bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of maternal and perinatal morbidity and mortality in eclampsia by early termination of pregnancy
Authors: Mondal Suresh C. , Lahiri Sandip
Published: September 2020

Background: Eclampsia is one of the leading causes of maternal mortality in India.Methods: A prospective observational study was done on 200 pregnant women admitted with antepartum eclampsia in Malda Medical College from 1 April 2017 to 30 October 2019. Group A included patients who delivered through vaginal route within 10 to 12 hrs of eclampsia by stabilisation of patients while Group B included subjects who underwent early caesarean section for uncontrolled convulsions or poor Bishop score. Maternal and perinatal outcomes were compared between the groups. Data was recorded in a pretested performa and was analyzed using appropriate statistical methods with SPSS.Results: Caesarean section (group B) was done in 130 cases (65%) while vaginal delivery (group A) was done in 65 cases (37.5%). Group A had higher maternal mortality (10.7%) in comparison to group B (4.6%) which was statistically not significant (p=0.1075). There were 32 neonatal deaths (24.6%) and 11 still births (8.46%) in group A while there were 12 neonatal deaths (18.46%) and 3 still births (4.61%) in group B. There was a statistically significant difference (p<0.0001) between the groups with respect to total perinatal deaths.Conclusions: Antenatal and intranatal eclampsia should be managed by early termination of pregnancy preferably with Caesarean section. Early presentation and timely decision to terminate pregnancy will improve the maternal and perinatal outcome.
Correlation between peak expiratory flow rate and pectoralis muscle length
Authors: Subramanian Visalakshi H. , Chennakeshawaran Aruna , Kumar Vijay Krishna
Published: September 2020

Background: Peak expiratory flow rate (PEFR) is a measure of the maximum speed of exhalation after a deep inspiration. The peak expiratory flow is measured by a device named peak flow meter. This study concentrates on the correlation of the PEFR with the pectoral muscle length.Methods: It is a cross sectional study of 30 convenient samples based on gender distribution where the PEFR and pectoralis muscle length were measured in the subjects.Results: Statistical analysis shows that there is a significant correlation between right pectoralis major general muscle length and PEFR (p=0.030), left pectoralis major general muscle length and PEFR (p=0.014), right pectoralis major clavicular end muscle length with PEFR (p=0.010).Conclusions: There is a significant correlation between peak expiratory flow and pectoralis muscle length.
Tamoxifen treatment and its outcome in breast cancer patients at a hospital-based cancer registry in Kerala
Authors: Thomas Reema A. , Nisha Catherin
Published: September 2020

Background: Endocrine therapy for breast cancer is directed at reducing oestrogen synthesis or alternatively blocking oestrogen receptors (ER) in tumour-sensitive tumors. Despite side effects, the use of systemic adjuvant therapy after local management of breast cancer substantially improves survival and reduces the risk of relapse. The study objective was to assess the recurrence of breast cancer and the complications seen in breast cancer patients on tamoxifen therapy at a hospital-based cancer registry, Thrissur, Kerala.Methods: After obtaining institutional ethical clearance, included 75 patients of histologically diagnosed breast carcinoma currently on tamoxifen, diagnosed in the year of 2016. Data was obtained from the patient files and by personal intimation.Results: Of the 75 patients on tamoxifen, four (5.33%) patients had history of recurrence. 22.6% of patients on tamoxifen were noted to have increased endometrial thickness. Other side effects noted were weight gain, TIA, bone pain and vaginal discharge.Conclusions: It was found that the recurrence rate at three years for the study population was 5.33%. More studies from developing countries, with larger sample size and clinical trials will give us more accurate information regarding the efficacy of the drug.
The Bethesda system for reporting thyroid cytology: a prospective study in a tertiary care institute along with review of literature
Authors: Bhatnagar Avni , Mardi Kavita , Sood Shivani , Kaushal Vijay , Gupta Kanishk
Published: September 2020

Background: The Bethesda system for reporting thyroid cytology (TSBRTC) was devised by the National Cancer Institute (NCI) to obtain uniformity, reproducibility and a defined management protocol while dealing with thyroid lesions. This study was undertaken with the aim to see the benefits of adopting TBSRTC in the diagnosis of thyroid FNAC, and identify the malignancy risk of each category.Methods: This cross-sectional study was conducted in Indira Gandhi Medical College, Shimla, Himachal Pradesh from June 2016 to July 2017 on 181 thyroid FNACs which were reported according to the Bethesda system for reporting thyroid cytopathology (TBSRTC) under six categories: (I) non-diagnostic/unsatisfactory (II) benign (III) atypia of undetermined significance/follicular lesion of undetermined significance (IV) follicular neoplasm/suspicious for follicular neoplasm (specify if Hurthle cell (oncocytic) type (V) suspicious for malignancy (VI) malignant. Histopathological diagnosis was available for 65 cases where thyroidectomy was performed. Malignancy risk was calculated for each category. Sensitivity, specificity, positive and negative predictive values for TBSRCT were also calculated. All the data was analyzed in SPSS software version 22.0 (IBM, USA).Results: Benign lesions constituted the major bulk. After the use of TBSRTC, there was increased ability to look for follicular neoplasms, improvement in making definitive diagnosis of the cases, an improvement in diagnostic accuracy, and we were in line with the implied risk outlined by TBSRTC in most of the cases.Conclusions: Application of TBSRTC results in uniformity in reporting among pathologists and better interdisciplinary communication and patient management.
Effect of ethanolic extract of Centella asiatica on maximal electroshock seizure in albino mice
Authors: Kannoor Ahmed A. , T. Ramani P.
Published: September 2020

