bluuebunny/crossref_metadata_2025 huggingface dataset:
A clinical study on maternal and fetal outcome in pregnancy with oligohydromnios
Authors: Gupta Chetan Prakash , Choudhary Jaya , Chahar Deepika , Yadav Sapna Kumari
Published: October 2018

Background: Oligohydramnios is associated with various maternal and fetal complication. It’s correlated fetal complications like FGR, increased risk of meconium aspiration syndrome, Birth asphyxia, low APGAR scores and increased congenital abnormalities in fetus. It’s also associated with maternal morbidities in view of operative interventions for delivery. To study effect of oligohydramnios in mother in form of, operative delivery and progress of labour. To study effect of oligohydramnios in fetus in form of fetal compromise i.e.  FGR, fetal distress, altered APGAR score, need for NICU admission. congenital anomaly and perinatal death.Methods: 50 patients with ≥ 28 weeks POG with oligohydramnios, confirmed by ultrasonographic measurement of AFI using four quadrant technique; were selected randomly after fulfilling inclusion and exclusion criteria.Results: Incidence of oligohydramnios were more found in primigravida (56%) in present study. Most common cause of oligohydramnios was idiopathic (62%) followed by PIH (20%). Most common cause of caesarean was fetal distress (23%) either due to cord compression or FGR. oligohydramnios was related to higher rate of Fetal Growth restriction and NICU admission (24%).Conclusions: Oligohydramnios is very common encounter during pregnancy, Because of its frequent occurrence; it demands intensive fetal monitoring and systemic approach to antepartum and intrapartum fetal surveillance. There is increased risk of intrapartum complication, perinatal morbidity, perinatal mortality; thus, the rate of caesarean increasing day by day.one should always know the fine line between vaginal delivery and caesarean section; move ahead with best option without hampering fetal wellbeing and avoid unnecessary operative morbidity.
Postpartum intrauterine contraceptive device (PPIUCD) insertion: practices and aftermath at tertiary care centre
Authors: Rani Kanchan , Pangtey Nirmal Kumar , Khanna Garima , Rani Mahima
Published: October 2018

Background: According to USAID/ ACCESS 2009 survey, in India, 65% of women in first year postpartum have an unmet need for family planning. Recommended spacing between birth to next pregnancy is at least 24 months and between abortion to next pregnancy is at least six months (WHO Technical Committee,2006). Pregnancy before 24 months of previous birth increase maternal and perinatal morbidity and mortality. So, during this postnatal period woman must be offered any form of reversible contraceptive. IUCD is most frequently use reversible method of family planning in the world. The aim of present study is to evaluate acceptability safety efficacy and complication of PPIUCD in tertiary care center.Methods: This is a retrospective study conducted at Government Medical College and Hospital in northern India over a period of 1 year from January 2016 to December 2016. Patients were followed up to 6 months period and their complaints and various parameters were analyzed.Results: 219 patients were inserted PPIUCD during 1-year period. Acceptance rate was higher in P2 (51.6%), between 20 to 25 years of age (47.49%) followed by 26 – 30 years of age (38.8%). On follow up 44.3% had no complaints. Most common complaints were lower abdominal pain (15%), missing thread (14.6%) and vaginal discharge (8.2%). 5.48% women came for removal of IUCD. Main cause of removal was pressure from family and lower abdominal pain. Expulsion rate was low (2.74%). There was no case of perforation or failure (pregnancy).Conclusions: During present study authors found that PPIUCD is highly effective, acceptable, safe and with fewer side effects. PPIUCD is especially beneficial in Indian population where accessibility for contraception is lower during interval period and women do not come for contraception during postpartum period.
Inguinal pain during pregnancy, secondary to round ligament varicosities: case report
Authors: Estudillo Gamaliel Vázquez , Navarro Junior J. Araiza , Romero Martin F. Tellez , Cruz Rogelio Mata , Salazar Ivanhoe Larracilla , Mendoza Alex Simon
Published: October 2018

The exact incidence of round ligament varicosities (RLV) is uncertain, due to the fact that there are few cases reported in the literature, and in many cases, they can be confused with inguinal hernias. A 26-year-old female with 26.3 weeks of gestation by date of last menstruation, who went to the emergency service of the Naval Regional Hospital of Tampico with the presence of an increase in volume in the left inguinal region, accompanied by pain, which increased standing and decreasing with the dorsal decubitus, the physical examination confirmed an increase in volume at the left inguinal level. An ultrasound of the inguinal region was requested to rule out an inguinal hernia as the first diagnosis, Doppler ultrasound revealed RLV. The patient was treated conservatively and at two weeks after the resolution of the pregnancy, the RLV presented a spontaneous regression and her symptoms completely resolved. This is the first case of round ligament varicosities reported in present institution. It is important to be aware of this pathology, to perform extension studies (Doppler ultrasound) to avoid unnecessary surgery in pregnant women.
Prenatal diagnosis of fetal cholelithiasis: a rare case
Authors: Singh Anamika , Bansal Vandana , Singh Neha
Published: October 2018

