bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of multi detector computed tomography (MDCT) in evaluation of renal masses
Authors: Karthikeyan M. A. , Vohra Poonam
Published: February 2018

Background: Due to rapid pace in development of imaging techniques and increasing number of investigations being done, more number of renal masses are discovered incidentally during evaluation of unrelated or unspecific symptoms. Hence it is vital to differentiate neoplastic and non-neoplastic masses. Among the neoplastic masses, there is a need to differentiate benign and malignant masses so that appropriate treatment strategies like nephron sparing surgery, radio frequency ablation etc. can be planned at an early stage and avoiding unnecessary radical treatments for improved patients survival.Methods: A Cross-sectional Observational study was done in 35 patients. Patients of either sex in any age group who had presented with suspected renal mass by clinical signs and symptoms (palpable renal angle mass, renal angle pain, hematuria) confirmed on USG examination or an incidental Renal mass diagnosed on USG/CT examination were included in our study.Results: Ultrasound is the initial imaging modality of choice since it is inexpensive, easy to perform and no radiation exposure. On USG, the renal lesions are classified as solid or cystic. Anechoic, thin walled cyst without any septations or solid components is usually Bosniak I cyst (simple cyst) and does not need any further evaluation. Rest of the cystic and solid lesions cannot be characterized by ultrasound and hence need further evaluation.Conclusions: Multidetector Computed Tomography is the imaging modality of choice for further evaluation and characterization. CT is done in four phases viz., unenhanced, corticomedullary, nephrographic and excretory phase especially in cases of malignancy while in benign conditions like angiomyolipoma and abscess, evaluation with unenhanced and single phase post contrast in portovenous phase is sufficient.
POUR after spinal anesthesia in lower limb orthopaedic surgeries-a prospective study
Authors: Sen Anuradha , Singh Omeshwar
Published: February 2018

Background: Postoperative urinary retention (POUR) is a common problem with overall rates looking at the entire surgical population quoted between 4% and 6%. POUR has been defined as the inability to void in the presence of a full bladder.Methods: This was a prospective, single-centre, observational study conducted between June 2015 to December 2016 at a tertiary care centre of Northern India. The study group enrolled 186 patients undergoing various lower limb surgeries under spinal anesthesia.Results: In the present study, out of 186 patients, 101 patients were male and 85 patients were female. Most of the patients were in the 41-60 years age group (78) followed by 72 patients were in the >61 years age group. 21 patients (11.29%) suffered with post operative urine retention (POUR) in whom catheterization was required, the incidence of POUR in joint replacement surgeries was 20.96% (13/62). In the present study incidence of POUR was more in males (12 patients) as compared to females (9 patients). POUR was more common in the elderly age group.Conclusions: By carefully identifying patients at risk, adopting appropriate anesthetic techniques and perioperative care principles and accurately monitoring bladder volume by ultrasound, POUR may be prevented and the associated morbidity minimized. Hence it becomes imperative to evaluate the true incidence and consequences of POUR in large prospective clinical studies. Spontaneous micturition should remain a criterion for discharge after spinal anaesthesia.
A study of relation between primary open angle glaucoma and type II diabetes mellitus
Authors: Desai Aditya , Patel Dipak , Sapovadia Avani , Mehta Parin , Brahmbhatt Jyotindra
Published: February 2018

Background: Primary open angle glaucoma has been characterized by its adult onset, IOP >21mmHg at some point in the course of the disease, open angles on gonioscopy, glaucomatous visual field changes and glaucomatous optic nerve damage. POAG is a multi-factorial disease such as age, black race, positive family history, high myopia etc. Diabetes mellitus has also been considered as one of the risk factors, but no major study has been conducted to provide tangible proof.Methods: This cross sectional, case control study was conducted to determine whether diabetes stands as a risk factor in development of glaucoma. The selected patients were divided into 3 groups based on inclusion and exclusion criteria. They were subjected to complete ocular examination including gonioscopy and perimetry.Results: The 16 patients from 50 of the diabetic group (28%) were found to have POAG. The p value was <0.005 which was statistically significant. Also, no correlation was found between blood sugar and IOP levels in these patients.Conclusions: These data show a significant correlation between diabetes and glaucoma. Further studies are warranted to determine its actual role in pathogenesis of glaucoma.
A study of epidemiological co-relates of low birth weight babies born in tertiary care hospital
Authors: J. Patale Priti , S. Masare Monika , S. Bansode-Gokhe Seema
Published: February 2018

