bluuebunny/crossref_metadata_2025 huggingface dataset:
COVID-19 infection during pregnancy - maternal and perinatal outcomes: a tertiary care centre study
Authors: Hassan Nazia , Muzamil Mudasir , Banday Dawood
Published: August 2020

Background: With the exponential increase in the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2/COVID-19) worldwide, an increasing proportion of pregnant women are now infected during their pregnancy. The knowledge gained from previous human coronavirus outbreaks suggests that pregnant women and their fetuses are particularly susceptible to poor outcomes. The aim of this study was to summarize the maternal and perinatal outcomes of pregnant women infected with COVID-19 during their pregnancy.Methods: Eligibility criteria included pregnant women positive for COVID-19 as detected by real-time polymerase chain reaction (PCR) or dual fluorescence PCR-confirmed SARS-CoV-2 infection.Results: A total of 38 pregnant women positive for COVID-19 as confirmed by RT-PCR, were included in the study. 21% cases had preterm deliveries and LSCS was the preferred mode of delivery in 23 of 38 i.e., 60.5% cases. There was a tendency for low Apgar score at birth, higher rates of fetal distress, meconium, NICU admissions. There was one IUD and one neonatal death. The treatment patterns of COVID-19 infection among pregnant women during their pregnancy or following delivery was mostly supportive in the form of oxygen and antibiotic therapy.Conclusions: Although the majority of mothers were discharged without any major complications, severe maternal morbidity as a result of COVID-19 and perinatal deaths were reported. Vertical transmission of the COVID-19 could not be ruled out. Pregnant infected women had different symptoms, and they were given mostly supportive treatments than the general infected population. Careful monitoring of pregnancies with COVID-19 and measures to prevent neonatal infection are warranted.
Effectiveness of folic acid in unexplained infertility
Authors: Jadhav Sujata Narendra , Pitale Devdatt Laxman
Published: August 2020

Background: Folic acid is commonly used by infertile women worldwide. However, studies on the effect of folic acid in women with unexplained infertility are lacking. This aim of this study was to evaluate the effectiveness of folic acid in women with unexplained infertility.Methods: This prospective multicentric study was performed from June 2019 to July 2020 in women with unexplained infertility attending the fertility clinic. In this study, 50 women with unexplained infertility who satisfied the inclusion and exclusion criteria were started on folic acid therapy. The effectiveness of therapy was evaluated on the basis of successful conception and adverse effects if any.Results: Folic acid therapy showed a marked improvement in infertility status measured in terms of successful conception. After initial 12 weeks therapy successful conception was achieved in 40 (80%) women without any adverse effects.Conclusions: Folic acid supplementation has a positive effect on pregnancy outcome in women with unexplained infertility without any adverse effects. Folic acid is thus a safe and cost-effective option in women with unexplained infertility.
Fetomaternal outcome in women with hemolysis, elevated liver enzymes and low platelet count syndrome: a retrospective study
Authors: Divya M. B. , Kondakasseril Nishi Roshini , Andrews Mekkattukunnel Andrews
Published: August 2020

Background: HELLP (hemolysis, elevated liver enzymes and low platelet count) syndrome which is a variant form of severe preeclampsia is an important cause of maternal and fetal mortality and morbidity. The importance lies in the early diagnosis and timely intervention for better fetal and maternal outcome. The objective of this study was to assess the maternal and fetal outcome in pregnancies complicated with HELLP syndrome.Methods: This is a retrospective study analyzing fetomaternal outcome in 63 women diagnosed with HELLP syndrome in the department of obstetrics and gynecology, Government Medical College, Thrissur from 1st January 2014 to 31st December 2016. Details were collected from data records library.Results: Among 7,566 deliveries, 63 women (0.83%) had HELLP syndrome. Mean age was 29.5 years. 47.6% (n=30) women developed HELLP syndrome at gestational age less than 34 weeks. Maternal complications were abruption (27.78%), acute kidney injury (16.67%), DIC (16.67%), sepsis (11.11%) and postpartum hemorrhage (11.11%). In this study, HELLP syndrome lead to one maternal death (1.58%). The perinatal mortality was 25.75%.Conclusions: HELLP syndrome is an alarming complication, which brings high maternal and perinatal morbidity and mortality.
Role of risk of malignancy index 4 in evaluation of adnexal masses
Authors: Kaur Amarjeet , Sharma Sujata , Singh Sohan
Published: August 2020