Fetal gallstones are a rare ultrasonography finding. Authors came across a similar case of fetal gallstones detected in routine third trimester scan. Patient had Rh negative blood group which might be the cause of fetal gallstone in this case however in most cases, the cause is undefined. Case was confirmed to have gallstones in postnatal scan which eventually resolved spontaneously within 1 month. The presence of gallstones in the fetus does not alter the fetal prognosis or obstetrical management since complete resolution is seen in most of the cases in late third trimester or neonatal period which may be due to either spontaneous passage of gallstones during early neonatal period or dilution of cholesterol crystals with postnatal hydration.
Bilateral ovarian serous cystadenocarcinoma metastasizing to cervix: a rare case report
Authors: Mallick Arati , Jena Saubhagya K. , Kuanar Debasis
Published: October 2018

Ovarian carcinoma is the second most common gynaecologic cancer and the leading cause of death from gynaecologic malignancy. Two-third of all malignant epithelial ovarian tumors are constituted by serous ovarian cystadenocarcinomas. It is generally observed that ovarian cancer tends to remain intraabdominal even in advanced cases and that dissemination is usually by invasion of adjacent viscera, diffuse intraperitoneal implantation, and metastatic involvement of aortic and pelvic lymph nodes. Metastasizes to the uterine cervix, vagina, or vulva in ovarian cancer is rare. The reverse i.e. ovarian metastasis from cervical tumor is rather more common. Published literature suggest that, patients with cervical metastases had associated malignant ascites, retroperitoneal lymph node involvement, and significant peritoneal carcinomatosis. Cervical metastasis in ovarian malignancies always indicates the advanced stage of tumor and multi-organ involvement, indirectly stating poor prognosis. The median survival in cases of ovarian cancer metastasizing to cervix is 4.4 months. Authors report a case of bilateral ovarian serous cystadenocarcinoma metastasising to posterior lip of cervix resulted in poor prognosis and proved fatal for the patient with review of published literature.
Elderly primigravida and a comparative analysis of their pregnancy outcome with younger primigravida
Authors: Pegu Bhabani , Gaur Bhanu Pratap Singh
Published: October 2018

Background: Though pregnancy and child birth is a normal physiological process but a woman with advanced age is a risk factor for adverse pregnancy outcome. This study was conducted to find out the proportion of elderly primigravida and to compare their pregnancy outcome with that in younger primigravida of aged 20-25yrs.Methods: A retrospective study was carried out over a period of two years in a tertiary care hospital of Meghalaya. Secondary data on obstetrics outcome of 54 elderly primigravida aged ≥35 years (study group) was compared to 120 younger primigravida (control group) of aged 20-25 years, delivered during the period of study. The chi square test and Fisher’s exact test were used for statistical analysis and p value of <0.05 was taken as level of significance.Results: During two years of study period, 2048 patients had delivered, out of which 411 (20.1%) were primigravida, 54 (2.6%) were elderly primigravida, 120 (5.9%) were in the younger age groups and 66 (3.2%) were teenage pregnancy. Pregnancy induced hypertension (PIH) with preeclampsia 12 (22.2%), preterm labour 2 (3.7%), instrumental delivery 6 (11.1%), caesarean section 32 (59.3%) were found significantly higher in study group.Conclusions: In our study, the prevalence of elderly primigravida was 2.6% and they had high rates of complications during antenatal period and course of labour than younger primigravida.
Retrospective real-life efficacy assessment of teneligliptin in Indian T2DM patients
Authors: Nashikkar Nikhil , Panikar Vijay , Joshi Shashank , Panikar Krish , Walawalkar Samhita , Vadgama Jimit , Kamat Tejas , Modi Khushoo , Sachdev Ishita
Published: October 2018

Background: Teneligliptin is been introduced recently in Indian market and data available are limited on Indian patients. Hence, the hospital based real life retrospective evaluation was planned out to evaluate, the efficacy of teneligliptin in type 2 diabetes mellitus in Indian population. Hence study was designed, a retrospective evaluation, of efficacy of teneligliptin in type 2 diabetes mellitus in Indian population.Methods: Data of 775 patients, who were prescribed teneligliptin was collected from hospital records. Teneligliptin 20mg was prescribed to all patients who were uncontrolled on other OHAs and for a mean duration of 8 weeks. Parameter evaluated in this study were change in FBG, PPBG and HbA1c from the baseline at 8week. With profile of outcome i.e. response and failure rates were also assessed with respect to age, gender, BMI and duration of diabetes.Results: Of 775 patients were enrolled, 427 were males and 348 females. The average age was 53.04 years among the study population. The mean duration of diabetes was 23 months. There was significant change in HbA1c, fasting and postprandial blood glucose levels at 8 week of teneligliptin therapy. Changes in HbA1c, FPG and PPG from baseline to end of study were-1.22±1.12% (p=0.001), -35.8±25.5mg/dl (p=0.001) and -60.7±28.6mg/dl (p=0.001) respectively. Out of 775 patients, 106 (13,7%) were non-responders where it was further sub analysed with different parameter such as age, gender, BMI and duration of diabetes in order to observe response of teneligliptin in diabetic patients.Conclusions: This real life retrospective evaluation showed efficacy of teneligliptin in real world scenario. It can be an effective alternative to conventional gliptins available for prescription in India.
Prevalence and study of lipid abnormalities in nephrotic syndrome attending a tertiary hospital, Nepal
Authors: Baral Sushil , Baral Binaya Kumar , Joshi Karan , Shrestha Swarup , Raut Kanak Bahadur , Jha Bharat
Published: October 2018

