulasi , Verma Vikas
Published: September 2020

An interesting case of twin reversed arterial perfusion “TRAP” from a larger apparently normal pump twin with VACTERL abnormality; to smaller structurally abnormal twin in a monoamniotic monochorionic twin pregnancy resulting in fetal demise with subsequent termination of pregnancy. Defect in early embryogenesis leads to such rare multiple presentations.
Previous two lower segment caesarean section with placenta previa and placenta accreta woman with COVID-19 suspect: case report
Authors: Borse Dhananajay , Mitra Binay , Sharma Aparna
Published: September 2020

A pregnant woman with gravida 3, para 2, living 2 and gestational age of 37 weeks and 3 days was referred to a zonal hospital as previous two lower segment caesarean section (LSCS) term pregnancy with placenta previa for safe confinement with complaints of dry cough. She was admitted with a diagnosis of COVID-19 suspect. During her hospitalization, oxygen (O2) saturation was normal. On investigations her counts were normal. Patient was planned for elective LSCS. COVID-19 test i.e. real time-polymerase chain reaction (RTPCR) report was suspect and asked for repeat sampling. During elective LSCS, delivered single live female baby with intra operative findings of placenta previa with adherent placenta and permpartum hysterectomy was done for same. Uterus with placenta was sent for histopathological examination (HPE). During the surgery her oxygen concentration was normal. Her postoperative recovery was uneventful.
A case report of primary ovarian leiomyoma
Authors: Doddareddy Srikala , Undinti Nagashree , G. Vishnu Vandana
Published: September 2020

Primary ovarian Leimyoma is a rare benign mesenchymal tumour usually arising from smooth muscle of walls of ovarian blood vessels. It’s mostly discovered incidentally. Here we report a case in which a 24-year-old unmarried woman presented with pain and discomfort in lower abdomen since 10 days. On further evaluation through imaging and blood works, we proceeded with surgical management. Immunohistochemistry confirmed the final diagnosis of ovarian leiomyoma. However, it’s important to keep this entity as a differential diagnosis for solid ovarian tumors.
Xanthogranulomatous salpingo-oophoritis: a case report and review of literature
Authors: Patel Keval A. , Chothani Kinalee P. , Patel Bimal , Lanjewar Dhaneshwar N.
Published: September 2020

Xanthogranulomatous inflammation of ovary is a rare disease that is characterized by presence of large number of lipid laden macrophages with an admixture of neutrophils, lymphocytes, plasma cells and multinucleated giant cells. It is misdiagnosed as ovarian tumour that leads to extensive surgery including hysterectomy. In this report we describe a case of Xanthogranulomatous salpingo-oophoritis along with review of literature.
Laparoscopic intra-ovarian platelet rich plasma injection for ovarian rejuvenation: a new hope for infertile women
Authors: El Sherbeny Mohamed Farag
Published: September 2020

This case report was presented to show the outcome of bilateral laparoscopic platelet rich plasma intra-ovarian injection for 34-year old woman who had primary infertility secondary to premature ovarian insufficiency and had two previously failed attempts of ICSI. One month after the procedure, the patient had menses and her hormonal profile was improved with increased serum AMH and E2 and decreased serum FSH and LH. On the eleventh day of the menstrual cycle, folliculometry detected good follicle measuring 18×20 mm, on the fifteenth day, trans-vaginal ultrasonography assured ovulation and timed intercourse was ordered, and she got pregnant. At the thirty fifth gestational week, she had premature preterm rupture of membrane and urgent cesarean delivery was performed and the newborn was admitted to neonatal intensive care unit. As conclusion, intra-ovarian PRP injections could be safe, productive, and a natural treatment for women with POI. Laparoscopic injection allowed perfect under-vision intra-ovarian injection and can be conducted as one-day procedure and this can be considered a novelty of the applied procedure.
Obesity and women health: from womb to tomb
Authors: Garg Shivani , Grover Seema , Garg Nishi
Published: September 2020