Background: The discrimination between benign and malignant adnexal masses is important for clinical management and surgical planning in such patients. Various combined methods of evaluation adnexal mass have also been proposed. Risk of malignancy index (RMI) is a combined parameter which is simple, preclinical and highly sensitive, and more specific. Risk of malignancy index 4 (RMI 4) is calculated as a product of ultrasound score (U)×menopausal score (M)×CA 125×tumor size. Objective of this study was to determine if the RMI (RMI 4) can distinguish between benign and malignant adnexal masses.Methods: A prospective study was conducted on 30 women with an adnexal mass presenting in the OPD and emergency and RMI-4 calculated. Cut off level of 450 was set to differentiate between benign and malignant mass.Results: In this study, the value of RMI-4 is less than 450 in 17 patients with benign disease and 3 patients with malignant disease. The value is more than 450 in 2 patients with benign disease and 8 patients with malignant disease. RMI-4 >450 had a sensitivity of 72.73% and specificity is 89.47%. The positive predictive value is 80% and negative predictive value is 85%. The p-value for RMI-4 in this study is 0.001 which is highly significant.Conclusions: RMI is a reliable, simple, easy to use and cost-effective method in differentiating benign from malignant adnexal masses.
Prenatal diagnosis of congenital high airway obstruction syndrome: our experience from a tertiary care center
Authors: Saxena Deepti , Phadke Shubha R.
Published: August 2020

Congenital high airway obstruction syndrome (CHAOS) is an extremely rare and life-threatening condition. It occurs due to obstruction in fetal respiratory tract and is characterized by typical ultrasonographic findings. Risk of recurrence is low, so antenatal diagnosis can help in counselling regarding risk of recurrence. A retrospective record review of all cases referred to our institution for antenatal ultrasound over a period of 5 years from January, 2014 to December, 2018 was done. Cases diagnosed as CHAOS were reviewed in detail regarding the radiological findings, information regarding delivery, fetal karyotype and postnatal/ fetal examination. Between the period of 2014 to 2018 three fetuses with CHAOS were identified. All of them had characteristic radiological features. Two of them were associated with hydrops and one fetus had oligohydramnios. All the pregnancies were terminated after antenatal diagnosis. Amniocentesis was done in 2 out of 3 cases and fetal karyotype was found to be normal. Fetal autopsy was done in one case and site of upper airway obstruction was identified. Confirmation of diagnosis by antenatal ultrasound and if possible, by post-mortem examination is essential for providing estimation of risk of recurrence to the family and genetic counselling.
Case series on obstetrical outcomes in patient with uterine malformations
Authors: Solanki Kirti , Kochar Swati , Poonia Laxmi
Published: August 2020

Congenital uterine anomalies occur due to abnormal fusion of mullerian duct during embryonic life. It is associated with high incidences of reproductive failures and adverse obstetrical outcomes. It may be associated with malpresentation, preterm labour, or recurrent pregnancy losses. Authors report a case series of 7 patients which were admitted in obstetrics and gynaecology department of SP medical college and associated group of hospitals between time period of March 2019 to July 2019. Among 7 cases 6 cases were associated with malpresentation, 1 with abortion, and 1 with preterm labour. This series shows that uterine anomalies are associated with different obstetrical outcomes varying from totally uneventful antenatal and postnatal period to abortion or preterm labour. Prenatal diagnosis of uterine anomaly may help in improving the obstetrical outcome in these patients.
Rare case: enucleation of multiple fibroids after intraoperative vaginal sonographic detection of the solitary pelvic kidney by patient with Mayer-Rokitansky-Kuster-Hauser syndrome
Authors: Piriyev Elvin , Romer Thomas
Published: August 2020

Mayer-Rokitansky-Kuster-Hauser syndrome (MRKH) is a congenital anomaly of the genital tract that occurs in about 1 in 4000 women. MRKH syndrome can be associated with renal, skeletal, heart and hearing abnormalities. The frequency of renal/urinary tract abnormalities is 33%. Only a few cases of fibroid development in MRKH syndrome have been described in the literature. The diagnosis and surgery of a fibroid in MRKH syndrome may be complicated in associated kidney abnormality by an atypical kidney position, as in this case: pelvic kidney on one side and renal agenesia on the contralateral side. Authors present the case of a 47-year-old female patient with a known MRKH syndrome and a pelvic kidney on the right side who had presented with an unclear tumour in the right lower abdomen. A completed CT scan revealed the tumour directly next to the pelvic kidney. A malignancy could not be excluded with certainty, so that a laparoscopy in laparotomy readiness was indicated and performed. During surgery, two rudimentary uterine horns were found; on the right side retroperitoneally, below the uterine horn, the tumour was located and directly below it there was a soft tissue alteration, probably the kidney. For safety, a vaginal sonography was performed in between, to clearly identify the only kidney and to avoid damaging it. The tumour could be extirpated laparoscopically without kidney injury. The two uterine horns were removed simultaneously. Histologically the fibroid could be confirmed. In addition, three other fibroids (one on the left side and two on the right side) were detected. Due to the high probability of a simultaneous kidney abnormality in the MRKH syndrome, authors suggest an accurate kidney diagnosis preoperatively. If necessary, in the case of a pelvic kidney and/or renal agenesia, as in this case, an additional intraoperative kidney check should be performed.
A case of placental chorioangioma
Authors: Vasanthi D. , Nagashree U. , Sundaram Sreepriya
Published: August 2020

Chorioangioma is a benign tumor of placenta, incidence being 1 in 100 cases. It is mostly diagnosed ultrasonically in the second trimester of pregnancy. Large chorioangiomas render a challenge to obstetricians due to the foeto maternal complications and adverse outcomes. Here by authors present a case report of large chorioangioma with no fetomaternal complications but just for awareness of the importance of early diagnosis and to look out for possible adverse effects on mother and foetus.
Effect of vitamin C inhibiting liver fibrosis and lipid peroxidation in biliary obstruction of Wistar rats
Authors: . Widhitomo , Usman Nurhayat , Rudiman Reno
Published: August 2020