Background: The nephrotic syndrome is a common presentation of adult or pediatric kidney diseases characterized by proteinuria, dyslipidemia, edema and hypoalbuminemia. Mainly, two types of dyslipidemia are observed: elevated serum cholesterol alone (hypercholesterolemia) and elevation of serum cholesterol along with triglyceride (combined hyperlipidemia). Therefore, majority of patients could predispose for the development of coronary artery disease and other related complications.Methods: This was the prospective hospital-based study conducted in Tribhuvan University Teaching Hospital (TUTH), Nepal. Total sixty patients who meet the inclusive criteria were selected and enrolled from Nephrology outpatient department (OPD) and ward, attending from May 2009 till August 2010.Results: In this study, total sixty patients were enrolled who was diagnosis as primary nephrotic syndrome that was established by clinical parameters supported by renal biopsy. Minimal change glomerulonephritis was common diagnosis by renal biopsy followed by Focal segmental glomerulosclerosis (FSGS). The total serum cholesterol, TG and HDL was normal in 25%, 15%, 83.3% whereas, it is high among 75%,85% and 1.7% of the study populations. Similarly, 24hour urinary protein was >3.5gm/day in all patients. Total serum protein and albumin was normal in 18.3% and 8.3% respectively whereas, rest of the patients had low serum protein and albumin levels. TC/HDLc ratios were and among them, 70% had moderate to high risk value. Similarly, in this study, the serum cholesterol, TG and TC/HDL level was inversely correlated with low protein and albumin.Conclusions: Majority of patients have derangement of lipid profile among nephrotic syndrome patients, which could also predispose for the development of coronary artery disease.
Effect of tocopheryl acetate in neurobehavioral activity of cigarette of smoke exposed swiss albino mice
Authors: K. Supriya , Chaudhary Janardan
Published: October 2018

Background: Cigarette smoke exposure is well known abuse which impairs neurobehavioral activity by oxidative damage to sensory and motor areas of cerebral cortex. Aim of the present study is to report the effect of tocopheryl acetate on oral administration in impaired neurobehavioral activity of cigarette smoke exposed Swiss albino miceMethods: Total thirty six adult Swiss albino mice were assigned into six different groups. Group I (n=6, distilled water and standard diet), group II (n=6, tocopheryl acetate induced), group III (n=6, soyabean oil induced as vehicle), group IV (n=6, cigarette smoke exposed), group V (n=6, cigarette smoke expose plus tocopheryl acetate), group VI (n=6, cigarette smoke plus soyabean oil). Frequency of cigarette smoke exposure was 3 times a day for 20 minutes each time and tocopheryl acetate with dose of 200mg/kg/day in 0.3ml of soyabean oil as vehicle orally through oral gavage for 28 days. On 29th day morning, the mice were subjected to perform neurobehavioral test such as open field tests and force swim test. After completion of the test, mice were sacrificed by cervical dislocation and brain was autopsied to estimate malondialdehyde (MDA), superoxide dismutase (SOD) and reduced glutathione (GSR) for oxidative level and histopathological examination of brain.Results: The treated mice exposed to cigarette smoke showed decreased motor activity in open field test and increased anxiety in force swim tests. On histopathological examination, marked neuronal damage was observed in motor area of cerebral cortex. Oxidative level in neuronal tissue was highly variable by an increased level of MDA (815.2±56.62, p<0.0001) and decreased level of SOD (1.5±0.54, p<0.001) and GSR (0.025±0.007, p<0.001) as compared to control group. Administration of tocopheryl acetate improved the neurobehavioral activity and maintained oxidative level significantly (p <0.0001 in MDA, p <0.001 in SOD and GSR).Conclusions: Tocopheryl acetate can prevent neuronal damage due to cigarette smoke exposure. Thus, it can be used as a protective agent for neurobehavioral impairment, neuronal cell damage and altered oxidative level occurring in cigarette smokers.
Clinical and doppler monitoring of patients with Takayasu arteritis with ITAS 2010 and CDUS-K score respectively following medical intervention: a 12 months follow-up study
Authors: Sinha Debanjali , Mondal Sumantro , Nag Arijit , Lahiri Debasish , Ghosh Alakendu
Published: October 2018

Background: The objective of the present study was to monitor the disease activity of Takayasu arteritis clinically by the Indian Takayasu Activity Score 2010 (ITAS) and ultra sonographically by Colour Doppler Ultrasound-Kolkata (CDUS-K) Score after 12months of treatment with methotrexate and steroid, and to find the correlation between these two scores.Methods: Around 25 Angiographically proven Takayasu arteritis patients were treated with Methotrexate (15mg weekly) and Steroids (1mg/kg/day for 6weeks and then tapered) for 12months. Wilcoxon matched pair signed rank test was done to assess the change in ITAS 2010 with treatment. A correlation study was done between ITAS 2010 and change in CDUS-K scores at the end of 12months.Results: By Wilcoxon’s matched pair signed rank test, a non-significant change of ITAS 2010 (p=0.066) was observed at the end of 12months, which means that the treatment helps to control the disease progression by preventing a significant increase in ITAS 2010. Strong correlation (correlation coefficient of 0.878, 95% CI = 0.602 to 1.000) was found between the ITAS 2010 and change in CDUS-K scores at 12months follow up.Conclusions: The combination of Methotrexate and steroids helps to control the disease progression in Takayasu arteritis. Colour doppler ultrasonography may serve as a reliable and safe surrogate disease activity measure at follow up, as it avoids the radioactivity exposure and invasiveness of angiography.
Cytological spectrum of granulomatous mastitis: diagnostic and treatment challenges
Authors: Bhalla Shalini , Agarwal Preeti , Agarwal Harshita , Gupta Sameer , Mehrotra Prateek , Raghuvanshi Shivanjali , Sagar Mala , Goel Madhu Mati
Published: October 2018