Background: To study the Epidemiological Factors related with the low Birth weight Babies born in tertiary care Hospital of teaching Medical Institution.Methods: The present study was a cross sectional observational study carried out in the Post Natal ward of Obstetric department of a tertiary care hospital of a metropolitan city, data collection was done from the Mothers of low birth weight babies by conducting face to face interview in the post-natal ward with a predesigned, structured Performa. Data was analyzed using statistical package for social science program.Results: The study showed that most of mothers of the babies were between the age group of 22 to 30 years 87 (58.3%) while 49 (32.8%) were below the age of 21 years and 13(8.7%) were above 30 years of age. Most of the study subjects 70 (47.0%) belongs to the lower socioeconomic status where as 62 (41.6%) and 17 (11.4%) belong to upper lower and middle socioeconomic class respectively. It was observed in the present study that maternal education, socioeconomic status, parity, maternal weight gain during pregnancy, height of the mother, tobacco habits either chewing or smoking, birth order of the baby are the factors, significantly associated with low birth weight of the baby.Conclusions: Socioeconomic development, maternal nutrition, and increasing the use of health services during pregnancy, are all important for reducing LBW. There is need to strengthen the existing maternal services at the basic level of community.
Study internal fixation of subtrochanteric fracture of femur with dynamic hip screw, dynamic condylar screw and proximal femoral nail-a retro-prospective study
Authors: Kumar Mishra Sandeep , C. E. Deepak , Goari Kushal , Shukla Shurendra
Published: February 2018

Background: Sub trochanteric fracture is commonly seen in young adult and middle age man by high velocity trauma. Present study was taken up to study fracture fixation by PFN, DHS and DCS and compare their result in view of union rate, complication, functional out come, operative risk and effectiveness of implant. This study helps to decide appropriate implant for sub trochanteric fracture. In literature comparison of these PFN, DHS, DCS commonly used implants are rare and most of the studies are done in western population by using one or two implants.Methods: Study is done clinically, in a retro to prospective manner by comparing 75 (50 cases retro and 25 cases prospectively) cases of either sex above the age of 18years from May 2010 to May 2014. All fractures are classified by Seinsheimer classification system. Fracture is fixed with DHS, PFN or DCS in 25 cases each.Results: Males with an average age group 21-40-year were commonly affected with right femur fracture due to high velocity RTA. Fracture pattern was commonly type IIC as per seinsheimer classification. Mean union rate and clinical outcome for PFN is high.Conclusions: PFN attempts to combine advantage of a sliding hip screw with those of intramedullary fixation devices. Cases treated with PFN nail have shown easier rehabilitation, less blood loos, less surgical trauma, early mobilization, early rate of fracture union when compared to those cases treated with DHS and DCS barrel plate as per observation of our study. With our study PFN has given us encouraging results over conventional DHS and DCS. Hence, we recommend PFN as better implant for fixation of sub-trochanteric fracture.
Nevus sebaceous of Jadassohn of face with infundibular and keratinous cyst in an adolescent Arab male-a rare case report
Authors: Singh M. Scott Arockia , Raphel Paul , Devadas Sneha , Vellukara Sasidharan Siny
Published: February 2018

Nevus Sebaceous of Jadassohn is rare hamartomatous skin lesion. We report an interesting case of an Adolescent Arab male 18yr old, who presented to us with a velvety plaque of 7cm length in his left preauricular area. Excision biopsy revealed Nevus sebaceous of Jadassohn with infundibular and keratinous cyst. The lesion is present since birth started as a tiny lesion and grown to the current size. No such large sized lesion on the face has ever been reported in the medical literature till date. We advise an early excision as they have strong potential for malignant change.
Artery of percheron infarct: a case report
Authors: Kaur Harharpreet , Mohan Gurinder , Sharma Vikas , Pal Singh Kunwar , Girgla Kawalinder , Pal Raminder , Singh Harsehaj
Published: February 2018

Artery of Percheron is a part of the posterior circulation occlusion of which is relatively uncommon. It is classically characterised by bilateral infarcts in areas involving the rostral midbrain and/or ventromedial thalamus best seen by a diffusion-weighted imaging (DWI) sequence using MRI. Clinical presentations are variable and include, amnesic impairment, aphasia, dysarthria, ocular movement disorders, motor deficit and cerebellar signs. Our case was a 60-year-old hypertensive and diabetic male with history of alcohol abuse who presented with sudden derangement of sensorium along with restriction of ocular movements and marked cerebellar signs. The diagnosis of werniche encephalopathy suggested initially by the radiologist was rejected because of the acute onset, history of hypertension and marked cerebellar signs which suggested a cerebrovascular accident. Bilateral infarcts with the occlusion of a single artery i.e. artery of percheron which supplies structures bilaterally can easily be confused with werniche encephalopathy which has similar clinical and radiological picture but are managed on different lines. This diagnosis should be kept in mind in drowsy patients with restricted ocular movements and bilateral thalamic and midbrain hyperintensities.
Cytological detection of microfilaria in unsuspected clinical scenario
Authors: Kumawat Shivani , Bhagat V. M. , Gamit Bhavna , Jha B. M.
Published: February 2018