Background: Animal models had always served as integral part in introducing newer drugs for epilepsy. India has long tradition of using herbal medicines. Centella asiatica is an ingredient of various ayurvedic preparations to treat brain related disorders like insanity, memory loss and epilepsy. This research is done to find out the usefulness of Centella asiatica in epilepsy.  Methods: Ethanolic extract of the plant is prepared using Soxhlet apparatus. Experimental seizure is induced in albino mice by maximal electroshock method. Resulting seizure goes through different phases. Duration of the phase of hind limb extension was the measured data. Clinically used anti epileptic drugs can abolish hind limb extension. Effect is compared to that of standard drug phenytoin. Four different doses of the plant extract; 100mg, 200mg, 500mg and 1000mg per kilogram bodyweight was given orally. Statistical analysis of data was done by one way ANOVA and Dunnett test.Results: Ethanolic extract of Centella asiatica exhibited statistically significant protection from maximal electroshock seizures. All given doses of the extract had p<0.05 when compared to control.Conclusions: Centella asiatica is potential source of anti-epileptic drug. Detailed phytochemical studies and animal experiments are recommended.
Barriers encountered during online classes among undergraduate nursing students during COVID-19 pandemic in India
Authors: Gaur Rakhi , Mudgal Shiv Kumar , Dharni Isha Thakur , Sharma Ravikant , Suyal Neha
Published: September 2020

Background: The advents of new technologies are providing a variety of effective learning environment. However, many adult students still prefer traditional, academic settings and do not want to take online or hybrid classes.Methods: Present study included cross sectional descriptive survey design which was carried out on 394 undergraduate nursing students. Convenient sampling technique was chosen for selection of samples. A five-point Likert self-structured scale was used for data collection. Descriptive and inferential statistics were used to analyze the data in SPSS.Results: Study findings showed that there were 209 (53%) female participants. Significant difference (p=0.05) was found among participants’ gender and year of study, area of residence, father education, family income and whether they had ever attended online classes. Lack of control over the group was top perceived barrier with highest score (261 marks). Majority of participants (61%) perceived barriers encountered during online classes. Mann Whitney U test showed the significant differences of participants’ perceived barriers among male and female participants by their age, year of study, fathers’ education and family income (p<0.05).Conclusions: As more students are growing up familiar with internet-based learning, many students were still opposing to go with online classes. Barriers explored in the study can limit the acceptance of online classes among undergraduate nursing students. Higher authorities must find the ways for making online education user friendly.
Hysteroscopy in evaluation of intrauterine causes of abnormal uterine bleeding
Authors: Gandotra Nikita , Sunil Isha , Zargar Shazia
Published: September 2020

Background: Various endometrial pathologies contribute to a large proportion of cases of abnormal uterine bleeding (AUB) during the reproductive years as well as after menopause.Methods: This is a retrospective observational study conducted in department of Obstetrics and Gynaecology at SMGS Hospital, Jammu. 200 patients between 20-70 years age presenting to gynaecology OPD with abnormal uterine bleeding between January 2019 to December 2019 were studied. All patients were subjected to thorough clinical evaluation followed by hysteroscopy. Data collected from medical records, analysed and various intrauterine causes of AUB were studied. Hysteroscopy directed biopsies were taken in the same sitting and sent for histopathology and culture. Results: Mean age of patients in our study was 45 years with majority of patients in 40-50-year age group (69%). Most common symptom reported was menorrhagia (48%) followed by menometrorrhagia (18%) and polymenorrhea (10%). Hysteroscopy detected intrauterine abnormality in 59% cases. Most common being hyperplastic endometrium in 52 patients (26%) followed by polyp (20%). 14 (7%) had sub mucous fibroid, 8 (4%) had atrophic endometrium and 2 (1%) had intrauterine adhesions.Conclusion: Hysteroscopy provides a simple & easy method for visualization of the cervical canal & uterine cavity for the evaluation of AUB. Hysteroscopic pattern recognition is a useful concept to triage women who require sampling for histopathological diagnosis.
Correlation of serum magnesium levels with renal parameters in patients with acute kidney injury
Authors: R. Raveendra K. , R. Avinash H. , Gurav Nitish Ashok
Published: September 2020