Background: Granulomatous mastitis (GM) is an inflammatory disease of the breast which clinico- radiologically mimics both inflammatory and malignant lesions. This leads to diagnostic dilemmas and delay in treatment. The aim of the present study was to review the cases diagnosed as granulomatous mastitis on Fine Needle Aspiration Cytology (FNAC) with an objective to co-relate their clinico-radiological findings, histology review where available and follow up treatment received to establish etiology and study the treatment outcome.Methods: Cytologically diagnosed cases of granulomatous mastitis were retrieved and reviewed from August 2015 - July 2017 records. Clinico-radiological co-relation, histology review where available and follow up treatment records were sought for.Results: Around 31.7% (530/1670) cases were reported as malignant, 60.3% (1009/1670) as benign proliferative and 7.9% (131/1670) as inflammatory lesions by breast FNA. 3.1% (51/1670) cases were reported as GM of all breast FNAC and 38% (51/131) of all inflammatory lesions. Follow up was available for 47 cases. Of which 26 (55.3%) cases were diagnosed as Tubercular Granulomatous mastitis (TGM) and 21(44.7%) were idiopathic granulomatous mastitis (IGM).Conclusions: Countries where tuberculosis is endemic, high degree of clinical suspicion and detailed work-up to rule out TGM is essential for all cases of granulomatous mastitis. Authors recommend a multidisciplinary workup with microbiological culture and molecular based tests on FNA material. This retrospective study illustrates that the cause of GM needs to be determined accurately for timely treatment, to avoid unnecessary delays and treatment dilemma in these patients.
Evaluation of hybrid problem-based learning in large classrooms: a qualitative and quantitative analysis
Authors: Kharay Sonia S. , Sharma Anu , Bansal Priya
Published: October 2018

Background: Problem Based Learning (PBL) for teaching preclinical sciences has been proposed in curricular reform by Medical Council of India. PBL is a student-centred approach, enabling deep and transformative student learning. A 'hybrid' approach to PBL uses a range of class-based teaching methods; delivering a mode of PBL which is less resource intensive and more flexible than ‘pure’ PBL. In hybrid PBL, problems are solved in groups, but lectures are used to present the fundamental concepts and difficult topics. Our institution follows a traditional lecture-based curriculum. The present cohort study was undertaken to determine student and faculty perceptions for hybrid PBL as well as impact on student engagement.Methods: Hybrid PBL method was implemented for one cohort of hundred first year medical students. Previous batch was used as control taught by traditional lecture-based curriculum alone. Methodological triangulation design was employed for impact of hybrid PBL on student engagement (attendance scores-Chi square) and student and faculty perception to hybrid PBL (reflections- grounded theory)Results: The mean attendance score of MBBS batch 2016 was significantly better than batch 2015 (p=0.0001). The emerging themes in student reflections were innovative method, collaborative learning, quest for knowledge, promote long term retention and links to real-life scenario. Acquisition of soft skills (social and moral responsibility) was novel emerging theme in student reflections. Active student participation and improved critical thinking were themes expressed in faculty perceptions.Conclusions: Hybrid PBL with small groups is successful in large classrooms. Introduced at the initial phase of undergraduate medical education, it can assist robust self-appraisal in students and strengthen soft skills.
A comparative study of laparoscopic cholecystectomy with and without abdominal drain
Authors: Gadhvi Udit I. , Bhimani Dhaval A. , Waghela Jaivik , Rajgor Darshil K.
Published: October 2018

Background: Laparoscopic surgery has several advantages when compared to open surgery, including faster post-operative recovery and lower pain scores. Laparoscopic cholecystectomy is the main method of treatment of symptomatic gallstones. Routine drainage after laparoscopic cholecystectomy is an issue of considerable debate.Methods: Study was randomized, prospective, observational and longitudinal including 100 patients, selected according to inclusion criteria.Results: The sub hepatic fluid collection on first ultrasound at 24hrs was higher in drained group than in non-drained groups. Further, the difference became insignificant on subsequent ultrasound at 72hrs. Incidence of post-operative drain site pain was present in 25% of patients with drain (more at drain site). Incidence drain site infection was present in 16.6% of patients in drain group. Majority of the patients with drain group (n=24) required hospital stay for ≥3 days, while for majority of patients without drain group (n=20), required hospital stay was 1 day.Conclusions: An uncomplicated gall stone disease can be treated by laparoscopic cholecystectomy without need for drain with reasonable safety by an experienced surgeon. With no usage of drain, it is significantly advantageous in terms of post-operative pain, use of analgesics and hospital stay.
Correlation between ABO blood groups and various cancers in the north eastern region of India: a retrospective observational study
Authors: Kalita Chandana , Sarma Anupam , Sharma Jagannath Dev , Kalita Manoj , Krishnatreya Manigreeva , Kataki Amal Chandra
Published: October 2018