Obesity is a highly prevalent disease reaching epidemic proportions these days in India. Obesity affects all human beings especially women affecting their health drastically. It affects each phase of their life in serious manner. We present here the spectrum of diseases that obesity can cause to a women during her entire life.
A study of lipid profile and glycemic status in patients with chronic kidney disease of unknown etiology in Sri Lanka
Authors: Basnayake Duminda B. , Sandamali W. G. H. , Nayanamali Ayesha , Wazil Abdul W. M. , Siriwardena R. M. P. A. , Thennakoon T. M. C. I. , Dharmasiri Thilak , Nanayakkara Nishantha
Published: September 2020

Background: Dyslipidemia and impaired glucose tolerance are common complications of chronic kidney disease (CKD) and are responsible for increased cardiovascular risk. Studies on lipid profile and glycemic status in CKD of unknown origin (CKDu) are scarce. The objective of this study was to evaluate the lipid profile and glycemic status of the patients with CKDu and to aid in preventing morbidity and mortality.Methods: The descriptive, cross sectional study was conducted in a rural CKDu endemic area, Girandurukotte.  Data was collected from February 2018 to June 2019. For the diagnosis of CKDu, history and clinical features with supportive biochemical, renal biopsy and radiological evidence were taken as criteria. Blood samples were taken for serum creatinine, lipid profile and HbA1C. Already diagnosed patients with diabetes mellitus and dyslipidemia were excluded.Results: A total of 168 patients within the age range of 32-66 years (mean 50.3±7.7) were participated. There were 106 males (63%) 46.4% were farmers. Majority of the patients (65.5%) had normal body mass index (BMI) (mean 22.9 kg/m2, normal range 18.5-23.5%) followed by overweight (23.5-30 kg/m2) in 55 (32.7%) patients. The prevalence of dyslipidemia in CKDu was found to be 55.9%.  Majority of the abnormality was seen in the HDL group with 68 (40.5%) patients having low HDL cholesterol (mean 44.7 mg/dl, SD=12.3).  There was a significant rise in the serum triglyceride concentration (>150 mg/dl) in 53 (31.5%) (mean 152.4 mg/dl, SD=73.5) and total cholesterol (>200 mg/dl) in 30 (18%) patients (mean 182 mg/dl, SD=36.9). LDL cholesterol abnormality (>130 mg/dl) was seen in only 9 patients (mean 88.7 7658mg/dl, SD=25.4). From the total, 144 (85.7%) patients had abnormal HbA1C levels; 27 (16.1%) patients had HbA1C levels between 5.7% and 6.4% (pre-diabetes), and 117 (69.6%) patients had HbA1C level more than 6.5% (diabetes mellitus). There was no statistically significant association between HbA1C levels and BMI (p=0.29) or HbA1C and lipid abnormalities (p=0.32)Conclusions: The high prevalence of dyslipidemia, pre-diabetes and diabetes mellitus in patients with CKDu may accelerate the progression of chronic kidney disease and increase the risk of cardiovascular disease. Early detection, initiation of appropriate medication and early referral to the expertise will ameliorate morbidity and mortality.
Impact of diabetes mellitus on nerves
Authors: Khan Muhammad Dilawaer , Yousaf Hamza , Umar Muhammad , Zaib Muhammad Shah , Qazi Shaheryar , Irshad Khurram , Chaughtai Zeeshan , Akbar Usman Ali , Awais Rehan
Published: September 2020

Background: Involvement of the peripheral and autonomic nervous systems is probably the most common complication of diabetes. The main symptoms of diabetic polyneuropathy include negative symptoms (those related to nerve fiber loss or dysfunction) such as numbness and weakness, and positive symptoms (those related to abnormal function of surviving nerve fibers) such as tingling and pain.Methods: This was a cross-sectional study held in diabetic clinic of Nishter hospital, Multan, Pakistan. The study included any diabetic patients showing symptoms of neuropathy.Results: There were total of 140 in this study. This study included 85% of male and 15% of female. Most common symptoms of diabetic neuropathy were pain (70%) and tingling (70%) followed by numbness in 65% of patients. There were 28 patients in 5 years duration of diabetes, 35 people in 6-10 years duration, 21 patients in 11-15 years duration, and 14 patients in 20+ years duration.Conclusions: Neuropathy due to diabetes is crippling especially when pain is the prominent symptoms. Autonomic symptoms like constipation and lightheadedness are discomforting for the patients. The most commonly used screening test is vibrating tuning fork test which is east to perform is clinical setting and is not time consuming. Diabetic patients need to take special care of.
Effect of antenatal education on knowledge and utilization of facility-based delivery services among pregnant women in two health institutions in Alimosho, Lagos state
Authors: Okafor Orji Urenna , Yewande Ademuyiwa Iyabo
Published: September 2020