Filariasis is a major public health problem in tropical countries, including India. Fine needle aspiration cytology plays an important role in prompt recognition of disease. Aim was to highlight the role of fine needle aspiration cytology as a simple and cost effective tool to detect microfilarial infestation. A retrospective study of 10 cases in which fine needle aspiration cytology was done and was useful in detecting microfilaria. Patient’s age were ranging from 19-62 years. M:F ratio being 7:3. Out of ten cases, maximum cases of microfilarial detection was reported in soft tissue swelling (four cases), followed by lymph node swelling (three cases), thyroid swelling (two cases) and breast swelling (one case). Careful screening of fine needle aspiration cytology smears is helpful in detecting microfilaria even in asymptomatic patients living in endemic zone which plays a significant role in recognition of disease and obviating severe manifestations of filariasis if treated in time.
Knowledge, attitude and practice of oral healthcare among pregnant women in Assiut, Egypt
Authors: Khalaf Shimaa Abdelrahim , Osman Safaa Rabea , Abbas Ahmed M. , Ismail Taghreed Abdul-Aziz M.
Published: February 2018

Background: Pregnancy is an important time in a woman's life with many complex physiological changes that may occur. These changes may negatively affect their oral health. The study aimed to assess oral health knowledge, attitude and reported practices among pregnant women in Assiut Governorate.Methods: A descriptive cross-sectional study design was used. A structured interview questionnaire was used; included two tools: Tool (I); part (1) personal data, part (2): assessment of knowledge about oral health, part (3): reported practices of oral health and tool (II): included pregnant women attitude toward oral health.Results: the study revealed that: 79.7% of the interviewed women were aged ≤30 years, 82.5% of them were from rural area. Illiterate women represented 33.2% of the studied group. 85.5% of the pregnant women were housewives. Positive attitude toward oral hygiene was significantly higher among urban, educated, working and primigravidae (p=0.007, 0.03, <0.0001 and 0.04 respectively). Practices of daily cleaning of the teeth was higher among urban than rural residents (79.7% versus 46.8% respectively), university educated (89.3%) than other groups, and working women than housewives (84.9% versus 47.1%)with statistical significant difference while neither age nor number of pregnancies affected daily teeth cleaning.Conclusions: Being highly educated, working and of urban residence positively affected both the oral hygiene attitude and practices among interviewed pregnant women.
Predicting adverse drug reaction outcomes with machine learning
Authors: Chen Andy W.
Published: February 2018

Background: Adverse drug reactions are a drug safety issue affecting more than two million people in the U.S. annually. The Food and Drug Administration (FDA) maintains a comprehensive database of adverse drug reactions reported known as FAERS (FDA adverse event reporting system), providing a valuable resource for studying factors associated with ADRs. The goal of the project is to build predictive models to predict the outcome given patient characteristics and drug usage. The results can be valuable for health care practitioners by offering new knowledge on adverse drug reactions which can be used to improve decision making related to drug prescriptions.Methods: In this paper I present and discuss results from machine learning models used to predict outcomes of ADRs. Machine learning models are a popular set of models for prediction. They have gained attention recently and have been used in a variety of fields. They can be trained on existing data and retrained when new data become available. The trained models are then used to make predictions.Results: I find that the supervised learning models are work similarly within groups, with accuracy between 65% and 75% for predicting deaths and 70% to 75% for predicting hospitalizations. Across groups the models predict hospitalizations better than deaths.Conclusions: The predictive models I built achieve good accuracy. The results can potentially be improved when more data become available in the future.
Evaluation of diagnostic value of n-terminal pro brain natriuretic peptide in pleural fluid with cardiac origin
Authors: Babapour Behzad , Mirzaaghazadeh Mohammad , Shahbazzadegan Bita , Mohsenifar Hadi , Mohammadzadeh Alireza , Zamani Bijan
Published: February 2018

Background: Pleural effusion is a common finding in patients. For a long time, a light criterion is used to analysis of pleural effusion for separation of transudative from exudative fluid. Sensitivity of light criteria is very high to determine exudative pleural effusion (98%). However, the ability of these criteria for ruling out of transudative effusions is low. For this reason, this study was carried out to determine the level of NT-proBNP in pleural fluid.Methods: A descriptive-analytic study was carried out on 21 patients with complaints of shortness of breath and diagnosis of pleural effusion. Pleural fluid was tapped in these patients and the following tests were performed: LDH, total protein, albumin, cell count, cell differentiation, cytology for malignant cells, ADA, smear for AFB, gram smear and culture.The results of all experiments were analyzed using SPSS V16.Results: Mean age of participants was 65 years. Male and female frequencies were 52.4 and 47.6, respectively. 33.3% of patients had CHF, 28.5% TB, 19.4% malignancy, 4.76% hydatid, and the rest left without diagnosis. A pleural fluid in 66.7% of participants was exudative and in 33.3% was transudative. The levels of NT-proBNP (Pg/ml) in serum and pleural fluid of patients with CHF were 11288.42 and 11036.81, but in malignant patient were 1721.68 and 713.59, respectively, and the levels of NT-proBNP in serum and pleural fluid in TB patient were 2429.30 and 2810.08, respectively. Also, there was no significant difference between the levels of serum and pleural effusion NT-proBNP in transudative and exudative fluid but the level of NT-proBNP was significantly higher in CHF patients compared to others.Conclusions: The results showed that the levels of NT-proBNP in serum and pleural fluid of cardiac patients are higher than other patients, but no significant difference in NT-proBNP between transudative and exudative pleural effusion.
Prevalence of non-alcoholic fatty liver disease and its risk factors in patients referred to Ardabil city hospital during 2015-2016
Authors: Zakeri Anahita , Karamat-Panah Sepideh
Published: February 2018