Background: Acute kidney injury is a common problem with various causes and consequences like electrolyte disturbances in the form of hypocalcaemia, hypokalemia, hyperkalemia depending on the phase. Hypomagnesaemia is one of the most common electrolyte disturbance found in hospitalized patients especially in the critically ill patients. Prevalence of hypomagnesemia varies from 11 to 65% in different studies. Hence, we decided to conduct a study to evaluate correlation of serum magnesium levels in AKI.Methods: A cross-sectional, hospital based time bound study was conducted between November 2016 and August 2018 with a sample of 100 patients aged 18-65 years and who had AKI were included and patients with diabetes mellitus, multi-organ dysfunction, obstructive uropathy and drug induced AKI were excluded from study. The decrease in magnesium <1.7 mg/L was defined as hypomagnesaemia. AKI was defined as per AKIN criteria. Day 1, day 3 and day 6 magnesium levels were measured.Results: Prevalence of hypomagnesaemia was 53%, 30% and 36% on day 1, day 3 and day 6 respectively. It was observed that there was a positive correlation between serum magnesium, and serum creatinine. Normomagnsemia and hypermagnesemia on day 1, 3 and 6 were significantly associated with recovery of AKI (p<0.001).Conclusions: The prevalence of hypomagnesemia was significantly higher in AKI patients and normal magnesium and hypermagnesium on day 1, 3 and day 6 was associated with recovery than non-recovery. Hypomagnesemia was associated more with non-recovery then recovery.
Meigs syndrome: literature review of a case report
Authors: Acuña Pinzón Camilo Levi , Ugarte Diego Hinojosa , Herevia Aldo Edyair Jimenez , Guerrero Miguel Angel
Published: September 2020

Ovarian cancer is the presence of one or multiple tumors, which appears in one or both ovaries. These tumors are usually classified as epithelial and non-epithelial. Sex cord-stromal tumors are a group of benign and malignant neoplasms that develop from the sexual cord. Many are functional and therefore have hormonal secretions. Meigs syndrome is defined by the presence of pleural effusion and ascites in association with an ovarian tumor. We present a case of a 55 years old patient who was admitted due to a pelvic tumor, exudative pleural effusion that was difficult to manage, and ascites. A benign ovarian stromal tumor associated with elevated Ca 125 was diagnosed. After the management of the effusions, a 20x20x10 cm ovarian tumor resection was performed by laparotomy, and a transoperative report of a thecoma/fibroma type stromal tumor was received. Meigs syndrome occurs in 1% of ovarian tumors, being very rare before the third decade of life, the pathogenesis of ascites and pleural effusion could be related to the imbalance of hydrostatic forces between arterial flow and lymphovenous drainage culminating in a stromal transudate. Treatment of this syndrome should be focused on tumor debulking surgery and symptomatic treatments such as chest tubes and pleurodesis.
Pathological fracture of subtrochanter femur, soft tissue infection along the fracture site, shaft femur bone cortex thickening and blastic lession on contralateral shaft femur due to renal osteodystrophy on the end stage renal disease patient: a case report
Authors: Andika Gde Dedy , Nugraha Gede Ketut Alit Satria , Sunaria I. Made , Astawa Putu , Wiratnaya I Gede Eka , Maharjana Made Agus
Published: September 2020

Renal osteodystrophy (ROD) is a skeletal complication resulting from pathologic alterations in calcium, phosphate, and bone metabolism. The potential link between bone turnover and bone quality is an important question meriting study because of the relatively high incidence of fractures reported. In this case presents a pathological fracture on a routinely hemodialyzed woman. She complained pain on her left subtrochanteric area after low energy trauma accident. A thickening of the shaft femoral bone cortex was also found, reflecting the osteosclerosis event due to imbalance of proliferation and differentiation of osteoblast with increase bone formation. She also had a blastic lesion on her contralateral shaft femoral during the bone survey, but this finding remains asymptomatic. Decreased osteoclastic activity may contribute to cortical thickening, resulting in overall bone mass increase, which may lead to decreased elasticity of the bone or impaired repair capabilities, therefore increasing the risk of fracture. The blastic lesion that occurred on contralateral side may indicated effect of ROD or primary bone lesion. Careful assessment and holistic management of patients with kidney disease is necessary to achieve optimal outcome. The prevention of falls is also an important strategy to prevent pathological fractures. End stage renal disease (ESRD) have reduced bone mineral density, a risk factor for fracture incidence. Careful anamnesis and clinical examination are needed for diagnosis and management.
Subarachnoid haemorrhage mimicking unstable angina: a case report
Authors: Chand Subhash , Chander Subhash , Gargi Gaveshna , Sharma Tarun , Sharma Rittin
Published: September 2020

Subarachnoid haemorrhage (SAH) is medical emergency caused by bleeding into the subarachnoid space. It is caused by rupture of an aneurysm or arteriovenous malformations (AVM). Symptoms of SAH are severe headache, nausea, vomiting, impaired consciousness and seizures. Neck stiffness and neck pain are relatively uncommon. Risk factors are high blood pressure, smoking, family history, alcoholism and even cocaine use. Diagnosis is mainly made by CT scan of head which should be done within six hours of the onset of symptoms and occasionally lumber puncture can also be done. An electrocardiogram (ECG) of all patients with subarachnoid should be done because patient with SAH can have myocardial ischemia due to increased level of circulating catecholamines or due to autonomic stimulation of the brain. ECG changes associated with SAH primarily reflect repolarisation abnormalities involving ST segment, T wave, U wave and QTc interval. Myocardial ischemia or infarction is often suspected in patients with SAH. Even troponin levels may be raised in these patients. However, suspicion of SAH is a contraindication for thrombolytic and anticoagulant therapy. This is a case of SAH which was initially treated for acute coronary syndrome (ACS) on the basis of symptoms and gradually changing ECG findings but on CT Head, patient was having SAH.
Alveolar soft part sarcoma of extremity
Authors: Kaushal Shilpa , Negi Muninder K.
Published: September 2020