Background: The aim of this study was to evaluate the potential inhibiting effects of vitamin C as an antioxidant against liver fibrosis and lipid peroxidation in the bile duct ligation- induced biliary obstruction of Wistar rats.Methods: A total of 25 male Wistar albino rats were divided into five groups: sham operated, control (bile duct ligation/BDL) without given vitamin C, BDL with vitamin C 75 mg, BDL with vitamin C 150 mg, and BDL with vitamin C 225 mg. Each group contained 5 animals. Vitamin C was given orally on day 3 after operation and after 14 days following vitamin C administration, all animals were performed laparotomy to obtain liver tissue samples for histopathological investigation of liver fibrosis and blood samples for malondialdehyde (MDA) as lipid peroxidation measurement.Results: The changes demonstrating hepatic fibrosis including moderate to markedly thickened wall of central veins, localized to diffuse perisinusoidal fibrosis, enlarged portal track, increased number of septa, and thickened width of septa were observed in BDL groups. MDA measurement were also observed in all groups. Treatment of biliary obstruction in BDL groups with vitamin C given orally attenuated liver damage. Both the MDA measurement and histopathologic investigation of hepatic fibrosis were observed to be reduced with the vitamin C treatment.Conclusions: Our data indicate that vitamin C inhibited liver fibrosis and lipid peroxidation in bile duct ligation-induced biliary obstruction of Wistar rats.
Clinico-pathological study of locally advanced breast cancer and their hormone receptor analysis
Authors: Jain Sanjay , M. Guka Priyan K. , Songara M. C.
Published: August 2020

Background: Breast carcinoma is one of the most common malignant tumor of women. Determination of estrogen receptors (ER) and progesterone receptors (PR) status, prior to therapeutic intervention has become standard practice. Survival and response to hormone therapy are most favorable among women who are receptor positive. The aim of this study is to assess the hormone receptor status in locally advanced breast carcinomas and correlate this reactivity pattern with tumor stage, clinical stage and lymph node metastasis. Objective of the study was to co-relate the locally advanced breast cancer and their hormone receptor analysis.Methods: Patients who visited Department of General Surgery, Hamidia Hospital, Bhopal were assessed clinically, radiologically and histopathologically and then ER and PR study was done, for a total of 50 cases were done.Results: In our study majority of the cases were locally advanced breast cancer (50%) which may be due to the low socio economic status, late presentation, pain tolerance, illiteracy and availability of the resources. Majority of cases were in postmenopausal, clinical stage 3 and histological grade 2. ER positivity 50% and PR positivity 44% and it was found that hormone receptor positivity was high in locally advanced breast cancers 63.5%.Conclusions: Hormone receptor analysis should be an integral part of initial workup of carcinoma breast, as the percentage of hormone receptor positivity is increasing in our population in locally advanced breast cancer. So locally advanced breast cancer can be diagnosed at an early stage by screening and conducting breast awareness programs.
A study of incidence of inguinodynia in inguinal hernias repair at a tertiary center
Authors: Prasad Dinesh , Patel Yash
Published: August 2020

Background: Chronic groin pain (inguinodynia) following inguinal hernia repair is a significant, though under-reported problem. Mild pain lasting for a few days is common following mesh inguinal hernia repair. However, moderate to severe pain persisting more than 3 months after inguinal herniorrhaphy should be considered as pathological. The main aim of this study was to assess the incidence of inguinodynia in inguinal hernia repair patients at a tertiary centre.Methods: This non-randomized retrospective study was undertaken in the department of general surgery, SMIMER Hospital, Surat, Gujarat, India from August 2016 to July 2019. Total 940 patients were operated for inguinal hernia repair during this period. Out of these 940 patients, only 460 patients could be traced for clinical evaluation as Surat is an industrial city with very high percentage of migrant population and so only, they were included in the study.Results: In this study, total 460 patients were included, in which 310 patients were operated for open inguinal hernia repair and 150 patients were operated for laparoscopic hernia repair. Total 102 (22.17%) patients has developed inguinodynia out of 460 patients evaluated in this series. Incidence of inguinodynia is more in open inguinal hernia repair than laparoscopic inguinal hernia repair i.e., 24.83% versus 16.67%. Incidence of testicular complication in inguinodynia patients is more in open inguinal hernia repair and non in laparoscopic repair.Conclusions: Authors conclude that overall incidence of inguinodynia is 22.17% and incidence of inguinodynia is higher in open hernia repair in comparison to laparoscopic hernia repair (24.83% versus 16.67%). The incidence of mild inguinodynia is approximately eight times more common than severe inguinodynia.
Prevalence of Helicobacter pylori infection in dyspeptic patients undergoing upper gastrointestinal endoscopy in a tertiary-care teaching hospital
Authors: Ganesh Pranav , Ramakrishnan Ramya , Sundaram Sandhya
Published: August 2020