Background: Fatty liver is the most common liver disease worldwide, and the number of people with this disease is increasing in the world and in Iran. The aim of this study was to determine the prevalence of non-alcoholic fatty liver disease and its risk factors in patients referred to Ardabil city hospital during 2015-2016.Methods: This is a cross-sectional descriptive study which was done on 80 patients with fatty liver Referred to Ardabil city Hospital dueing 2015-2016. Required information including age, gender, degree of fatty liver, body mass index, serum lipids, liver aminotransferases, serum uric acid, and diabetes mellitus were collected by a cheklist and then analyzed by statistical methods in SPSS.19.Results: 40% of the patients were males and 60% were females. The mean age of the patients was 49.22 ± 14.58 years. 81.2% of the patients were overweight or had some degree of obesity. ALT in 38.5%, AST in 32.5%, ALP in 13.75%, and bilirubin in 21.25% of patients were above their normal range. Total cholesterol in 35%, triglyceride in 50%, and LDL in 17.5% of patients were higher than normal range, and HDL was lower than normal range in 41.2% of patients. 21.25% of patients had hyperuricemia and 38.8% had diabetes.Conclusions: The results showed that non-alcoholic fatty liver is more prevalent in females and older ages. Doing multi-center studies was recommended in Ardabil province or other provinces in Iran in future.
A study on assessment of mass drug administration for elimination of lymphatic filariasis in Datia district, Madhya Pradesh
Authors: Gupta Ginisha , Marskole Priyesh , Yuwane Praveen
Published: February 2018

Background: Currently 947 million people globally live in areas having endemic lymphatic filariasis and require preventive chemotherapy to stop the spread of infection. LF is transmitted by many mosquitoes particularly Culex and in some areas by Anopheles and Aedes too. This study was conducted to assess the programme implementation with respect to process and outcome indicators and to assess the reasons for non-compliance among population.Methods: We conducted a cross sectional study in Datia district, Madhya Pradesh during September 2014. We determined the sample size for survey based on standard guidelines for MDA coverage assessment. We identified four separate clusters, each with thirty households, for the survey. We selected three clusters from rural areas and one cluster from urban area to ensure adequate representation. We used stratified sampling technique for selection of three rural clusters.Results: We surveyed 859 study participants of Indergarh block, Datia district, residing in 120 households across four clusters. Among 859 study participants, the eligible population (excluding less than two year child and pregnant females) was 92% (790/859). District health authorities reported coverage of MDA across entire district to be 91%. We determined the distribution rate of DEC across all four clusters to be 84% (±9%). We identified highest drug distribution rate in Uchad (97%; 193/200) and lowest in Bargai (75%; 133/178).Conclusions: Non-compliant individuals are potential reservoir for the parasite which may serve as source of infection and transmission even after the mass drug administration ceases. As the prevalence of lymphatic filariasis continues to decrease with the implementation of control measures, addressing the issue of non-compliance holds primary importance to further substantiate the effect of our efforts.
Geriatric morbidity pattern in a tertiary care center in the hilly state of Sikkim
Authors: Singh Kulwant , Dey Sowmya
Published: February 2018

Background: This study was done to find out geriatric morbidity pattern in a tertiary care hospital in the hilly state of Sikkim.Methods: The study was conducted in Central Referral Hospital, a tertiary care center, in the hilly state of Sikkim, over a period of three months. All geriatric patients, 60 years or above, were included in the study. Morbidity affecting specific organ systems was classified based on the outpatient department (OPD) visited and case files of those patients.Results: 215 elderly patients visited outpatient department during the study period. Morbidity related to eyes was most common followed by cardiovascular, gastrointestinal and respiratory systems.Conclusions: Our study compares well with range of distribution of complaints in other studies. However, there is a wide range of proportionate distribution of different morbidities in different geographic areas of our country. Hence, before deciding about resource allocation for geriatric health facilities related to different specialties, distribution of morbidities should be determined for that region.
Evaluation of mass drug administration programme for elimination of lymphatic filariasis in Bidar district, Karnataka
Authors: Hoolageri Mahesh S. , Kamath Ramachandra , Ravikumar K. , G. Jagadish , Kamath Surekha
Published: February 2018

Background: Lymphatic filariasis (LF) is endemic in 83 countries and territories, with more than a billion people at risk of infection. Filariasis has been a major public health problem in India next only to malaria. Study was done to assess coverage and compliance of mass drug administration (MDA) against lymphatic filariasis in Bidar district.Methods: This cross-sectional coverage evaluation survey was done in one urban and three rural clusters in district. The data was compiled, tabulated and analyzed using proportions.Results: A total of 739 subjects were interviewed, male subjects constituted about 57.5%. 96.58% persons have received the drugs. Out of the 678 persons who have received the drugs, 85.4% persons have consumed the drugs. Only 31.95% of study subjects consumed tablets in front of health workers. A total of 99 subjects not consumed tablets, 22.22% told drug distributor did not visit, 21.21% were out of station and 14.14% subjects were not aware. 24 persons suffered from nausea and vomiting.Conclusions: There is an urgent need for more effective drug delivery strategies and also proper IEC should be done to educate and to improve the coverage and compliance in the districts.
Availing entitlements under Janani Shishu Suraksha Karyakram in Tamil Nadu: a reality
Authors: Chellaiyan Vinoth Gnana , Christopher Christina S. C. , Daral Shailaja
Published: February 2018