Alveolar soft-part sarcoma (ASPS) is an extremely rare connective tissue tumor, predominantly seen in adolescents and young adults, with a female preponderance. Alveolar soft-part sarcoma (ASPS) is a slow growing tumor, but with high likelihood of metastasis, leading to high mortality. A classical histopathological feature of an alveolar pattern from the biopsy of the lesion favors the diagnosis. We report a case of 14 years old male patient who presented with a history of single painless swelling over thigh for which surgical excision was done. Histopathology was suggestive of Alveolar soft-part sarcoma (ASPS). There was no evidence of distant metastases. He was treated with external beam radiotherapy in view of vascular invasion.
Myeloma coexisting with jejunal light chain amyloidosis
Authors: Marimuthu Aishwarya K. , Ramkumar Purnima , Abdulsalam Mohammed S. , Pandurangan Prabu , Jameel Jainudeen Khalander Abdul , Menon Maya
Published: September 2020

Amyloid Light chain (AL) amyloidosis is a rare disease, which is seen in approximately one-tenth of patients with multiple myeloma. We report a 52 years old male, who presented with complaints of anorexia and weight loss. He was diagnosed to have multiple myeloma-international staging score (ISS) Stage 3 and was started on VTD (Bortezomib, Thalidomide, and Dexamethasone) chemotherapy. Within 2 weeks of therapy, he had abdominal symptoms like abdominal pain, loose stools, vomiting and hematochezia. Imaging showed dilated proximal bowel loops with fluid filled contents and prominent vessels in rectum. Emergency surgical exploration revealed thickened proximal jejunum with blood clots in the lumen. Resection of proximal jejunum was done. Histopathological examination of resected specimen was suggestive of AL amyloidosis. Post-surgical resection of jejunum, patient had initial improvement followed by deterioration. He was discharged against medical advice as per relative’s request. Hence an index of clinical suspicion of amyloidosis must been present in all Multiple myeloma patients.
The anti-synthetase syndrome in a type 1 diabetes
Authors: Sajjan Kshithija , Pahuja Anuj , Ponvijaya Yadav , Jeyaseelan Manoj Prakash
Published: September 2020

Anti-synthetase syndrome is an autoimmune disease associated with interstitial lung disease (ILD), dermatomyositis and polymyositis. It has been recognized as an important cause of autoimmune inflammatory myopathy in a subset of patients with dermatomyositis. 37-year-old male, known case of type 1 diabetes mellitus, came with complaints of: generalized anasarca, pain in both knees, ankles, wrist and small joints of fingers. He also had dyspnoea on exertion, chronic non-productive cough, and fever off and on, all for 1 month. Initially all involvement was attributed to diabetes. For joint pain an antinuclear antibodies (ANA) was sent. He turned out to be anti-Jo1, antibody positive. Rash on hands was diagnosed by dermatologist as, mechanic’s hand, hence diagnosed as an inflammatory myopathy with dermatomyositis anti-synthetase syndrome. Patient was successfully treated with immunosuppressants and supportive treatment and responded to tablet Prednisolone and Mycophenolate mofetil. The patient had one major and 2 minor criteria-ILD, arthritis and Mechanic’s hand and anti-Jo 1 antibody positive. Thus, diagnosed as anti-synthetase syndrome with type 1 diabetes mellitus.
Rhabdomyolysis with acute kidney injury after single episode of generalized seizure in a known case of epilepsy: a case report
Authors: Pandey Sudhakar , Borah Nomal C. , Dwivedi Manjari , Das Rup J.
Published: September 2020

Rhabdomyolysis is defined as breakdown of skeletal muscle fibers with subsequent release of its cellular components into the circulation. It is associated with variety of causes and status epilepticus is one of it. The excessive muscular activity associated with seizure is possible explanation for it. It is clinically evident by the new onset severe generalized bodyache, weakness and myalgia associated with dark coloured urine. Acute kidney injury is one of the most serious complications associted with rhabdomyolysis. Single episode of generalized seizure is not a frequent cause for rhabdomyolysis. Acute kidney injury due to rhabdomyolysis, following a single episode of seizure is a rare entity. Here we report a case of rhabdomyolysis with acute kidney injury following a single episode of generalized seizure. High index of suspicion is required to timely diagnose and treat such patients. Timely intervention with hemodialysis along with other supportive care can completely revert this potentially serious complication to normal.
Management of X-linked hypophosphatemic rickets: a review
Authors: Azar Mohammed
Published: September 2020