Background: Helicobacter pylori infection is widely prevalent in the world especially in the developing countries. The common clinical presentation of this disease includes peptic and duodenal ulcer. A major post-infection complication of this disease is gastric carcinoma. The scope of this study was to determine the prevalence of active H. pylori infection in the local population by retrospective review of patient records, which can give a better picture of the current situation and estimate the at-risk population of gastric carcinoma. Objective of the study was to determine the prevalence of H. pylori infection in biopsy specimens obtained from upper gastrointestinal endoscopy performed in dyspeptic patients in a tertiary-care hospital.Methods: The study was performed as a retrospective review of biopsy reports of 262 dyspeptic patients with previously unknown H. pylori status who underwent upper gastrointestinal endoscopy during the months of January 2018 to May 2018. Biopsy obtained from stomach was evaluated for the presence of H. pylori infection by Rapid Urease Test (RUT) or histopathological examination.Results: The prevalence of H. pylori infection in dyspeptic patients obtained from the above study was 44.7% and was found to be more common in males compared to females.Conclusions: H. pylori is a risk factor for gastric carcinoma. Determining the prevalence with early identification of active infections results in better treatment and post infection monitoring for malignancy.
In search of ideal donor site wound dressings
Authors: Sharma Dev Jyoti , Mishra Bharat , Arora Chetna
Published: August 2020

Background: Split skin grafting (SSG) is a commonly used reconstructive technique for wound cover. Donor site wounds (DSW) after split-skin graft harvesting are rather clean wounds. Depending on the thickness of the SSG, the DSW should re-epithelialize completely in 7 to 21 days. This study was initiated with a background to look for an ideal dressing for the management of DSW. Aim of the study was to compare efficacy of Cellulose acetate mesh, Collagen sheet, Hydrocolloid dressings and chlorhexidine tulle for donor site wound management after harvesting split thickness skin graft.Methods: 100 patients with 100 donor site wounds were included in the study. Patients were randomized into four different groups of 25 each, depending upon the type of dressings used to cover the wound. Data regarding time to complete wound healing and pain at the donor site were recorded on visual analogue scale (VAS). Requirement of pain killers during post-operative period were recorded. Complications like infection or hyper-granulation were also recorded.Results: The study included 72 males and 28 females. The primary objective was to observe the effectiveness of wound dressings in the treatment of DSWs and time to complete wound healing. In this context, collagen dressing was found to be the most effective in current study (p<0.07) and also the least pain was experienced by the patients where collagen dressings were used.Conclusions: The study concluded that collagen dressings was best amongst the various dressings studied with average healing time of 9 days with least pain score over DSW.
A comparative clinical evaluation of outcome of medical and surgical management of symptoms due to benign prostatic hyperplasia
Authors: Gnana Bhushan Kumar , Matlapudi Sanjeeva Rao
Published: August 2020

Background: Benign hypertrophy of prostate is common disorder and benign neoplasm of man above 50 years of age. Around 30% patients with benign hypertrophy of prostate lower urinary tract symptoms (LUTS) but all symptoms may not be due to benign hypertrophy of prostate (BHP). Present study has been designed for comparative evaluation of the outcome of medical and surgical management of symptoms, due to benign prostatic hyperplasia by using IPSS (international prostate score) and quality of life score as tool.Methods: In present study patients with LUTS, clinically diagnosed by per rectal digital examination and transrectal ultrasonographically confirmed cases of enlargement of prostate are enrolled for this study. Patients enrolled were divided equally in three groups.Results: After six month the mean IPSS score in silodosin (Sd) group was 6.55±0.86 and in Sd+Dutasteride (Dt) group it was 5.09±1.12. After six months mean IPSS score in Sd+Dt group was 5.09±1.12 and in TURP group it was 2.44±0.59.Conclusions:  Single drug treatment with silodosin is associated with slow and less improvement in IPSS score in comparison with silodosin and dutasteride. But the response to TURP was better and faster than medical management.
Supraclavicular artery flaps for head and neck reconstruction: a prospective study
Authors: Mahipathy Surya Rao Rao Venkata , Durairaj Alagar Raja , Sundaramurthy Narayanamurthy , Jayachandiran Anand Prasath
Published: August 2020

Reconstruction of defects of the head and neck remains a challenge to the reconstructive surgeon. This is due to the complex anatomy of the region as well as the age and comorbidities of the patients, which prevent the use of free tissue transfer as the primary tool of reconstruction. The supraclavicular artery (SCA) island flap is a well vascularised tissue and provides a thin and pliable skin for cutaneous and mucosal defects of the head and neck region. Here, we had done this flap for eight patients with no major complications and hence, we concur that it is a safe, reliable and versatile reconstructive option for these defects. The study period was from January 2015 to June 2016 where we operated on 8 patients, 5 for post burn contracture neck and 3 for post oncologic resection. The flap was used as a pedicled fascio-cutaneous and was based on the transverse supraclavicular artery. Eight cases underwent supraclavicular artery flap of which 5 were males and 3 females. Mean defect size was 15×10 cm. All the donor sites were closed with a split skin graft. One patient had distal necrosis which was managed with debridement and secondary suturing. The supraclavicular artery flap is a thin, versatile, reliable and easy to harvest flap for reconstructing head and neck defects, with good cosmetic and functional outcome.
Acute pancreatitis and relative polycythaemia: a case series
Authors: Modi Shraddha , Subbarayan Boopathi , Subbaraj Saravanakumar , Tirougnanassmbandamourty Tirouaroul , Smile S. Robinson
Published: August 2020