Background: Facility-based delivery care is an essential component of maternity care. Overtime, its under-utilization despite improvement in antenatal attendance has become a public health concern in Nigeria. To assess the effect of antenatal education on the knowledge and utilization of facility-based delivery services among pregnant women in primary health facilities in Alimosho, Lagos.Methods: Quasi-experimental design of 2 groups pre- and post-intervention was adopted and through multi-staged sampling techniques, 128 participants were selected but 117 completed the study. Self-developed structured questionnaire with reliability index of 0.76 was used for data collection. The intervention package was antenatal education package on benefits and components of delivery services. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 23 statistical package.Results: The mean age of participants in control and experimental groups was 32.3±9.60 and 34.7±8.21 years respectively. Findings revealed moderate knowledge mean score (control- 54.97±10.52; experimental-52.14±11.09) and low pre-intervention utilization mean score (control 13.33±3.41; experimental-13.17±4.21). Findings also showed significant improvement on post-intervention mean knowledge score of 52.14±11.09 versus 104.75±5.56 and a significant difference in post-intervention utilization (p=0.000) and follow-up (p=0.013) on the experimental group.Conclusions: The study concluded that the antenatal education programme had positive effect on the pregnant women’s knowledge and utilization of health facility delivery services, therefore, there is need to strengthen and intensify antenatal education at all levels of healthcare using appropriate teaching techniques.
Effect of cardiopulmonary resuscitation training towards cardiac arrest emergency knowledge upon students at Student Health Association of Universitas Gadjah Mada, Indonesia
Authors: Achmad Bayu Fandhi
Published: September 2020

Background: The cardiovascular disease, especially the sudden cardiac arrest, was the main cause of death and disability throughout the world. The cardiopulmonary resuscitation (CPR) that should be taken by the first responder or witness was an important part in the chain of survival out of the hospital that could improve the prognosis and avoid the rest of the symptoms. Hence, it is important for students to know and possess the skill, especially the cardiopulmonary resuscitation, to handle the emergency situation. University became the appropriate place to organize the CPR training because the students were more conditioned in emotional, social and cultural terms.Methods: This research utilized the quasi-experiment method. The total number of research subject was 56 Universitas Gadjah Mada students at Student Health Association. The implementation of intervention of this research was conducted on 07 July, 2018. The topic in this research intervention were formed based on American Heart Association (AHA) Guideline 2015. Pretest and posttest instrument were 10 multiple choices with five choices of answer.Results: This research proved that the CPR training gave effect on the improvement of the knowledge about emergency situation, particularly the cardiac arrest through cardiopulmonary resuscitation. The pre-test and post-test results showed that there was a knowledge improvement after the training (p=0,000).Conclusions: CPR training could be recommended to have an impact on increasing student knowledge in emergency management, especially cardiac arrest.
Prevalence and components of metabolic syndrome in HIV-infected patients at the Tiko Central Clinic and Cottage Hospital in Cameroon
Authors: Njongang Vigny N. , Nguedia Assob J. C. , Walter Ojong E.
Published: September 2020