There are two types of management in X-linked hypophosphatemic rickets (XLH), out of which the main stay of treatment is conventional treatment which includes combination of oral phosphate supplements and active vitamin D (calcitriol or alfacalcidol) after the diagnosis is established. Although, conventional treatment with phosphate supplementation and active vitamin D might improve the rickets and control the renal phosphate excretion but it has significant risk of high calcium excretion in the urine and thereby increases the risk of nephrocalcinosis. The other emerging treatment is burosumab therapy which is human monoclonal IgG1 antibody against fibroblast growth factor 23 (FGF 23) for the treatment of XLH in children ≥1 year of age and in adolescents and is found to be effective in improving rickets without major adverse events. In this review, modalities for XLH treatment over the past and the near future will be discussed along with clinical manifestations and investigations.
Prevalence of work-related musculoskeletal disorders among IT professionals in India-a literature review
Authors: Singh Ritika M. , Borkar Pradeep
Published: September 2020

Musculoskeletal disorders are typically characterised by discomfort (often persistent) and restrictions in mobility, dexterity and functional ability, reducing people’s capability to work and participate in social roles with associated influences on psychological welfare, and at a wider level influence on the prosperity of communities Information technology- has played a vital role in transforming India from a slow administrative economy into a land of innovational entrepreneurs. The aim of this review is to, critically analyze the literature and report on the prevalence of work-related musculoskeletal disorders in information technology professionals. The review focused on computers users and software professionals. An extensive literature search was undertaken using google scholar and PubMed databases for last 10 years from 2011 to 2020. Further Following a thorough search of the databases, a total of 25 articles were evaluated. A number of articles reported a high prevalence of MSD, generally various studies have been done on information technology professionals and related to the work of IT professionals and studies on various risk factors also have been done in different states of India. 17 articles had selected for the study purpose in which prevalence study had selected for the review. The prevalence among the IT professionals is not uniform; however, Software engineers and computer operators appear to be more prone to neck, shoulder and back pain.
Effect of telephone calls and text message reminder interventions on the adherence to antiretroviral drugs among HIV/AIDS clients receiving care in Sokoto state, Nigeria
Authors: Oladigbolu Remi A. , Oche Mansur O. , Raji Mansur O. , Gana Godwin J. , Ezenwoko Zainab A.
Published: September 2020

Background: Adherence to antiretroviral therapy (ART) has been proven to be a good predictor of clinical outcome among patients on ART. This study aimed to assess the effect of phone reminder interventions on the knowledge of Human immunodeficiency syndrome (HIV)/ Acquired immunodeficiency syndrome (AIDS), ART and adherence to ART drugs among non-adherent patients receiving care in Sokoto State.Methods: A quasi-experimental study was conducted among 196 non-adherent HIV patients between February and July 2017. The intervention group received monthly telephone calls and weekly text messages for twelve weeks while the control group received only standard of care. Self-report adherence, forgetfulness to take ART and knowledge of HIV/AIDS and ART were measured pre- and post- intervention. Data were processed and analysed using IBM Statistical package for social sciences (SPSS) version 22 computer statistical software package.Results: At baseline, although majority of participants in both groups had good knowledge of HIV/AIDS, ART drug adherence, they were both non-adherent to ART and it was mainly due to forgetfulness. At post intervention, respondents with good knowledge and adherent to ART were significantly higher in the intervention group. There was also a significantly lower proportion of forgetfulness among the intervention group compared with control group (c2=47.57, p<0.001).Conclusion: The interventions were found to be effective. The Federal Ministry of Health (FMoH) with the support of implementing partners need to integrate these interventions into clinical setting as part of comprehensive care for HIV care and treatment to assist in improving their knowledge of HIV/AIDS, ART and adherence to ART.
Factors influencing incomplete immunization among under five years old children at CHUK hospital, Nyarugenge district, Rwanda
Authors: Nwankwo Chinenye Mercy , Orua Elizabeth
Published: September 2020

Background: Low-income countries still have challenges with vaccine-preventable diseases, despite improvement in immunization coverage in Rwanda, cases of drop out and incomplete immunization persists.Methods: The study adopted descriptive cross-sectional approach with the use of quantitative and qualitative techniques on a population of 186 guardians/mothers with their under five children. Convenience sampling techniques was used to draw study sample size of 127 that attends the clinic and approval to participate in the study.  Data was obtained from validated study instruments and immunization records over a period of one month.Results: Study results showed that religion (p=0.01), gender (p=0.03), age (p=0.009) and educational status (p=0.04) influenced incomplete immunizations. About 78 (61.4%) respondents are unaware that vaccines prevents specific diseases, while 61 (48.0%) were too busy with other duty at the time of immunizations and 89 (70.1%) Participants do not see the need to complete the immunization. Furthermore, the age of the mother Knowledge of child immunization and hospital delivery were statistically significant with (p<0.05). Immunization cards and histories verified showed about 120 (94.4%) children were fully immunized, 46(24.5 %) were partially immunized and 67 (52.8%) children immunized before age one.Conclusions: A number of children were not fully immunized in their first year of life; others were inappropriately vaccinated. Emphasis made on completion of immunization schedule.
Addressing the challenges that affect COVID-19 prevention in the rural areas of Abia State, Nigeria
Authors: Enwereji E. E. , Ezeama M. C.
Published: September 2020

