bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of safety and efficacy of laparoscopic appendectomy during pregnancy
Authors: Abdelhameed Hosam F. , Abdelmageed Samir A.
Published: August 2018

Background: Optimal surgical approach for appendectomy during pregnancy remains controversial. The objective of this study is to evaluate (LA) during pregnancy as regard safety and outcome compared with open appendectomy (OA).Methods: Patients with acute appendicitis during pregnancy who were admitted to Sohag University Hospital from August 2014 to April 2018 were randomized to 2 groups: Group A (OA, 22 patients) and group B (LA, 20 patients). The primary end point was incidence of fetal loss. Secondary endpoints comprised preterm delivery, operative time, length of hospital stay, conversion rate and surgical complications.Results: Forty-two patients were enrolled after exclusion of three cases due to severe cardiac disease. Fourteen patients (33.3%) presented during first trimester 7 patients per group, 19 (45.2%) during second trimester 10 in group A (23.8%) and 9 in group B (21.4%) and 9 (21.4%) during third trimester 5 in group A (11.9%) and 4 in group B (9.5%). Mean maternal age was 22.3±4.2 (range, 18-38) years in group A and 21.3±3.6 (range, 17-35) years in group B. Fetal loss occurred in one patient in group A (4.5%) and in 2 patients in group B (10%). No pre-term delivery occurred in either group. Operative time was slightly longer in group A (mean op. time was 42±12 min vs. 40±11min) than in Group B. No intra operative complications occurred in either group. Hospital stay was significantly shorter in group A (1.2±1.8 days) while it was (3.6±1.1days) in group B. Wound infection occurred in two patients (10%) in group B while no post-operative complications occurred in group A.Conclusions: Forty-two patients were enrolled after exclusion of three cases due to severe cardiac disease. Fourteen patients (33.3%) presented during first trimester 7 patients per group, 19 (45.2%) during second trimester 10 in group A (23.8%) and 9 in group B (21.4%) and 9 (21.4%) during third trimester 5 in group A (11.9%) and 4 in group B (9.5%). Mean maternal age was 22.3±4.2 (range, 18-38) years in group A and 21.3±3.6 (range, 17-35) years in group B. Fetal loss occurred in one patient in group A (4.5%) and in 2 patients in group B (10%). No pre-term delivery occurred in either group. Operative time was slightly longer in group A (mean op. time was 42±12 min vs. 40±11min) than in Group B. No intra operative complications occurred in either group. Hospital stay was significantly shorter in group A (1.2±1.8 days) while it was (3.6±1.1days) in group B. Wound infection occurred in two patients (10%) in group B while no post-operative complications occurred in group A.
A study of role of non-operative management in blunt abdominal trauma with solid organ injury
Authors: Bansod Atish N. , Umalkar Rohan , Shyamkuwar Ambrish T. , Singade Amar , Tayade Priyanka , Awachar Neha
Published: August 2018

Background: The present study of role of non-operative management in blunt abdominal trauma with solid organ injury was done to assess the feasibility and safety of non-operative management in hemodynamically stable patients and identify the causes, predictive factors to delineate the rate of non-operative management failure.Methods: A longitudinal observational study was carried out from September 2013 to November 2015. All cases of blunt trauma abdomen with ultrasonological e/o solid organ injury and were hemodynamically stable were included in study.Results: Total 138 cases presented with a history of blunt trauma abdomen of which 56 cases had ultrasonological evidence of solid organ injury. 8 cases were excluded as 6 of these were hemodynamically unstable at presentation while 1 had bowel perforation and another had severe head injury all requiring operative management. Maximum cases were of age group 21-30 years (41.66%) and 31-40 years (31.25%). 42 (87.5%) cases were male and 6 (12.5%) cases of 48 were females.  28 (66.67%) cases presented as Road Traffic Accident. 28 (66.67%) cases had abdominal pain as the commonest symptom while tenderness in 38 (79.17%) cases and tachycardia in 30 (75%) cases was the predominant sign. Most injuries were seen in spleen 23 (47.92%) cases f/b Liver with 14 (29.12%). Conservative management was successful in 40 (83.33%) cases and failed in 8 (16.67%) cases. Mortality of the study was 1 (2.08%) case.Conclusions: Non-operative strategy is a successful approach in patients who are hemodynamically stable and authors strongly recommend it.
Clinical profile and outcome of pelvi-ureteric junction obstruction (PUJO) in children presenting above 1 year
Authors: S. Pramod , Ramji Ashwath Narayan
Published: August 2018