Background: Numerous studies have documented the association of the ABO blood groups with the occurrence of cancers. Aim was to find out an association of ABO blood groups and various cancers in the North Eastern region of India.Methods: The study was a retrospective observational study that included 1000 cases and 1000 controls. The data included the ABO blood typing of the selected cancer sites which were head and neck, esophagus, stomach, breast, cervix, and ovary. Patients who attended blood bank of regional cancer center with requisition for blood transfusion from 2014 to 2016 were included. The control group was healthy blood donors. Chi square test was used to assess the difference among the compared groups. Risk was calculated by regression analysis. P value <0.05 was considered as statistically significant at 95% confidence interval.Results: Out of 1000 cases and 1000 controls, O blood group were seen in 377 (37.7%) and 395 (39.5%) cases and control, respectively. Significant reduced odds ratio (OR) in non O blood groups for head and neck, esophagus, stomach, and breast was observed. In case of carcinoma cervix, OR for B group was 1.5 (P=0.05), and for blood group A OR=2.2 (P=0.02) was seen in carcinoma ovary.Conclusions: In the studied population, patients with O blood group are at an increased risk of developing head and neck, esophagus, stomach, and breast cancers.
Correlation between thyroxin hormone level, bilirubin and uric acid in diabetic subjects
Authors: Mathur Rajendra Dutt , Gupta Rameshwar Prasad , Gupta Deepak , Bhargav Ajay Kumar , Mathur Reenika
Published: October 2018

Background: Levels of thyroxin hormone along with T3, TSH and other markers such as uric acid, bilirubin and glucose are important in diagnosis and medical management of diabetes mellitus and thyroid disorder. Relationship between these parameters are important in both diabetes mellitus and Thyroid gland disease, as both disorders are increasing very fast in Indian population. Present study aimed to analyzed T3, T4, TSH, uric acid and bilirubin in Haroti Region of Jhalawar, Rajasthan in diabetic and non diabetic subjects.Methods: One hundred diabetes mellitus subjects and 100 healthy control subjects were analyzed for determination of thyroxin, T3, TSH, uric acid and bilirubin by commercial kit method.Results: One hundred subjects of diabetes mellitus between age 30-60 years male and female were analyzed. It was observed significantly T3 <0.001 T4 <0.001 TSH <0.001 bilirubin <0.01 in diabetic subjects and found to be significant when compared in both groups. However, uric acid level insignificant in both patients and control groups.Conclusions:This study demonstrated that thyroxin hormone with T3, TSH and bilirubin and uric acid, are important parameters and their values are significant when compared with healthy subjects in diabetes mellitus and thyroid disorder.
Prevalence of hypothyroidism in patients with type 2 diabetes mellitus attending a tertiary care hospital in a rural area of Bihar, India
Authors: Kamendu Abhishek , Aslami Ahmad Nadeem
Published: October 2018

Background: Diabetes has become a major health challenge all over the world. Previous studies have found that diabetes and thyroid disorders mutually influence each other and both disorders tend to coexist. The aim of this study was to find out prevalence of hypothyroidism and its associated factors in type 2 diabetes mellitus patients.Methods: Consecutive 200 patients with type 2 diabetes mellitus attending outpatient department of medicine in a tertiary care centre in Sasaram, Bihar were evaluated clinically and biochemically. Subclinical hypothyroid and overt hypothyroidism was diagnosed as per standard definitions. The results obtained were statistically analysed by using chi square test and finding odds ratio.Results: Out of 200 patients, 75.5% were euthyroid while 24.5% were hypothyroid. Out of 49 hypothyroid patients, subclinical hypothyroid (SC-Hypo) was present in 41 patients and overt hypothyroid (C-Hypo) was present in only 8 patients. The prevalence of hypothyroidism was found more in males, age ≥60 years, patients with HbA1c value ≥7%, patients with diabetes duration less than 5 years and in hypertensive patients.Conclusions: Thyroid dysfunction screening should be done in all type 2 diabetic patients periodically and appropriate individualized treatments in addition to thyroid function test should be given to diabetes mellitus patients with subclinical hypothyroidism as well.
Study of brainstem auditory evoked potentials in early (grade I) essential hypertensive patients
Authors: Gawali Sangeeta , Suryavanshi Garima , Badkur Manish , Suryawanshi Gaurav
Published: October 2018

Background: Essential hypertension is one of the most common world’s health diseases. It   frequently affects central nervous system (CNS) by producing micro-infarctions which results into altered evoked potentials. Previous studies have shown correlation between hypertension and brain stem auditory evoked potentials. But very scarce data is available on all the parameters of BAEP and essential hypertension especially “amplitude ratio” which distinguishes between central and peripheral impairment. This study was undertaken to evaluate the brain stem auditory evoked potentials (BAEPs) as early marker of cognitive damage in essential hypertension.Methods: BAEPs were recorded in 50 hypertensive subjects and in 50 normotensive controls. Absolute peak latencies, interpeak latencies of different waves and amplitude ratio were compared in both the groups by using unpaired student’s T test.Results: Significant changes in absolute latencies of wave I and V, Interpeak latency I-III, III-V and I-V and amplitude ratio V/I was observed in hypertensive group as compared to control group.Conclusions: Findings of the current study suggests that hypertension does affect the neuronal excitation in the auditory pathways, thereby suggesting that BAEP may provide the early evidence for the presence of CNS dysfunction in the patients of essential hypertension.
Promoting independence in dementia: protocol for a feasibility trial of the PRIDE intervention for living well with dementia
Authors: Csipke Emese , Yates Lauren , Moniz Cook Esme , Leung Phuong , Charlesworth Georgina , Walton Holly , Birt Linda , Orrell Martin
Published: October 2018

Background: Dementia can lead to social exclusion, loss of identity and independence, due to deterioration in cognition and activities of daily living. The aim of the study is to investigate the feasibility of the Promoting Independence in Dementia (PRIDE) intervention, designed to facilitate independence in people with mild dementia.