Background: Using directives have been the standard approach of changing public behavior. But studies have shown that directives fail because people hate being told what to do. Telling individuals to use limited resources and other social amenities in rural areas to prevent coronavirus disease 2019 (COVID-19) infection may lead to skepticism in practice of public health recommendations on COVID-19 prevention. Even non-availability of basic hand washing facilities (soap and clean water) which form fundamental mechanism to prevent COVID-19 can expose people to infection. Study assesses factors and conditions that influence the practice of Center for disease control (CDC) preventive measures against COVID-19 in rural areas.Methods: This is a qualitative study that utilized information from 36 health care professionals under the aegis of committee for COVID-19 prevention. These committee members are working together in partnership with state government to provide services to control, prevent and cushion effects of COVID-19 pandemic.Results: Findings from 36 health care professionals made up of 10 (27.8%) females and 26 (72.2%) males showed that factors such as denial of existence of the virus, labeling virus as only urban limited, poor knowledge of mode of transmission, terming virus as ploy politicians use to siphon resources meant for rural development contributed to non-observation of CDC guidelines for COVID-19 prevention.Conclusions: Denying existence of COVID-19 and not observing CDC guidelines will increase community transmission thereby, expose people in communities to infection. Therefore, education is needed to enlighten people in communities on benefits of observing CDC guidelines.
Evaluation of boiled milk hygiene and safety in the markets of El-Obied City- North Kordofan State- Sudan
Authors: Ahmed Ibrahim Mirghani Elnager , Humaida Mohammed Ismail
Published: September 2020

Background: This study was conducted in the markets of Elobeid City- North Kordofan State-Sudan, to evaluate the hygiene and safety of the boiled milk vended in the markets of El-Obied City, Sudan, during the period from October 2012 to October 2015.Methods: The study covered all the places for the boiled milk sale in the markets of El-Obeid City, which are 84 places. Data were collected from all milk handlers (87) by questionnaire and observation-check list about the health requirements for milk handling in those places. The data were analyzed manually and the results presented in tables and figures. Eighty-four milk samples were collected from the offering containers of boiled milk vended in that places, and examined for the total aerobic plate counts in the laboratory of veterinary research station in El-Obeid City. The microbial indicator (aerobic plates count for microbes) was used to evaluate the extent of boiled milk hygiene and safety.Results: The results showed that the sound milk samples (free of microbes) concerning the aerobic plates count for microbes were only 9.52% and most milk samples (76.19%) were of low microbiological quality. Also this study demonstrated that the bubbling of milk without stirring contributed to the existence of microbial contamination of boiled milk by 41.67% and the use of dirty utensils and equipment contributed to the existence of microbial contamination by 15%.Conclusions: This study concluded that the milk in the markets of El-Obeid City was marketed under unhygienic conditions and there is no assurance to its safety and wholesomeness in most places.
Baseline characteristics, level of disease severity and outcomes of patients with COVID-19 admitted to intensive care unit in COVID-19 dedicated Mugda Medical College and Hospital, Dhaka, Bangladesh
Authors: Hossain Irin , Khan Manzurul H. , Tuhin Shah G. , Aktaruzzaman M. M. , Rahman Shafiur , Mullick Ashekur R. , Shahin Md. , Yasmin Nahid , Choudhury Adnan Y. , Haque Monjurul
Published: September 2020

Background: Novel coronavirus disease is associated with highly intensive care unit (ICU) mortality. With the dramatic increase of confirmed cases as well as death toll in Bangladesh, timely and effective management of severely and critically ill patients appears to be particularly important. This includes streamlining workflows for rapid diagnosis and isolation, clinical management, and infection prevention. The main objective of this study was identification of the demographic, clinical characteristics, severity and outcome of patients admitted into ICU.  Methods: We aimed to describe the demographic and clinical characteristics, severity of disease, management patterns and outcomes of critically ill patients with coronavirus disease 2019 admitted to ICU in a Bangladeshi setting and for this purpose a retro-prospective study of conveniently selected 63 ICU admitted patients with COVID-19 was conducted from May 1 to June 30, 2020. Data were obtained from patient charts and the hospitals’ records using a structured questionnaire.  Results: Most of the ICU patients were older male (30, 65.3%) and most of them were 70 or above years of age group (17, 37.0%). ICU patients more likely suffered from comorbidities like hypertension (938, 60.3%); diabetes             (36, 57.1%); chronic kidney disease (21, 33.3%). In most cases treatment in ICU included the administration of antibiotics (100.0%) (Meropenem, 20, 31.7%). Forty-Eight patients died (discharge mortality, 76.2%), and fourteen patients were discharged alive from the ICU with a rate of 22.2%. One patient transferred (Palliative discharge, 1.6%) to other facilities for palliative care purpose.Conclusions: Our findings also highlight the importance of planning for mass critical care along with central oxygen supply system as the need for ICU care and ventilator support to treat patients with COVID-19 grows rapidly in Bangladesh.
The application of family stress management of the quality of life on breast cancer patients
Authors: Rahayu Novi W. , Kardiyudiani Ni K.
Published: September 2020