Relative polycythaemia is an apparent rise in erythrocyte level in the blood. However, the underlying cause is reduced blood plasma. Relative polycythaemia is often caused by loss of body fluids seen in conditions such as burns, dehydration and stress manifesting itself as a raised Haemoglobin or haematocrit. This case series presents a clinical summary of three patients with acute pancreatitis (AP) and relative polycythaemia due to reduction in plasma volume as a result of intravascular volume depletion as demonstrated by increase in haemoglobin and haematocrit.  Haem concentration may be considered as a marker for acute severe pancreatitis and correcting the volume depletion by adequate fluid improves the outcome of AP as seen in all our three patients.
A vesico-peritoneal fistula in a patient with history of diverticulitis-related colovesical fistula repair: a case report
Authors: Garza Alberto Riojas , De Elguea Lizárraga José Ignacio Ortiz , Müller Giovanna Arteaga , Orozco Saldivar Miguel A. , Salgado Cruz Luis E.
Published: August 2020

A vesico-peritoneal fistula is an epithelialized communication between the peritoneal cavity and the urinary bladder. It is a rare entity scarcely reported in medical literature. High index of suspicion is needed for diagnosis and treatment. Here we expose the case of a vesico-peritoneal fistula presenting with chronic abdominal pain 4 years after sigmoidectomy. A 38-year-old male presented with lower quadrant abdominal pain. He had history of sigmoidectomy with colorectal anastomosis and bladder repair due to diverticular disease-related colovesical fistula 5 years prior to admission. Elevated serum creatinine levels and oliguria were documented. Intraperitoneal free fluid was found by computed tomography (CT) scan. Percutaneous drainage was performed, and laboratory test showed elevated peritoneal creatinine levels. CT-Cystography revealed a vesico-peritoneal fistula. Dissection of fistulous tract and primary closure of bladder defect was achieved. Vesico-peritoneal fistulas have been described as surgical procedure complications with a variable postoperative time of presentation. Low index of suspicion led to delayed diagnosis, finally suspected by intraperitoneal fluid analysis and confirmed by cystography. Intraperitoneal reabsorption of urine elevated serum creatinine levels mimicking renal failure. Management ranges from conservative to surgical procedures, in this case fistulous tract dissection and primary bladder closure was accomplished. Vesico-peritoneal fistulas are rarely reported. Common clinical findings include chronic abdominal pain and free intraperitoneal fluid. Misdiagnosis of acute renal failure is frequent due to elevated serum creatinine levels and oliguria.  Laparoscopic dissection of fistulous tract and primary closure of bladder defect is a safe option as treatment of this condition.
Splenic cystic lymphangioma in adult: a case observed in the Visceral Surgery Department II of Mohamed V Military Hospital
Authors: Rebbani Mohammed , El Brahmi Yasser , El Mouhafid Failsal , Ait Ali Abdelmounaim , Zentar Aziz
Published: August 2020

Cyctic lymphangioma is a primary benign tumor due to congenital malformations of the lymphatic vessels. It is more often seen in pediatric patients and the usual site for lymphangioma is the cervical and axillary region. However, it is exceptionally seen in adults and involving rarely the spleen. The discovery of the splenic lymphangioma is generally accidental during imaging performed for another pathology. Indeed, being most often asymptomatic, the clinical presentation of cystic lymphangioma is polymorphic and it is related generally to mass effects. In this paper, we report the case of a 43 years old patient in whom the discovery was fortuitous during imaging for a non-specific symptomatology. The physical examination was normal and magnetic resonance imaging strongly evoked the diagnosis of cystic lymphangioma. A total splenectomy was performed and the histological examination has confirmed the positive diagnosis of splenic lymphangioma. Finally, this case confirmes that the diagnostic of splenic lymphangioma should be evoked in front of splenic cystic lesions and the confirmation and the differential diagnosis are made by histopathology and immunohistochemistry studies.
Primary renal lymphoma: a rare cause of renal mass in pediatric age group: case report and review of literature
Authors: Thakur Karishma , Wadhwani Sonam , Ghodawat Meha , Prakash Advait , Khare Abhinav , Khaitan Aditya , Singh Sangram , Malhotra Anuj
Published: August 2020