Background: Janani Shishu Suraksha Karyakram (JSSK) was launched in India to improve maternal and child healthcare, and to alleviate out of pocket expenditure on healthcare. The objective was to analyze the awareness and utilization of the JSSK entitlements among residents in Kancheepuram district of Tamil Nadu.Methods: This cross sectional study was conducted in Thriuporur block, which was selected randomly from 13 blocks of Kancheepuram district. Two primary health care centers - Ezhichur and Thiruporur of Thriuporur block, were selected based on population proportion to size. A total of 80 mothers who had recently delivered a live child were selected randomly from these two PHCS. The data was collected through house to house visits by trained interviewers using a pretested, validated, structured questionnaire.Results: Mean age of the participants was 24.58 (±3.32) years. Around fifty two participants were aware about the scheme. Better awareness was seen with higher literacy and higher socioeconomic status (p=-0.043, 0,032). Cashless deliveries (100%) and free drugs (100%) were availed by all participants and among the neonates, free diagnostics (100%) and blood transfusions (100%) were availed by all. Transportation services to and from health institutions were utilized by 1.2% of the participants. Majority of the participants (98%) spent on conveyance to and from hospital.Conclusions: Though the study revealed good awareness of the scheme among the participants, it showed insight into the existing gaps in utilization of these services. Further effort is required in providing additional information on JSSK and its services within institutions and at the community level.
Nutritional status of 1-5 years children in the urban slum area of Jagdalpur city, Bastar region, Chhattisgarh
Authors: Khan Q. H. , Arora Garima , Nalli Susheel Kumar
Published: February 2018

Background: Nutritional status is the best indicator of the child health. Malnutrition has both short and long term adverse ramifications. As per NFHS III 47% children are stunted in the state of Chhattisgarh. However still many communities in the tribal dominated and naxal affected state may remain affected, hence the study was planned to identify the nutritional status of children and find out its determinant.Methods: Present cross-sectional study was conducted among 12-59 months children in the urban slum of Jagdalpur city, Bastar region of Chhattisgarh. Predesigned and pretested questionnaire was administered to the caregiver of the child, information on socio-demographic characteristics was obtained and anthropometric measurements were taken. Statistical Analysis: all frequencies were derived for completeness of data. WHO Anthro Software version 3.1.0 was used to classify the malnutrition status. Chi-square test was applied to find association between dependent variables.Results: Out of 225 children 53.3% were boys and 46.7% were girls. The overall prevalence of underweight stunting and wasting was 28.4%, 41.3%, and 19.1% respectively.Conclusions: Prevalence of underweight has reduced in the district over a period of years. However high level of stunting, a sign of chronic hunger points towards the pivotal role of socio-demographic and behavioral practices prevalent in the district. Interaction with health system in the form of ANC, institutional delivery and safeguarding effective 100% immunization coverage has shown preventive effect.
ROME: a tool to train under graduate medical students as community health care providers
Authors: Konduru Rajesh Kumar , Mishra Amit Kumar , M. Manikandan , Bazroy Joy
Published: February 2018

Background: Re-Orientation of Medical Education (ROME) program is relatively a new teaching and learning method for undergraduate medical students which enables them to achieve the knowledge and skills to provide effective community health care. Objective of this study was to find out which of the various activities that were carried out during the ROME posting helped them to achieve the required knowledge and skills to provide effective Community Health Care.Methods: A descriptive study was conducted among 101 undergraduate MBBS students who participated in the ROME posting under the Department of Community Medicine of a medical college in Puducherry. Predesigned and pretested questionnaire was used to get the feedback regarding the various teaching-learning methods applied during this ROME posting which was carried out for one full month and about various activities that were carried out by the students such as clinical examination, data collection, data entry and analysis, development of IEC materials and their administration, organizing medical camps, maintaining drug inventory, sanitation campaign and report writing under the supervision of Intern, PG and faculty.Results: “Learning through performing individual tasks” was the most popular teaching-learning method. “Conducting survey” and “data entry” were the most sought after activities by the students.Conclusions: ROME posting helps in motivating undergraduate medical students to apply the principles of comprehensive approach towards various medical problems and thereby fulfill the ultimate aim of creating efficient Community Health Care Providers.
Challenges faced by the visually disabled in use of medication, consequences of medication errors and their self-adopted coping strategies at a tertiary care hospital in Goa, India
Authors: Naik Mrudul , Cacodcar Jagadish A. , Dhupdale Nitin Y.
Published: February 2018