Background: Breast cancer is a malignant tumor that grows around the breast area and can metastasize to other organs of the body. The complaint that is often felt by patients is that it is very severe pain that reduces the patient's ability to carry out daily activities and will affect the patient's quality of life. The role of the family is important in improving the quality of life of patients, with the moral and material burdens of the family that can affect the family in caring for patients. This study aims to determine the quality of life in breast cancer patients after family stress management interventions. Methods: This research method is a qualitative research design with one group pre-test to post-test with consecutive sampling technique on 22 samples. Data analysis methods used were univariate analysis and bivariate analysis with the non-parametric statistical test Wilcoxon signed rank test.Results: The results showed that the asymp.sig value was 0.004 so that it was smaller than 0.05 which showed that there were differences between stress management interventions before and after the interventions. Conclusion: Family stress management interventions affect the quality of life of breast cancer patients.
A study on reported fire incidents in major hospitals of India
Authors: Patharla Shyam Siddharth Rao , Pyreddy Souri Reddy , Panthagani Shilpa N.
Published: September 2020

Background: An uncontrolled fire is dangerous especially in the healthcare establishments as they frequently cater to the sick who often require assistance. We studied the various aspects of fire incidents that occurred in major Indian hospitals through media reports in the past decade (January 2010 to December 2019). It is our intention that this study would act as a reference to prioritize and stimulate research in hospital fire safety.Methods: An extensive internet search was done for news reports/articles on fire incidents in major hospitals by mainstream media outlets. Major hospitals were those with more than 100 in-patient beds.Results: 33 major fire incidents were reported during the defined period. The most common cause of fire was due to electrical short circuit 78% with air conditioners being the most common source. Functional firefighting systems were reported in 19 incidents. Fires originated at or near intensive care units (ICU’s) in 10 instances. 72.72% accidents occurred at night (8:01 p.m. to 7:59 a.m.). Casualties were reported in 39% of the fire accidents.Conclusions: The most common cause of fire accidents is electrical short circuit. Hospitals need to prioritize periodic testing of firefighting systems and regular training of staff on their use. Judicious placement of electrical equipment combined with oxygen monitoring devices in intensive care areas is recommended. Storage of flammable materials and placement of central gas supply points should be away from the vicinity of patient care areas and always in conjunction with robust fire detection and control methods. Hospitals should adhere to their planned capacity.
Seasonal trends in oto-rhino-laryngology outpatient clinics in the North Indian state of Punjab: a 3 year pilot study
Authors: Munjal Manish , Kaur Japneet , Rishi Porshia , Tuli Nitika , Sidhu Harjinder , Munjal Shubham , Nagpal Japsimran Singh
Published: September 2020

Background: Otorhinolaryngological disorders are amongst the common reason for seeking medical advice in health care setup. This study was conducted in a tertiary care hospital and medical college in North India. The monthly records of 93438 patients were analysed over a period of 3 years from January 2016 to December 2019. All monthly outpatient visits for ear nose throat (ENT) ailments, in the state with extremes of weather were recorded. No such epidemiological data about the attendance rates of patients to outpatient department (OPD) with respect to changing seasonal patterns is available. The aim of this study was to identify the various trends in the attendance pattern of ENT outpatient clinics with respect to the changes in the seasons.Methods: The monthly record of 93438 patients attending the general and speciality outpatient clinics of Dayanand Medical College, Ludhiana were studied. The study period was from January 2017 to December 2019).Results: A total of 93438 patients attended ENT OPD in three years from 2017 to 2019. Male: female ratio as 1.22:190. 1 percent of the patients belonged to 3rd and 4th decade of life , 9.9 percent of the patients were children. Patients from rural background comprised (63.1%) of the total number of patients The summer months of July, September have shown the maximum attendance during the year. The winter months of February and December have shown minimum attendance.Conclusions: Maximum patient visits were recorded in the month of July and minimum during the winter months of November to February.
Study on postnatal care in a tertiary care hospital in eastern India and the reality
Authors: Das Bharati
Published: September 2020

Background: Post-natal period remains the most important time in which maximum maternal and neonatal mortality occurs. Many studies had been done on postnatal care in India also in abroad before. However, most of them were basically community-based surveys in rural areas or urban slums. The objective of the current study was to assess knowledge and practice of postnatal care services and its status in mothers in urban area.Methods: It is a prospective, hospital-based study done from February 2019 to July 2019. Data was collected by structured questionnaire method from the mothers who were coming for routine immunization for their babies at 6 weeks.Results: Total number of mothers were 214, 52.34% were delivered in medical college and DHQH and 47.66% at private sectors. Health related issues were present in 36 (16.6%) of mothers and 33 (15.4%) of babies. Only 2.8% of mothers received post-natal check-up. IFA and calcium supplementation were taken (128) 60% of mothers as opposed to advised in 151 (70.56%) of cases of varying durations.Conclusions: Post-natal care was unacceptably low despite various government programmes, well socioeconomic status, education of the mother and presence of health-related issues in the mother or the baby. Which was mainly due to lack of proper counselling for postnatal care. Strengthening the postnatal care services by sensitization of the staffs with uniform policy and mother centred counselling remains the need of the hour.
A cross-sectional study on awareness and practice of universal precautions among laboratory technicians of a tertiary health care facility
Authors: Roohen Sara , Bhavani Kenche , Vemuri Jyothi Lakshmi Naga , Anjum Shabnam
Published: September 2020