Methods: This is a mixed-methods feasibility trial of the PRIDE, in preparation for a future randomised controlled trial. Up to 50 people with dementia will be recruited. Demetia advisors will deliver the three session intervention. Quantitative outcomes will be taken at baseline and up to three months post baseline. Fidelity checklists will assess fidelity to the intervention. Qualitative implementation data will be gathered in a series of post-intervention semi-structured interviews with staff and participants. This will include data to examine participant experiences of and engagement with the intervention, and other aspects of delivery such as recruitment of DAWs, fidelity and experiences of receiving and delivering the intervention. This study aims to establish and field test the PRIDE intervention; determine the recruitment rate of sites, providers and participants; assess fidelity in delivery of the intervention and engagement with people with dementia; assess the feasibility and acceptability of outcome measure data and assess the acceptability of the intervention by stakeholders.

Conclusions: There has been increased need for non-pharmacological interventions for mild dementia. The results of this feasibility study will allow us to plan for a definitive RCT of a three session dementia advisor led intervention for mild dementia.
Knowledge and vaccination status on hepatitis B among the students of Patuakhali Science and Technology University, Bangladesh
Authors: Sabbir Ahmed M. , Rahman M. Wahidur , Fayeza Fahmida , Sharmin Tarana
Published: October 2018

Background: Hepatitis B virus (HBV) infection is a serious global public health problem as well as in Bangladesh. The most common liver disease in Bangladesh is viral hepatitis. Bangladesh is an intermediate endemic zone for hepatitis B virus infection. Research shows that about 10 million people in Bangladesh have been suffering from hepatitis B.Methods: The research was a cross-sectional survey and appropriate statistical formula was used to select 341 respondents randomly. The data were collected through a pre-designed, pre-structured questionnaire, which was distributed among the students. All the data was analysed using Microsoft Excel 2013.Results: Most of the respondent 95% knew about hepatitis B and about 87% knew that it is a viral infection. About 69% students respond that hepatitis B can increase liver cancer. Among the respondents, 76% supported that hepatitis B can be transmitted by blood transfusion. Most of the students 82% supported blood transfusion as a causative factor and 67% informed that jaundice is the major sign and symptoms of hepatitis B. More than half of the students 53% reported that they were vaccinated for hepatitis B. The major reasons for not taking vaccination were lack of free time and lack of feeling of necessity for vaccination.Conclusions: The overall knowledge and vaccination status on hepatitis B virus was not satisfactory. Different types of seminars and campaigns on hepatitis B, arranged by university will help to increase the student’s level of knowledge on hepatitis B.
Knowledge regarding diarrhoea and its management among mothers of under-five children in an urban area of Amritsar, Punjab
Authors: Kaur Amanpreet , Kaur Harpreet , Kaur Harpreet , Devgun Priyanka
Published: October 2018

Background: Diarrhoeal diseases are a leading cause of childhood morbidity and mortality in developing countries, and an important cause of malnutrition. In 2003 an estimated 1.87 million children below 5 years died from diarrhoea. In India nearly 1.5 million under-fives are dying every year only due to acute gastroenteritis. Therefore the present study was conducted to find the knowledge about diarrhoea and its management among the mothers of under-five children.Methods: A total of 400 mothers of under-five children were interviewed. The mothers were selected by adopting simple random sampling method. A pre-designed and pre tested questionnaire was used to collect the information. House to house survey was done to collect the information. Statistical analysis was done by using SPSS 20.0.Results: Majority of the mothers (72.8%) were in age group of 21-30 years. Out of total 53% knew that diarrhoea is passage of three or more loose stool in a day. Education status of mother has significant relation with the knowledge about diarrhoea and its spread (p=.000). 69.5% of the mothers knew that ORS should be given in dehydration. Only 66.3% could tell the correct method of preparing ORS solution. Source of knowledge about ORS for the mothers was mass media (45%), health workers (40.7%), books (29.7%), neighbours (28.2%) and family member (22.2%).Conclusions: The study concludes that there is lack of knowledge among mothers regarding diarrhoea and its management. There is a need of health education for mothers about diarrhoea and its management. IEC activities should be increased to educate the community about the principles of environmental hygiene.
An epidemiological cross sectional study to assess the prevalence of reproductive tract infections and sexually transmitted infections among married women in the reproductive age group in urban slum of Mumbai, Maharashtra, India
Authors: Rathod Neeta D. , Akre Charuhas V.
Published: October 2018