The secondary renal involvement of non-Hodgkin lymphoma is frequently encountered but primary renal lymphoma is extremely rare in children. We hereby present a rare case of primary renal diffuse lymphoma in a 3-year-old girl child who presented with bilateral renal masses.  The tumour was initially diagnosed as bilateral Wilms’ tumour but on biopsy, it turned out to be non-Hodgkin's lymphoma. Primary renal lymphoma is an aggressive tumour with guarded prognosis. There are a variety of diseases which present as renal masses in children amongst which primary renal lymphoma is extremely rare. This article describes the clinical features and diagnostic features of primary renal lymphoma. Our report highlights the importance of keeping this neoplastic condition under consideration while evaluating children with renal mass .In order to distinguish primary renal lymphoma from other renal tumours, the authors have also described the clinical, imaging and pathological features of various other renal tumours prevalent in children.
Transoral endoscopic excision of cystic hygroma vestibular approach in adult (novel approach): a case report
Authors: Gajbhiye Raj N. , Kharkate Ganesh K. , Tirpude Vidhey S.
Published: August 2020

Lymphangioma, soft tissue tumor was originally reported by R. Backer in 1828 and “cystic hygroma” name was first given by Wernker in 1834. It can occur in the head, neck, axilla, cervico-facial regions and below tongue. Although it is well recognized in children, it may present in adulthood. Cystic hygroma neck is traditionally removed via an overlying incision near or over the swelling. The resultant scar can be displeasing to an adult. Various endoscopic approach present in literature for excision are via neck, anterior chest, combined or robotic assisted. We here, are reporting transoral endoscope excision of cystic hygroma via vestibular approach. A 51 year old female with swelling over anterior aspect of neck, trans-illumination positive, diagnosis confirmed on CT neck, of size ~4×4 cm was our case. We decided for transoral endoscopic vestibular approach for excision, first of its kind with no assisted approach. Patient discharged after 3 post-operative days (PODs). There was mild seroma which resolved within a week. Transoral endoscopic excision of cystic hygroma via vestibular approach without any assisted approach can be applied in adult. Various approach present in literature for excision of cystic hygroma are via neck, anterior chest or combined or robotic assisted. Hence this approach can be an excellent choice for adult cystic hygroma patients who desire to avoid a neck incision. Transoral endoscopic excision of cystic hygroma via vestibular approach was successfully performed. Patient was satisfied with good cosmosis. It results in good cosmesis and better dissection. Hence can be a new method of excision of cystic hygroma in adult.
Acute intestinal obstruction due to gastrointestinal stromal tumours: case report
Authors: Newme Kewithinwangbo , Khongwar Donkupar , Hajong Ranendra , Raphel Vandana
Published: August 2020

Gastrointestinal stromal tumours (GIST) as such is a rare disease, but according to some study it may end up to malignant type in approximately 10-30%. Herein we present a 2 cases of GIST who presented with acute intestinal obstruction in emergency department. In imaging studies (X-ray erect abdomen, ultrasonography abdomen), it showed a features of intestinal obstruction but could not rule out the exact mechanism or pathology behind the obstruction. As commonly adhesions is a main culprit behind the cause of acute intestinal obstruction in case of any post-operative patient. So, we try to highlight that in case of any old aged individual and in virgin abdomen GIST should be keep in mind as a cause of intestinal obstruction.
Synchronous malignancy of stomach and kidney: an unusual combination: a case report
Authors: Chaturvedi Shruti , Subbarayan Boopathi , Subbaraj Saravanakumar , Tirougnanassambandamourty Tirou Aroul , Smile Samuel Robinson
Published: August 2020

Synchronous occurrence of primary gastric cancer with primary renal cell carcinoma (RCC) is exceedingly rare. We report a case of a 70 years old gentleman who presented with a history of epigastric fullness and tarry stools from 1 month, along with significant weight loss which he was unable to quantify. Esophagogastroduodenoscopy showed ulceroproliferative growth in the antropyloric region of stomach causing complete outlet obstruction. Histopathology revealed poorly differentiated mucinous adenocarcinoma. Contrast enhanced computed tomography (CECT) abdomen showed an asymmetrical circumferential growth in the antropyloric region leading to obstruction. A heterogeneously enhancing hypervascular mass was also visualized over the lower pole of left kidney with an initial impression of metastasis. A concomitant radical subtotal gastrectomy and radical left nephrectomy was performed. Pathological examination confirmed gastric adenocarcinoma (T4a) and renal cell carcinoma-RCC (T3a). Most of the operable synchronously occurring second primary malignancy (SPM) can be resected in a single stage.
Acute appendicitis in adults
Authors: Vagholkar Ketan
Published: August 2020

Acute appendicitis is one of the commonest abdominal emergency encountered by a general surgeon. Understanding the surgical pathology is pivotal in identifying the stage of disease at which the patient presents for better correlation of clinical features, laboratory and imaging reports. Various scoring systems enhance and aid this process. Imaging confirms the diagnosis. Early diagnosis is essential to prevent complications. Surgery is the mainstay of treatment. Appendicitis may present in various forms in different clinical settings. A uniform approach to presentations may not always yield good results. Though appendectomy is the mainstay of treatment yet a tailor made surgical plan needs to be developed after holistic evaluation of the patient. The article discusses the differential surgical approach based on the etiopathogenesis, diagnosis and variable clinical presentations.
Comparison of depression among medical and dental students of Qassim University 2019
Authors: Alsumaani Anas Saleh , Sekhar K. Chandra
Published: August 2020