Background: Visual impairment (VI) does limit individual’s ability to complete everyday tasks and impact their quality of life and ability to interact with their environment. The objectives of this study are to determine challenges faced by people with Visually Disability, medicine administration errors and self-adopted coping strategies.Methods: An observational case series study design was used for the data collection. The data was collected from January-June 2014. The study participants were included all patients more than 18 years who were certified as visually handicap.Results: The major challenges faced by total 146 visually disabled patients studied were, 51.36% couldn’t locate the place of medication and 45.89% couldn’t identify the separate containers of medications. The major Medications errors included of 30.13% study participants had missed doses and spilled medications. The most commonly used coping measures were keeping medications at specific places, identifying separate drugs by feeling the shape of the container.Conclusions: The challenges included, inability to locate the place of medication, inability to identify the separate containers of medications, unaware of correct dose, inability to maintain dose schedule and difficulty in using liquid medications. Medication errors included, missing doses, spillage of medications, consumption of wrong medication, wrong dosage, inability to complete course of prescribed medications. The coping strategies adopted included, keeping medications at specific places, identifying separate drugs by feeling the shape of the container, tracking the time of routine medications with the timings of the TV serials/shows.
A study to assess mass drug administration of DEC for filaria control in district Satna, Madhya Pradesh: a mid term assessment
Authors: Sharma Vivek , Kabirpanthi Vikrant
Published: February 2018

Background: Lymphatic filariasis is a major public health problem which is caused by Wuchereria Bancrofti and Brugia Malai. The disease is endemic in 250 districts in 20 states and UTs. In India national health policy 2002 envisages elimination of lymphatic filariasis by 2015. Important strategy for elimination of lymphatic filariasis is through annual mass drug administration of single dose of DEC for 5 year or more to the eligible population. Present cross sectional study was carried out to assess drug compliance after mass drug administration of DEC and the factors responsible for poor compliance among the population of Satna district of MP.Methods: The present study was a cross-sectional study which was carried out in filarial endemic Satna district. In this district 120 houses from 3 CHC & one urban ward was randomly selected. 30 households each from 3 rural and one urban site were interviewed related to MDA for DEC.Results: Coverage of tablet distribution in Satna was 90.9%. Consumption of drug among the people who received the drug was 87.97%, while the total effective consumption was 79.9%. Drug distributors ensured consumption of drug in only 16.9%.Conclusions: Focus of MDA is primarily to mere distribution of drug. There is need to give emphasis on consumption of drug, health education, common side effects and its management in order to increase effective coverage rate.
A study of the factors influencing the utilization of family planning methods in urban slums of Allahabad district, Uttar Pradesh, India
Authors: Setu Yachna , Prakash Shiv , Parveen Khurshid , Singh Richa
Published: February 2018

Background: India was the first country to launch National Family Planning Program in 1952, but still the country’s desired total fertility rate and contraceptive prevalence rate have not achieved. The use of family planning methods is better in urban areas as compared to rural areas and it is worse in urban slums. Objective of the stud was to find out the utilization pattern of family planning methods and identifying the factors influencing it.Methods: A community based cross sectional study was carried out on eligible couples selected from urban slums of Allahabad district by multistage random sampling and were interviewed by using pre-tested schedule. Data analysis was done by using SPSS version 21.Results: A total of 356 eligible couples (age 15-49 years) were surveyed for a period of one year. It was observed that 45.78% (163/356) of eligible couples were using any of the family planning method and most commonly used method was female sterilization (53.98%), followed by condom (18.40%), then IUCDs (13.49%), injectables, OCPs and Natural methods (approx 4%) use. The use of family planning methods was found to be associated with women’s age, duration of marriage, caste categories, men’s education status, number of living children.Conclusions: The use of family planning methods is low in slums areas and to improve the condition awareness should be created.
How determinants of health determine health?
Authors: Khan Ramsha , Qureshi Muhammad Salman Haider
Published: February 2018

In this article, a broader discussion of determinants of health will be provided by giving the relevant examples, demonstrating how these determinates influence the health at individual and community level. Moreover, the definitions of the terms such as determinants of health, health inequalities and inequities, will be given. Although there are many factors that influences health, the article will focus on lifestyle, biological and environmental determinants of health. At the end a brief conclusion about the key points discussed in the essay will be provided. 
Status of thyroid autoantibodies among Nigerian vitiligo patients
Authors: Amadi Collins , Odum Ehimen P.
Published: February 2018

Background: The prevalence of thyroid autoantibodies among vitiligo patients is higher than the general population. This study was therefore aimed to evaluate the status of thyroid autoantibodies in Nigerian patients with vitiligo.

Methods: A retrospective study of thyroid autoantibody test parameters of vitiligo patients who visited the Department of Chemical Pathology and Metabolic Medicine of the University of Port Harcourt Teaching Hospital between 1st January 2012 and 31st December 2016 was undertaken to evaluate the status of thyroid autoantibody. Data collected irrespective of vitiligo variant were age, sex, serum thyroid stimulating hormone (TSH), thyroid peroxidase antibody (anti-TPO) titers and thyroglobulin antibody (anti-Tg) titers. The analysis was done using Shapiro-Wilk, descriptive statistics, chi-square, and Fisher’s exact, two-sample t-test. The level of p<0.05 was considered significant.  