Background: Biological hazards and health safety issues are a special concern in laboratory technicians who handle blood, body fluids, and tissues which may contain infectious agents. Lack of knowledge of standard precautions has been noted to influence the practice and behaviour change in relation to these precautions requires knowledge. This study therefore aims to study the awareness and practice of universal precautions (U.P) in lab technicians.Methods: Cross sectional type of study was conducted in the tertiary health care facility (Osmania General Hospital) in Hyderabad district among laboratory technicians of various departments from 1-20/11/18. Random sampling was done and data was collected using a self-administered questionnaire.Statistical analyses were performed using Microsoft excel 07. Descriptive analysis was done and Chi-square tests were used for establishing association.Results: The mean age of the respondents was 32.37 years, all of them were graduates by education and the mean length of experience was 5.45 yrs. The mean score for knowledge was 14 (41.1%).In the domain of practice, the responses were quite satisfactory with majority of the responses being “always” for all the practices, wearing eye shields and face masks was only “sometimes” followed and majority of “not applicable” were for wearing glovesConclusions: Although standard and isolation precautions are introduced, the overall performance of respondents was unsatisfactory.
Coexistence of fluoroquinolone resistance and ESBL production in urinary isolates
Authors: Khan Nazia , Panda Pragyan Swagatika , Rastogi Megha , Sharma Swati , Rana Neha , Faridi Maryam , Mehndiratta Man Mohan
Published: September 2020

Background: Enterobacteriaceae group of organisms are commonly implicated for causing urinary tract infection (UTI). Fluoroquinolones (FQ) are widely used as empirical therapy for UTI. Enterobacteriaceae exhibits high resistance rates to FQs. The plasmid mediated extended spectrum beta lactamase (ESBL) production confers resistance for FQs as well. The aim of the study is to determine the prevalence of fluoroquinolones resistance in urinary isolates and to study the coexistence of FQ resistance and ESBL production in urinary isolates.Methods: Retrospective data of the urine samples received in our microbiology laboratory between December 2018 to May 2019 were reviewed. The organisms were isolated and identified as per standard procedures and the antibiotic susceptibility testing was done following CLSI 2019 guidelines. Ceftazidime (30 µg) and ceftazidime-clavulinic acid (30 µg/10 µg) were used for detection of ESBL production.  Levofloxacin (5 µg) and ciprofloxacin (5 µg) were used for detecting FQ resistance.Results: Out of a total of 1403 urine samples received in our laboratory, 240 (17.1%) sample showed growth of Enterobacteriaceae. The different species were E. coli (80.4%), Klebsiella spp (12.2%), Citrobacter spp (4.2%), Enterobacter spp (1.6%) and Proteus mirabilis (1.6%). Amongst these organisms 121(50.4%) were ESBL producers. Co-existence of FQ resistance among the ESBL producers was observed in 106(87.6%) isolates which is higher as compared to that among the ESBL non producers 71(59.7%).Conclusions: Around 50% of the UTI Enterobacteriaceae bacteria are ESBL producers. Fluroquinolone resistance amongst ESBL producing Enterobacteriaceae is very high (87.6%).
Using qualitative research methods to identify problems faced by adolescent girls in rural Andhra Pradesh
Authors: Koneru Geethika , Rao N. S. Sanjeeva , Swapna B. , Sai T. S. R.
Published: September 2020

Background: Adolescence lays the foundation for physical wellbeing, emotional stability and mental ability. Quantitative methods often lack depth of understanding on crucial issues and leave many lacunae in the information available about the problems faced by adolescent girls in India. Using qualitative methods, a researcher can go beyond the surface and gather hidden information and associated feelings. Objective of the research was to qualitatively assess the knowledge, attitude and practices of health among adolescent girls (15-19 years) living in a rural area.Methods: This qualitative study to explore issues surrounding the health of adolescent girls in a rural area was conducted from August 2018 to November 2018 in the rural field practice area of the NRI Medical College. The qualitative methods used to gather information were focus group discussions (FGDs) and in-depth interviews (IDIs). Triangulation of information was done through key informant interviews (KIIs) with professionals working with adolescents.Results: The themes identified were causes of stress, education & marriage, safe pregnancy, prevalent diseases, exercise and leisure, health seeking behaviour and domestic violence. In-depth interviews with girls having significant social and psychological risk factors revealed a sense of loss of freedom, decision making power and resignation to their fate. Key informants revealed the neglect of adolescents in health programmes.Conclusions: Adolescent girls have poor knowledge about important health issues. Interventions that focus both on the continuation of the girls’ education and creating options for generating income are necessary along with non-judgmental counseling services and adolescent friendly health care facilities.