Background: Prevalence of depression enormously increasing throughout the world including developing and developed world. Especially in case of medical and dental students, after completion of schooling, will enter into University level and there will be different exposure, syllabus load and scientific terminology and adjustment to the surroundings leads to become depressive nature. Objective was to estimate the prevalence of depression, demographic variables and risk factors association with depression among medical and dental students of Qassim university.Methods: A cross sectional study was conducted March 2019 to June 2020 among the medical and dental students of Qassim University. A total of 235 sample collected through Google forms due to COVID-19 pandemic situation. Data entered in Statistical package for social sciences, 21.0 version and necessary statistical tests were applied.Results: In the present study about 235 study participants, of which 174 medical and 61 dental students participated. Among the 174 medical students, about 62.1% were males and among the 61 dental students, about 39.3% were males. Prevalence of depression among medical students and dental students was 82.90% and 86.90% respectively. Socioeconomic status was significantly associated with depression in both the groups’ medical and dental students.Conclusions: High prevalence of depression was noticed in medical and dental students. Need to strengthen the supportive health programs to the medical and dental students to be arranged and will indirectly reduce the stress among the students.
The effect of meditation and murotal hearing combination therapy on reduction of stress and blood pressure in hypertension
Authors: Haryono Rudi , . Taukhit , . Suyamto
Published: August 2020

Background:World Health Organization(WHO) in 2012 showed that 26.4% of people suffer from hypertension. One of the things that affects blood pressure is stress. Blood pressure can be lowered by reducing stress levels. Nonpharmacological efforts to reduce stress are relaxation techniques, including meditation and murotal hearing. The purpose of this study was to determine the effect of a combination of meditation and murotal hearing on stress levels and blood pressure of hypertension sufferers.Methods: This study used a quasi-experimental design in the form of pretest - posttest intervention with control group. A sample of 30 respondents was divided into 15 intervention groups and 15 control groups. The intervention group received meditation and murotal hearing and antihypertensive therapy for 3 consecutive days while the control group only received antihypertensive therapy. The analysis uses paired t-test to determine the effect of the intervention on the intervention group and the independent t-test to see differences between influences between groups.Results: Meditation and murotal hearing significantly reduced stress scores by p=0, also significant in decreasing systolic blood pressure with p=0.008 and not significant in decreasing diastolic blood pressure with p=0.206. In the different test between intervention and control groups showed that a significant difference was found in the reduction in stress levels with a value of p=0.002.Conclusions:The combination of meditation and murotal hearing significantly reduces stress and systolic blood pressure. As for diastolic blood pressure, this combination therapy can decrease but not statistically significant.
Incidence of dengue in the Islands
Authors: Rao Shivani , Sethuraman Ajay Raj , Thatkar Pandurang Vithal
Published: August 2020

Background: Dengue is transmitted mainly by bite of Aedes mosquito namely Aedes aegypti and Aedes albopictus posing major public health concern. The objective of the study is to study incidence of dengue in Andaman and Nicobar Islands.Methods: Prospective study from January 2012 to December 2018 from all primary, community and tertiary health centres of Andaman and Nicobar Islands.Results: Out of a total of 5255 blood samples tested from 2012 to 2018 the total dengue positive cases were 525 (9.99%).Conclusions: There has been gradual increase in number of dengue cases from 2012 to 2016 thereafter there has been reduction of cases.
Undergraduate nursing students’ attitude towards online classes during lockdown period in India: imposed or interested?
Authors: Gaur Rakhi , Mudgal Shiv Kumar , Kaur Simarjeet , Sharma Ravikant
Published: August 2020

Background: Online classes were never been a part of regular habit in India. But due to corona pandemic every institute is offering online classes whether medical or nursing institutes. Aim was to ascertain the attitude towards online classes among undergraduate nursing students during lockdown period.Methods: This cross-sectional descriptive survey was conducted on 394 undergraduate nursing students in which samples were chosen through convenient sampling technique. A valid and reliable self-structured questionnaire based on 5 point Likert scale was used to ascertain the attitude of undergraduate nursing students towards online classes and data were analysed using descriptive and inferential statistics in SPSS version 23.Results: More than two-third (76%) participants showed unfavorable attitude towards online classes. There was a significant difference between age, residence, father and mother education with participants’ year of study (p<0.05). Overall mean score for attitude towards online classes was 73.37 (SD±23.52) and there was no significant difference between overall attitude score with participants’ year of study. Only one subscale (interest to computer and intention to adopt component) had significant difference (p=0.011) among participants. There was significant association found among gender, mother education and family income with their year of study (p<0.05).Conclusions: Online classes may have lots of advantages over traditional classes yet it does not seem to be of much interest among undergraduate nursing students in India and they are not willing to consider it on a regular basis. Policy makers should find the way to make online classes more interesting.
Assessment of iodine deficiency disorder among school going children aged 5-10 years in Sagar district of Madhya Pradesh: an observational cross sectional study
Authors: Jain Arpita , Verma Shipra , Toppo Manju , Nair Akhil R.
Published: August 2020