Results: There were a total of 102 subjects with 40 (39.2%) males and 62 (60.8%) females. Subjects’ age ranged from 4–61 with a median value of 23 years. The mean serum TSH, anti-TPO and anti-Tg were 2.6 IU/ml, 64.6 IU/ml, and 55.2 IU/ml respectively. Positive thyroid autoantibodies titers was documented in 35 (34.3%; <0.001) subjects. Anti-TPO and anti-Tg positive titers were detected in 34 (33.3%) and 19 (18.6%) subjects respectively, while autoimmune thyroid disease was observed in 20 (19.6%) of the vitiligo subjects.

Conclusions: Thyroid autoantibodies are more prevalent among vitiligo patients than the general population. Regular screening for these thyroid autoantibodies should be made compulsory in the management of patients with vitiligo.
A residential habitat quality model for population health vulnerability assessment in Urban Nigeria
Authors: Adewoyin Yemi
Published: February 2018

Background: The quality of the living environment affects the population’s exposure and susceptibility to diseases, yet most available indices for the measurement of residential environmental quality are based on the population’s perception of their environment rather than on objectively verifiable indicators. This paper develops an index based on the peculiarities of the urban environment in Africa.

Methods: In constructing the residential habitat quality (RHQ) model, 30 indicators measuring residential environmental quality and housing conditions were employed The indicators follow from an adaptation of the major risk factors of unhealthy living conditions of the WHO and from disease promoting habitat conditions highlighted in relevant theories. Primary data on household incidence of malaria was also collected from the study area.  

Results: The construct recorded a reliability coefficient of 0.979 while the factor-analytic procedure employed for validation identified three dimensions that accounted for 86.6% of the total variance in the construct. Its application in the analysis of the relationship between the quality of the living environment and the prevalence of malaria in urban Nigeria was further tested in the study. The result (r=-0.954, p<0.001) shows that there is a very strong and statistically significant negative correlation between the quality of the living environment and household incidence of malaria in the study area.

Conclusions: The RHQ model is sufficiently adequate to measure variations in residential environmental quality and becomes particularly useful in the identification of health risk habitats, and health planning for vulnerable population based on their places of residence.

 
Violating the Maxims of Quality and Quantity on the ‘Demo Sabun’ Sketch of Extravaganza Situation Comedy TV
Authors: Rini Setia
Published: February 2018

This study focuses on analyzing the violation of maxims as proposed by Grice in his cooperative principles. The subject of the study is on one of TV sitcoms broadcasted by one of the private owned TV station in Indonesia. The writer collected the data by transcribing the dialogues among the comedian in one sketch. In this modern era there are many busy people who need such kind of entertainment to lead them release their fatigue after having a day work. This situation invites some creative people to produce humor which is then packaged in the form situation comedy. These sitcoms can be broadcasted in many television stations now. In creating such funny expressions, there must be the violation on some maxims. By violating the maxims; the humorous verbal interaction can be achieved. The writer found that there are two types of violation on maxims of quality and quantity in one of the extravaganza’s sketches.keywords; Violation;  Maxims, Humor
The Teaching of Speaking in Big Classes
Authors: Ruwandi Ruwandi
Published: February 2018

Speaking is the most important language skill. The language user’s capability will be immediately understood and measured through the skill because this is the most visible proficiency. Difficulties of teaching speaking vary dependent upon the class size. Teaching speaking in big classes is more difficult than teaching of it in small classes. The main constraint is the time allotment. To answer the problem, speaking teachers should be creative to set the intensive classroom activities. If this is true, they need to identify students speaking skill to understand their alertness for the following language instructions. Besides that, they are also responsible to identify their basic need in the class whether this is only for question and answer, dialog, discussion, debate, or others. To anticipate the time constraints, the teachers engage to select the possible methods and strategies for presenting the interesting instructional materials. At the end, teachers should divide the time allotment adjust and proportionally for their students so they are able to self-express and share ideas in those interactive classroom situations.keywords; Speaking, Existing Skill;  Need Analysis;  Classroom Management; Methods & Strategies ; Presentation
Cross Cultural Conflicts in Not Without my Daughter
Authors: Setyoningsih Setyoningsih
Published: February 2018

This study aims to identify and analyze the cultural conflicts between the main characters in the novel Not Without my Daughter (NW). The analysis was carried out through the following process. The first procedure related to problems of classification i.e. cross cultural conflicts. The next phase of data analysis related to the colletion data of cross cultural conflicts in NW. The last phase is presentation the result of the analysis that had been conducted in this research. Having analyzed the data, the researcher concludes  that cultural conflicts occured in NW because of  stereotype, prejudice, and ethnocentrism. Cultural conflicts can be prevented if we increase our awareness of our own attitudes and learn to be sensitive to cross-cultural differences. However, if we develop intercultural sensitivity, it does not mean that we need to lose our cultural identities-but rather that we recognize cultural influences within ourselves and within others.Keywords: Culture; Cross-Cultural Conflict; Culture Understanding
Transforming First Nations Health Care in British Columbia: An Organizational Challenge
Authors: Wilmot Stephen
Published: February 2018