Background: Pelvi-ureteric junction obstruction (PUJO) is defined as anatomical or functional obstruction to the flow of urine from the pelvis to the upper ureter. With the advent of ultrasonography most of the cases of PUJO are identified in antenatal period. The treatment protocol for antenatal diagnosed PUJO is standardized. Few children present later in life. Present study was done to evaluate clinical profile and outcome of children presenting with PUJO above 1 year.Methods: A retrospective observational study conducted by the department of Paediatric Surgery, KIMS hospital Bangalore.  All children with PUJO above 1 year of age from January 2015 to January 2018 were included. Clinical, biochemical and imaging findings of these children were tabulated. A diuretic renogram was done to confirm the diagnosis. The children underwent either pyeloplasty or nephrectomy, depending on the function of the kidney. In children with calculi, pyelolithotomy with pyeloplasty was done. The children were followed up post-surgery.Results: Twenty-six children were included in the study. Mean age of presentation was 6.86±4.13years. Most common presentation was pain abdomen. Left kidney was commonly involved. The mean anteroposterior pelvic dimension (APPD) of involved kidney was 38.96±17.7 mm. 5 children presented with poorly functioning kidney with split renal function less than 10%. In three children PUJO was associated with pelvic calculi. Out of the 26 children simple nephrectomy was required in 4 (15%) children. The remaining 22 children underwent pyeloplasty. Mean duration of stay was 6.19±1.8 days. Post-pyeloplasty diuretic renogram showed improved drainage with improved function.Conclusions: PUJO is common cause of urinary obstruction in children. Delay in diagnosis or presentation leads to increased chances of renal damage and loss. Hence it is important to diagnose PUJ obstruction at the earliest and receive prompt treatment.
Evaluation of hematological findings in children with Down syndrome
Authors: Sarbay Hakan
Published: August 2018

Background: Various hematological disorders and malignancies may be encountered with Down syndrome. In this article, hematological findings of children with Down syndrome were investigated.Methods: The hematological results of 106 Down syndrome children aged 3 months to 17 years were assessed retrospectively. The results were compared with a patient group consisting of non-DS and healthy children with a similar age range.Results: When compared with the control group, a significant difference was found between the frequencies of neutropenia, monocytosis, macrocytosis and anisocytosis. No significant difference was detected between the patients with macrocytosis and those without macrocytosis when the relation of macrocytosis with other hematological disorders was examined. On the other hand, the comparison between the groups with and without macrocytosis showed that the prevalence of acute leukemia was significantly higher in patients with Down syndrome.Conclusions: DS children with macrocytosis should be more closely monitored for myelodysplastic syndrome and acute leukemia.
Persistent processus vaginalis presenting as hydrocele and hernia
Authors: Prabakaran S. , Thilagam K. Kasthuri
Published: August 2018

Background: Inguino-scrotal swelling is a common finding in the paediatric population, attributed to the persistent processus vaginalis. But the reason why some children present with hernia and some with hydrocele is not yet clear. Histological examination of the sac may be useful in understanding the reason for this differential presentation. Hence the current study was undertaken to assess the association between type of clinical presentation and histological findings in pediatric population.Methods: A prospective observational study was done on 51 children aged below 12 years presenting with inguinoscrotal swelling and subsequently diagnosed with either hernia or hydrocele and treated with surgical intervention. The samples were sent for histological examination and analysed for association with diagnosis.Results: There were 31 Inguinal hernia and 20 Hydrocele subjects. The predominant age group was 6 to 10 years. The number of children with hydrocele right and left, inguinal hernia right and left was 21 (41.2%), 10 (19.6%), 17 (33.3%) and 3(5.9%) respectively. All hydrocele subjects had mesothelial lining, smooth muscle but scanty lymph vessels and absent inflammatory cells. 95% of the Inguinal hernia subjects had low cuboidal lining, inflammatory cells, and lymph vessels.Conclusions: Paediatric inguinal hernias and hydroceles are due to incomplete or abnormal obliteration of the processus vaginalis. Mesothelial lining, Presence of smooth muscle, Scanty lymph vessels, absence of inflammatory cells are characteristic of Hydrocele Inguinal hernia is characterized by low cuboidal lining, absence of smooth muscles, presence of lymph vessels and inflammatory cells.
Early periventricular leukomalacia in preterm neonates
Authors: Kapoor Saurabh , Sharma Ravi , Sapare Anilkumar , Aggarwal Rajiv
Published: August 2018