Background: HAART and HIV related metabolic syndrome (MS) is associated with increased cardiovascular risk in aging HIV patients. This study was aimed at comparing the prevalence of MS between HIV-infected patients on HAART and apparently healthy HIV-uninfected individuals and identifying key MS components in these groups of subjects.Methods: This was a hospital-based case-control study. The cases were HIV sero-positive individuals on HAART for at least 6 months and controls were HIV sero-negative individuals.Results: 74/135 (54.8%) participants were females amongst which 53/75 (70.7%) and 21/60 (35%) were in the test and control groups respectively. The prevalence of MS was insignificantly higher in HIV-infected patients on HAART than in control subjects according to the IDF (22.7% versus 20%, p=0.834) and NCEP ATP III criteria (18.7% versus 18.3%, p=1.000) respectively. The most prevalent components of MS in HIV-infected patients on HAART were low HDL-c (100%), abdominal obesity (IDF: 68%, ATP III: 32%), and hypertension (28%). Multivariate analysis of MS components in HIV-infected patients on HAART revealed that hypertension (OR: 15.996, 95% CI: 3.385-75.585; p≤0.001) and high blood glucose (OR: 10.760, 95% CI: 1.642-70.505; p=0.013) were associated with MS. Significantly more HIV-infected females were seen with abdominal obesity than HIV-infected males (86.8% versus 4.5%, p≤0.001).Conclusions: Abdominal obesity is a driving component of MS in HIV-infected patients particularly among females and hypertension is a prevalent and predictor component of MS among HIV patients.
Changing indications for intravitreal anti-vascular endothelial growth factor injections at the university college hospital, Ibadan, Sub-Saharan Africa
Authors: Adewole Adeyemi Timothy , Oluleye Tunji Sunday , Babalola Yewande Olubunmi , Majekodunmi Oluwole , Ijaduola Modupe
Published: September 2020

Background: Compare the current indications for intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy, to make recommendations for planning of services. To review the current indications for intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy, in order to make recommendations for planning of services.Methods: The medical records of 172 patients who had intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections from January 2016 to December 2019 were retrieved. Socio-demographic and clinical data were extracted, analysed, and compared with data from the previously published audit report covering 2010 to 2012.Results: Three hundred and thirty injections were given to 182 eyes in this cohort of patients. The mean age was 61.1±16.3 years (range <1-90 years), with a male to female ratio of 1.1:1. Retinal vein occlusion, 64 (35%) remained the most common indication for anti-VEGF injections in the eyes treated. This was followed by choroidal neovascular membrane/wet age-related macular degeneration which accounted for 42 (23%) as reported previously. However, cases of proliferative diabetic retinopathy/ diabetic maculopathy needing anti-VEGF were noticed to have almost doubled from about 8 (10%) in the previous study to 15 (27%) in the present study. In addition, idiopathic polypoidal choroidal vasculopathy, 18 (10%) ranked above proliferative sickle cell retinopathy in the present study. Retinopathy of prematurity (ROP), neovascular glaucoma, retinal artery macro-aneurysm and myopic choroidal neovascular membrane were the new emerging indications.Conclusion: There is an expanding indication for anti-VEGF in the management of retinal vascular diseases in the health facility and adequate measures should be put in place for early diagnosis and management. Patients should be counselled on the availability of this treatment option.
Intravenous ferric carboxymaltose for anaemia in pregnancy
Authors: Gandotra Nikita , Zargar Shazia , Mahajan Neha
Published: September 2020

Background: Anaemia in pregnancy is associated with unfavourable consequences both for the mother and the fetus and is a major cause of maternal and perinatal mortality and morbidity.Methods: The study was conducted over a period of one year in which 100 pregnant females who met the inclusion criteria were administered ferric carboxymaltose (FCM) preparation.Results: There was significant rise in mean haemoglobin and serum ferritin after transfusion of ferric maltose in the patients with very less adverse effects.Conclusions: FCM, because of its high efficacy and safety can revolutionize the management of iron deficiency anaemia (IDA) in pregnancy.
Pregnancy emerged thrombocytopenia: maternal and fetal outcome
Authors: Tasneem Fasiha , Sharma Vinutha M.
Published: September 2020