Following a series of agreements on First Nations health care in British Columbia beginning in 2005, several organizations were created to contribute to the development of a system of health care for First Nations in the province, with the aim of transforming First Nations health care to better meet users’ needs. This article considers the role of these organizations and their relationships with the provincial government, the federal government, and the First Nations people of British Columbia. It explores possible levels of transformation, as well as the possibilities and problems for these organizations in undertaking the transformation process, particularly with regard to their position on the boundary between the worlds of First Nations and Canada. It also considers sources of, and threats to, their legitimacy in this undertaking. Finally, wider points of relevance beyond British Columbia are identified.
Искуство Универзитетске библиотеке „Светозар Марковић” у успостављању Дигиталног репозиторијума Универзитета у Београду - PHAIDRA
Authors: Столић Драгана
Published: February 2018

Први мултидисциплинарни институционални репозиторијум у Републици Србији успостављен је на Универзитету у Београду 2011. године. Одржавање и контрола његовог функционисања поверени су Универзитетској библиотеци „Светозар Марковић”, која је била координатор Темпус пројекта Нови библиотечки сервиси на универзитетима Западног Балкана у оквиру којег је покренут овај и још пет репозиторијума у региону. Као програмска основа узет је систем PHAIDRA, креиран на Универзитету у Бечу и развијен на темељу софтвера отвореног кода Fedora. У раду се даје преглед функционалности система и приказује начин његовог коришћења на универзитетима. У овом тренутку бригу о садржају репозитoријума воде универзитети, односно библиотеке (универзитетске и факултетске), док је самоархивирање заступљено знатно мање. Највећи део садржаја обухвата докторске дисертације, кроз систем Етезе, или мастер радове, које похрањују библиотекари неких факултетских библиотека. За потпун развој система потребно је, поред непрекидног техничког усавршавања и унапређивања, да га прихвате и наставници и сарадници универзитета јер је њима првенствено и намењен као алат за наставни и научни рад.
Библиотеке и библиотекари у уметничкој књижевности и популарној литератури
Authors: Матијевић Милица , Ђорђевић Виолета
Published: February 2018

У раду се анализира начин представљања библиотека и библиотекара у савременој српској књижевности. Мада се ретко појављују као мотив у делима домаћих аутора, они су ипак присутни, како у у књижевности за децу, тако и у свим родовима књижевности за одрасле. Разматрају се уобичајени стереотипи на којима се заснива слика библиотека и библиотекара. Такође, откривају се нови, савремени стереотипи који постепено замењују оне из ранијих периода. Приказом одређених књижевних дела истражује се улога књижевног стваралаштва на креирање слике о библиотекама и библиотекарима у јавности, као и у којој мери савремена српска књижевност доприноси или се супротставља постојећим стереотипима. Рад преиспитује у којој мери су сами библиотекари свесни уврежених представа о себи и својој професији у савременој домаћој уметничкој књижевности и популарној литератури.
Библиотека у сопственој соби: ауторке, јунакиње и књиге од Вирџиније Вулф до данас
Authors: Гордић Петковић Владислава
Published: February 2018

Кад одлучи да пише о положају жене у свом времену, Вирџинија Вулф истраживање почиње од библиотечке претраге; есеј Сопствена соба (1929) може се данас читати као виртуелно путовање скривеном и потискиваном женском историјом која, ма како оскудна и анонимна, ипак постоји у оквирима Британске библиотеке. Роман Џепарош (2005) британске списатељице Саре Вотерс користи мотиве библиотеке, текста и читаоца да би проговорио о темама идентитета и утицаја. Колико су књиге и библиотеке важне у карактеризацији јунакиња британске прозе и есејистике двадесетог века, тема је овог рада. У самој анализи узима се у обзир и конфликтан однос према тематизацији женског искуства, које се рађа из свести о томе да књижевна традиција оскудева у јасном и артикулисаном промишљању женских тема.
Поље књижевности у јавним библиотекама у Србији
Authors: Сабовљев Драгана , Арсенић Владимир
Published: February 2018

Рад се бави односом поља књижевности и делатности јавних библиотека у Србији у историјској перспективи и савременом тренутку. Проучавајући феномен књижевног дела (али не улазећи у вредносно одређивање високе и тривијалне књижевности) и развој јавних библиотека, аутори настоје да покажу њихову блиску повезаност. Она се посматра кроз структуру фондова јавних библиотека и однос различитих чинилаца поља књижевности (писци, читаоци, издавачи). Објашњење ове везе проналази се и у дефиницији и функцијама јавних библиотека и структури њихових корисника. Представљају се промотивне активности, традиционалне манифестације и издавачка делатност засноване на књижевности. Истакнута је и образовна структура запослених и менаџмента у јавним библиотекама која такође сведочи о вези са пољем књижевности.