Background: In developing countries reproductive tract infections (RTI) and sexually transmitted infections (STI) continue to present a major public health problem. Women in India had very low knowledge in sexually transmitted infections and HIV/AIDS. It is found that many of the RTI/STI is preventable and curable. The occurrence of STI/RTI among married women is quite high. Hence, this study will be carried out to assess prevalence of STI/RTI in the married women of reproductive age group in an urban slum.Methods: A cross-sectional study was carried out in the general OPD of Urban Health Centre, Mumbai during the period of 1st July 2015 to 31st July 2015. The data of 180 women in the reproductive age group of 15 to 49 years was collected by Pretested, semi structure interview schedule and statistically analyzed.Results: In the present study, the prevalence of STIs/RTIs symptoms was found to be 35.6%. Maximum prevalence of the symptoms among the study subjects found to be higher in the age group of 35 years and above (40.4%), in illiterate women (53.7%), women having one or two children (52.7%), women using IUD (50%) and women having per capita income <Rs. 5000/- (45.2%).Conclusions: There is a need for preventing new STI/RTI cases by educating people about the common symptoms, common methods of transmission, complications and preventive measures.
A cross sectional study to assess the functioning of cold chain in a tribal district of central India
Authors: Chourasiya Sanjay K. , Baghel Anil S. , Verma Arpit , Kale Saket
Published: October 2018

Background: Immunization is one of the best efforts that India is putting forward currently to fight against various vaccine preventable diseases. Cold chain maintenance is always an issue. Therefore, cold chain maintenance is a pre-requisite in the correct delivery of immunization services.Methods: A cross sectional study was conducted among 18 cold chain points (CCPs) of Jhabua district using standard Government of India (GOI) structured questionnaires.Results: Out of 18 cold chain points only 5.55% had dry room for the storage of needle, syringes and other clerical material. A separate voltage stabilizer was attached each to deep freezer and ILR at only 22% of the health centers. Only 55.55% CCPs waste disposal pit constructed as per guideline. 94.45% cold chain handlers (CCHs) knew the definition of cold chain and correct temperature range at which vaccines to be stored, whereas only 33.33% CCHs knew about Shake test. 72.23% CCHs knew how to read vaccine vial monitor (VVM) and stages of VVM correctly. Knowledge of the CCHs regarding open vial policy was poor, with only 33.33% knowing exactly, the details of open vial policy.Conclusions: The quality of immunization programme can be increased by proper maintenance of cold chain and management of vaccine logistics at every designated cold chain point. There is need to improve the knowledge level of CCHs regarding cold chain maintenances and handling practices.
Assessment of knowledge and attitude regarding intrauterine devices among auxiliary nurse midwife in two districts of North Bengal
Authors: Biswas Romy , Bhattacherjee Sharmistha , Ray Kuntala , Roy Jayanta K. , Sarkar Tapas K. , Chakraborty Manasi
Published: October 2018

Background: Despite being one of the most easily available and reversible methods of family planning, IUD utilization continue to remain low, as evident in the nationwide surveys. One of the reasons was poor knowledge and skills on IUD provision among health care providers. This study examined factors related to providers, by examining their IUD-related knowledge, and their attitudes toward recommending or inserting the IUD.Methods: A descriptive cross sectional study was conducted among 503 ANMs from Uttar Dinajpur and Darjeeling Districts using a semi-structured questionnaire exploring the service providers’ knowledge, current practices and experience with IUD insertion. Attitudes regarding IUDs were assessed by asking how much they agreed with a number of hypothetical statements about the IUD.Results: The proportion of good knowledge and favourable attitude was 57.5% and 60% respectively. The knowledge was found to be significantly higher among ANMs aged less than 30 years and who had graduate education than their counterparts. Better knowledge and favourable attitude was found among the ANMs posted in Darjeeling and had service experience of more than 5 years.Conclusions: The knowledge and attitude of the ANMs were found to be less than satisfactory. Addressing IUDs and other newer contraceptives in pre-service curriculum, within job training and peer group education in both public and private areas may help the situation.
Study of correlation of ER, PR, HER2 receptor status in breast cancer at a single tertiary care hospital with emphasis on clinical utility of PR receptor
Authors: Shukla Anjika , Singh Poonam , Shukla Anju , Mehrotra Prateek Kumar , Arshad Farah , Jain Priyanka
Published: October 2018

Background: The receptor status of breast cancer, including ER, PR and HER 2, play a crucial role in the development of treatment plan of breast cancer. Clinical utility of ER as a predictive biomarker to identify patients likely to benefit from hormonal therapy is well established, added value of PR is less defined. This study aim to know the demography of breast cancer and to document the status of ER, PR and HER 2 status in the north Indian population, as catered by single tertiary care hospital in Lucknow, Uttar Pradesh.Methods: All the patients of breast cancers where surgery or core biopsy was performed for invasive breast carcinoma followed by evaluation of ER, PR and HER 2 status were included in the study from January 2014 to June 2018. Cases were analyzed retrospectively for documentation of ER, PR and HER2 status, using American society of Clinical Oncology/College of American Pathologists (ASCO/CAP) interpretation guidelines.Results: 112 patients were included in the study with mean age of 53.70±12.47. Most common histological type was invasive carcinoma of no special type. 43.75% cases were ER+/PR+, 5.35% were ER+/PR-, and 50.89% were ER-/PR-. ER-/PR+ status was seen in none of our cases. Correlation of ER and PR with HER 2 was possible in 90 cases and triple negative breast cancer (TNBC) status was observed in 32.2% of cases.Conclusions: Demography and ER positivity and incidence of TNBC is not different from rest of India, however the clinical utility for evaluation of PR receptor is to be further investigated.
An epidemiological study to assess the determinants influencing decision of medical termination of pregnancy among women undergoing medical termination of pregnancy in maternity homes, in a metropolitan city
Authors: Chakkarwar Priyanka P. , Fernandes Sophia D.
Published: October 2018