Background: Iodine deficiency (IDD) is the world’s most prevalent cause of brain damage. glaciations, flooding, rivers lead to deficiency of iodine in crops grown on iodine. Diet low in iodine can result in stillbirth and abortions and many more sequelae. Objectives of the research work were to study the prevalence of IDD amongst 6-12 years children by clinical examination and to determine the concentration of iodine in salt sample at consumer level. Also, to determine the urinary iodine excretion amongst 6-12 years age group children.Methods: It was a cross sectional study conducted in the government schools of Sagar district among school children of 6-12 years of age. Total 2700 school children from 30 villages were included using PPS sampling. Students were clinically examined and their urine samples were taken for MUIC estimation.Results: Prevalence of goiter was more in 10 to 11 years of age (14.07%) and less in 8 to 9 years age group (7.59%). Overall prevalence of goiter in district Sagar is 10.51%.Conclusions: Despite NIDDCP, there is still dearth of awareness among general public about the usage and storage of iodized salt which is the root cause of Iodine deficiency.
Public perceptions towards air and water pollution in industrial areas of Himachal Pradesh, India
Authors: Barall Deepesh , Mazta Salig R. , . Sunita , Thakur Shashi P. , Jhingta Jyotsna
Published: August 2020

Background: Industrialization carries with it the seeds of environmental damage and has always entailed some serious population health challenges. Reforms initiated seems to be not sufficient. There was a felt need to identify people’s perspective on industrial pollution and its health hazards in the seriously polluted areas of Himachal Pradesh.Methods: We designed a qualitative study on the perceptions of people towards air and water pollution due to the industrial activities. Eight focus group discussions were convened to extract the public opinion.Results: The narratives of participants formed five broad thematic areas. It emerged that they have experienced the change in the climate of the area and relied more on their senses to assess their exposure and in identifying sources of pollution. It was endorsed that industries pollute mainly during the night hours. They were of opinion that the overpopulation due to immigration leading to overcrowding and unhygienic sanitation practices have also contributed adversely to their health. There is a general understanding that industry contribute more to these problems than individual. The level of health awareness needs to be raised through extensive IEC activities.Conclusions: The contribution of the industries to the environmental degradation has been perceived by the people. Multi sectoral approach is the need of the hour with more stringent laws and accurate monitoring mechanism and due importance to the views of the general public should be given in the policies and planning.
Sickness of neonates of recently delivered women and their referral in Uttar Pradesh, India
Authors: Tripathy Tridibesh , Das Shankar
Published: August 2020

Background: The current study done in 2017 explores some of the crucial variables of the type of problems of the newborns as reported by their mothers. The mothers also responded about the type of personnel who referred their newborns. The responses of these mothers or recently delivered women (RDW) (as named for the current study) had a 3 to 6 months old child during the time of survey. They were selected as respondents as they were in a position to recollect the events of their children during their newborn period.Methods: A total of four districts of Uttar Pradesh were selected purposively for the study and the data collection was conducted among the RDWs in the villages of the respective districts with the help of a pre-tested structured interview schedule with both close-ended and open-ended questions. These in-depth interviews were conducted amongst the RDWs and a total 500 respondents participated in the study.Results: The results reflected that more than 97% RDWs reported fever as the problem of their newborn in Banda, Gonda and Barabanki districts except Saharanpur where 82% RDWs reported fever in their newborns. Another major problem of newborn across the 4 districts was ‘unable to take feeds. The results as per the response of the RDWs in all the four districts demonstrated that ASHA was the personnel who referred the maximum number of their newborns.Conclusions: To conclude, fever was the leading cause of health problem as identified by the RDWs and mostly ASHAs referred the majority of the newborns.
Awareness and attitude towards smoking in public places among general population in Guntur city
Authors: Ravoori Srinivas , Yaddanapalli Suresh Chand , Shaik Parveen Sultana , Pavani Nizampatnam P. M. , Kommineni Harsh Chowdary , Velagapudi Dileep
Published: August 2020

Background: This study determined to know the awareness and attitude towards the state prohibition of smoking in public places law.Methods: Descriptive cross-sectional study design. 400 consenting respondents recruited using a convenience sampling method were interviewed using a semi-structured questionnaire covering their smoking pattern, awareness and attitude towards the law of prohibition of smoking in public places in Guntur, Andhra Pradesh State. Data was analysed using descriptive, Chi-square and Pearson correlation.Results: About 95.3% of the participants agreed that they do not encourage smoking in public places and 99% of them supported the proposition that smoking in public places causes problems to others where 53.8% supports ban of tobacco and 92% of participants perceived that implementing laws can prevent smoking in public places. 83% of participants restrict a person smoking in public places and only 3.3% of participants are aware of the act done by the government. 74% of the participants stated that television is the prime source of information that is effective in preventing smoking in public places followed by radio (8.5%) and cinema halls (7.8%).Conclusions: There is poor awareness and attitude towards the law of prohibition of smoking in public places in Guntur. It is necessary to increase sensitization of the general public and enforcement of the COTPA act.