Background: A low platelet count is often an incidental finding in pregnancy. It can be an indicator of a severe systemic disorder requiring emergent maternal and fetal care or can just be unique to pregnancy with no harm to mother or fetus. Physiological decrease in platelet count is seen in pregnancy due to hemodilution and hypercoagulating state, though the exact pathophysiology is still unclear.Methods: It is a prospective observational study done in a tertiary care centre.Results: In about 11,258 cases screened 46 patients had thrombocytopenia (0.4%). The commonest etiology is found to be gestational thrombocytopenia (n=21, 45.6%) followed by preeclampsia/ eclampsia/ HELLP (haemolysis, elevated liver enzymes, low platelet count) syndrome (n=19, 41.3%). Only one patient had immune thrombocytopenic purpura (ITP) and 7 (15.3%) were associated with amplified fragment length polymorphism (AFLP). Maximum of them (n=19, 41.3%) underwent spontaneous vaginal delivery. 4 patients (8.6%) had postpartum haemorrhage, 6 (13.04%) had ceserean section wound infection, 4 (8.6%) had disseminated intravascular coagulation (DIC) and 4 (8.6%) had multiorgan failure. 13 patients (28.3%) had platelet count between 40 to 60 thousand per cumm, 11 (23.9%) had between 60 to 80 thousand per cumm, 10 (21.7%) had between 80,000 to 1 lakh and none had their platelet count less than 20,000 per cumm.Conclusions: Gestational thrombocytopenia is not a preventable condition. It is an incidental finding in pregnancy. With strict vigilance during intrapartum and postpartum period, even without any treatment proper for the same, the maternal and fetal outcome is found to be good.
Comparison of two ophthalmic solutions of olopatadine hydrochloride (0.1%) and epinastine hydrochloride (0.05%) on clinical signs of vernal keratoconjunctivitis and side effects of the two drugs
Authors: Ansari Tahir Husain , Rizvi Yusuf
Published: September 2020

Background: Vernal keratoconjunctivitis (VKC) is a recurrent, bilateral, external, ocular inflammation primarily affecting young adults living in warm dry climates. The objectives of the research was to compare the two ophthalmic solutions of olopatadine hydrochloride (0.1%) and epinastine hydrochloride (0.05%) on clinical signs of vernal keratoconjuntivitis and to determine side effects of both the drugs.Methods: The study was carried out in 40 patients who attended the out-patient department (OPD) Ophthalmology, Darbhanga Medical College and Hospital, Laheriasarai from July 2007 to December 2008.  Forty patients with symptoms of VKC (ocular itching, ropy discharge, papillary hypertrophy, gelatinous thickening and horner-trantas spots were selected and included in our study.Results: Mean score of palpebral hyperemia at 0, 14, 28 and 42 days in olopatadine treated eye were 2.1, 1.4, 0.8 and 0.4 respectively having p value <0.01, and <0.01 and <0.05 respectively, while mean score at same stages in placebo eye were 2.1, 2, 1.9, and 1.5 having value >0.05. Epinastine treated group mean score of palpebral hyperemia were <0.01 and <0.01 respectively in epinastine treated eye whereas in placebo treated eye, mean score were 2.1, 2.0, 1.8 and 1.6 respectively having p value >0.05 in all stages. Statistically insignificant reduction at day 14 while very significant reduction at day 28 and 42 was observed in epinastine treated eye as compared to placebo.Conclusions: The present study had shown that both olopatadine and epinastine were effective in treating clinical signs of VKC as compared to placebo.
Role of diffusion: weighted magnetic resonance imaging in evaluation of renal masses
Authors: Meena Jitendra K. , Taneja Anil
Published: September 2020

Background: Diffusion-weighted magnetic resonance imaging (DWI) is a valuable tool to narrow down the differential diagnosis of renal masses. Studies have shown that benign renal masses have higher Apparent diffusion coefficient (ADC) value than malignant renal masses. Aim of study was to evaluate the role of diffusion-weighted magnetic resonance imaging in the characterization of renal masses.Methods: The study was conducted in department of Radio diagnosis at ABVIMS and Dr. RML Hospital, New Delhi between June 2017 to March 2019. This was a cross-sectional observational study comprising of 28 patients. Patients found to have renal mass on ultrasound and computed tomography (CT) were evaluated further on 3T siemens Magnetic resonance imaging (MRI) scanner. In addition to routine sequences, DWI using b value of 0,500,1000 s/mm2 sequence was used to study to differentiate benign and malignant renal masses.Results: Of a total of 28 cases, the most common malignant mass was renal cell carcinoma (RCC). Angiomyolipoma (AML) was the most common benign masses. DWI showed low ADC values in most of the malignant masses and high ADC values in most of the benign masses. The cut-off level of ADC value for differentiation among benign and malignant renal masses was 1.08×10-3 mm2/s. DWI-MR findings were correlated with histopathological diagnosis.Conclusion: DWI with ADC measurements are a non-invasive, problem solving tool for characterization of renal masses helping to differentiate malignant from benign masses.
A cross-sectional study on self-medication practice and attitude towards self-medication among medical students of GMERS Medical College, Valsad
Authors: Patel Hinaben R. , Patel Ravikant R.
Published: September 2020