Background: Unwanted pregnancy alone does not determine the decision to terminate pregnancy but a combination of factors influence each other to terminate pregnancy. This study was undertaken to know about the reasons for undergoing MTP. AIM: “An epidemiological study to assess the determinants influencing decision of medical termination of pregnancy among women undergoing medical termination of pregnancy in maternity homes, in a metropolitan city.”Methods: Cross sectional study was conducted from December 2013 to December 2015. The study area was the maternity homes under Municipal Corporation. Women in the age group 19-49 years undergoing MTP, who gave consent were included in the study. Women in the age group <18 years undergoing MTP and women not in a state to participate in the study were excluded from study. The sample size for study was 199. Data was collected using semi structured validated questionnaire and analysed using IBM SPSS Version 21.0 statistical software. Association between variables was analysed using Chi-square test, Fisher’s exact test.Results: All study subjects were married women. The mean age of the women undergoing MTP was 28.41 years. Illiteracy among wife and husband was (09.11%) and (10.55%) respectively. 54 (27.14%) subjects belonged to upper-lower socioeconomic class. The most common 123 (61.81%) reason for undergoing MTP was “completed family”, followed by “medical reason”.Conclusions: Study results emphasize the need to encourage women for the use of FP methods.
Morbidity pattern and its correlates among adolescent girls residing in rural and urban areas of Haldwani, India
Authors: Goyal Neha
Published: October 2018

Background: Adolescent girls are vulnerable to different morbidities as their health is a confluence of diverse factors, with the profile of disease burden varying from early adolescent girls of 10-14 years age, to late adolescent girls of 15-19 years age.Methods: This cross-sectional study was done in rural and urban schools of Haldwani block of district Nainital. Multistage random sampling was used to select adolescent girls of 10 to 19 years of age, who were clinically examined and interviewed. Data was analysed using SPSS v21. Statistically significant association was established by Chi-square test.Results: Common morbidities found among adolescent girls were menstrual problems (54.81%), malnutrition including nutritional deficiencies (54.03%), refractive errors (31.17%), hair problems (28.31%) and dental problems (28.18%). General morbidity was present among 51.69% and 61.47% of rural and urban girls respectively. 123 (15.97%) and 97 (12.60%) were found to suffer from skin diseases and respiratory diseases respectively.Conclusions: This study revealed a high prevalence of various morbid conditions among adolescent girls despite of various ongoing measures addressing them.
Knowledge regarding rabies and its prevention among first year medical college students, Mandya
Authors: Manjunath M. , Manuja L. M. , Harish B. R.
Published: October 2018

Background: Rabies is a zoonotic disease that is caused by a virus and is always fatal which can be prevented by timely and appropriate post exposure prophylaxis. The large number of deaths due to rabies can be attributed to the fact that in spite of availability of effective vaccination against rabies, people are unaware of various aspects of rabies and its prevention. Hence this study was conducted to assess the knowledge regarding rabies and its prevention among first year medical students.Methods: This descriptive cross sectional study was conducted among first year medical students of Mandya Institute of Medical Sciences, Mandya. The data was collected using pretested semi-structured questionnaire and analysed using descriptive statistics.Results: Of the total 80 students who were included, 90.0% knew that rabies is a disease caused by a virus. All of them knew that dogs transmit rabies. 96.3% were aware of the mode of transmission. 30.0% answered that rabies can be transmitted by scratch. 25% had the wrong perception that rabid person can present with epileptic features. 28.8% had given correct answer regarding the number of doses of vaccination. 86.3% knew that rabies can be prevented by vaccinating animal.Conclusions: Majority of the students had incomplete knowledge about rabies and its cause and mode of transmission and unaware of post exposure prophylaxis.
Fibro-osseous lesions of the paranasal sinuses and the skull base
Authors: Alturaiki Sajedh M. , Almomen Ali , Al Azzeh Ghaleb , Al Khatib Abdulrahman , Alshaikh Nada
Published: October 2018

Background: Osteomas, ossifying fibromas, and fibrous dysplasia comprise a set of benign neoplasms known as fibro-osseous lesions (FO), which can arise in the paranasal sinuses. The vast majority of benign FO lesions (BFOL) are incidental findings on radiographs. They tend to be slow-growing tumors, and are infrequently symptomatic. The management strategy can vary significantly for theses lesions. This can range from serial, observations to aggressive surgical resection, based on symptomatology, size, and location of the lesion.

Methods: Retrospective analysis of all the data of different symptomatic FO of the paranasal sinuses and the skull base was performed at King Fahad specialist hospital, Dammam, KSA (2006 to 2017).  

Results: A total of 21 patients were identified; 10 (46.7%) patients were diagnosed with osteoma, 8 (38.1%) with ﬁbrous dysplasia, 2 (9.5%) with ossifying fibroma and one (4.8%) with juvenile active ossifying (JAOF), 17 were adults and 4 were children, the range of f/u (3-60) months. 19 patients were managed by the endonasal endoscopic approach. They continue to be followed with no evidence of recurrence. Two cases required the revision combined endoscopic open approach to ensure adequate removal of the disease (residual and recurrence).

Conclusions: Diagnostic dilemma of BFOL can be overcome with a combination of clinical, radiological and pathological criteria. Correct diagnosis of fibro-osseous tumors is crucial for adequate therapy as their treatment, prognosis, clinical aggressiveness and long term complications of individual entities vary significantly. Endoscopic computer-assisted surgery is the treatment of choice. Endoscopic resection remains a technical challenge. 