Background: Self-medication is becoming a most prevalent practice among educated people across the world. In today’s era, internet and media is one of the most important sources for promoting self-medication practice. Medical students are highly influenced with this practice as their future medical preference and the fact that medical students find themselves having more knowledge about drugs this may lead to irrational usage of drugs. Aim and Objectives of the study were conducted to know the 1. Self-medication practices among medical students 2. Common, indications and reasons for self-medication practice. 3.Attitude of medical students towards self-medication practice.Methods: A cross-sectional, questionnaire-based study was conducted among undergraduate medical students of GMERS Medical College Valsad. The study was carried out in the months of October to December 2017. Medical students of first and final year MBBS participated voluntarily in this study after being briefed in detail about the goals & method of the study.Results: In this study, 91.50% of medical students were practiced self-medication. The common indication for self-medication was fever (76.50%) and cough (75.96%). Acquaintances (67.76%) are main source of information for self-medication. Common reasons they know the medicine (78.14%) and previous exposure (64.48%). 12.5% student perceived self-medication is harmless and 21.0% of medical students advise other to take self-medication.Conclusions: It was concluded that more than half of strength of students practice self-medication for various illnesses; the reason might be the awareness of drugs due to easy accessibility of information through books, internet as well as availability of medicine without prescription from pharmacist. So, essential measure should be taken to reduce the practice of self-medication among students to avoid development of drug dependence, resistance and drug interactions.
Soft tissue neoplasms: a clinicopathological study
Authors: K. T. Athulya Krishna Kumar , S. Ariya
Published: September 2020

Background: The current WHO classification has categorized soft tissue tumours into benign, malignant and so-called intermediate neoplasms. Soft tissue sarcoma comprises <1% of adult cancers. The aim of the study was to clinically correlate soft tissue neoplasms and study the histomorphological features of various malignant soft tissue tumors.Methods: This was a retrospective study conducted in a tertiary care hospital in Mangalore, India from January 2019 to June 2020. Clinical details of all cases of soft tissue neoplasms retrieved from the medical records of our institution. Data collected included age, gender, presenting symptoms, site and size of soft tissue neoplasms and clinical diagnosis. Pathological diagnosis of these tumours was made and details recorded.Results: A total of 113 cases of soft tissue neoplasms were collected. 94.4% benign and 18.6 %. malignant tumours were present. 77% cases presented with swelling whereas 23% presented with pain. Majority of benign soft tissue tumours were located in the trunk (36.9%) and the most common type was lipomas (66.38%). Malignant soft tissue tumours showed male to female ratio of 1.33:1. Most predilection was noted for the extremities (42.8%) and leiomyosarcomas were the most common type (38%).Conclusions: The incidence of malignant soft tissue tumours is rare. Majority of the cases were noted in the extremities. Leiomyosarcoma was the most common type, in our study. Lipomas were the most common benign soft tissue tumours, and majority of the benign tumours were located in the trunk.
Estimation of interleukin-17 levels in gingival crevicular fluid from healthy individuals, chronic gingivitis and chronic periodontitis patients using enzyme linked immunosorbent assay
Authors: Nainee Neha , Sanikop Sheetal , Jha Abhilasha
Published: September 2020

Background: Chronic Periodontitis (CP) is an infectious disease resulting in inflammation of supporting tissues of the teeth. A number of pro-inflammatory cytokines are formed against periodontopathogenic microorganisms. Interleukin-17 (IL-17) is a pro-inflammatory cytokine, implicated in numerous inflammatory and autoimmune conditions.Methods: A total of 25 periodontally healthy subjects (Group 1), 25 patients with gingivitis (Group 2) and 25 patients with CP (Group 3) were included for the study based on clinical examination. Gingival index, probing pocket depth and clinical attachment loss were recorded in all subjects.Results: The levels of IL-17 increased from healthy to gingivitis to periodontitis patients. A positive correlation was found with the IL-17 and the clinical parameters like gingival index, probing pocket depth and clinical attachment loss.Conclusions: There is a strong association between the levels of IL-17 with periodontal disease as well as with its severity and its possible use as a biomarker for inflammatory periodontal disease.