Background: Preterm neonates are at increased risk for brain injury. More than 10% will sustain neurological injuries leading to significant learning disabilities, motor developmental delay, cerebral palsy, seizures and mental retardation. Periventricular leukomalacia (PVL) is the most common form of white matter injury of prematurity. The objective of the present study was to identify the incidence of early periventricular leukomalacia (PVL) and its associated risk factors in the study group.Methods: All preterm neonates with either Gestational age <32weeks and/or Birth weight <1500 grams who were admitted to Neonatal Intensive Care Unit within the period of 1st November 2013 to 30th April   2015 were taken for study. A total of 112 babies met the inclusion criteria but 104 were finally taken into the study. Screening of intraventricular haemorrhage and early PVL changes in VLBW babies was done by neurosonogram on day 3 and day 14 of life by a single well qualified radiologist. Follow up cranial ultrasound was done weekly for the babies who were diagnosed to have IVH and/or PVL by day 14 of life.Results: The incidence of early periventricular leukomalacia in very low birth weight babies in present study was 7.7%. It was seen that 87.5% babies had periventricular flares and 12.5% babies had cystic changes. It was seen that birth weight<1000grams (OR 0.006; CI:0.00-0.50; p value 0.023) and neonatal sepsis (OR 80.9; CI:1.65-3947.6;p value 0.027) significantly increased the risk of developing PVL in VLBW babies. The duration of hospital stay was found to be significantly increased in babies having PVL.Conclusions: The incidence of early periventricular leukomalacia in babies born <32weeks gestation and/or birth weight<1500grams is 7.7%. Birth weight <1000 grams and neonatal sepsis were found to increase the risk of periventricular leukomalacia in these babies.
Study of correlation between gestational age and new-born foot length and chest circumference
Authors: Gupta Aayush , Mehrotra Gunjan Kela , Mulye Swati
Published: August 2018

Background: Globally, in 2015, 1 million children died on first day of their life. The neonatal mortality rate is declining less rapidly than the mortality rate for children between 1month and 5 years of age. Thus, contribution of the neonatal mortality to the under-five deaths is increasing. Usually as average income of a country increases, it leads to decline in child mortality yet some countries in the fast lane for global economic growth such as India have been in the slower lane for child mortality reduction.Methods: This study was conducted at Sri Aurobindo Medical College and PG Institute, Indore from October 2015 to March 2017 for period of 18 months. Total of 800 live new-borns were included in this study by simple random technique. The statistical analysis of data was done using SPSS for Windows (Version 20.0) software. The correlation of gestational age with new-born foot length and new-born chest circumference was analysed by applying correlation and regression analysis.Results: Foot length is significantly correlated with both gestational age and birth weight with p value of < 0.05 and highly positive correlation coefficient. Chest circumference is significantly correlated with both gestational age and birth weight with p value of < 0.05 and highly positive correlation coefficient.Conclusions: This study tried to identify anthropometric parameter (foot length and chest circumference) which allows for rapid evaluation of the infant for gestational age and provide at risk infants with timely care.
A study on the failure of breast feeding during the first month of life with effect on immunological level
Authors: Datta Shyamali , Datta Bijan Kumar , Banik Avirupa Kansha , Datta Nilanjan
Published: August 2018

Background: In the critical phase of immunological immaturity of the newborn, particularly for the immune system of mucous membranes, infants receive large amounts of bioactive components through colostrum and breast milk. Breastfeeding provides unsurpassed natural nutrition to the newborn and infant. Study was done to know the effects of breast milk feeding versus formula feeding in early infancy on the development of serum IgA, IgM and IgG.Methods: The present study investigated 100 cases of failure of breast feeding. The cases included both complete and partial failure. Values of immunoglobulin levels (IgA, IgM and IgG) in the serum of eleven breast fed and eleven artificially fed infants (all aged one month) were determined using Tripartigen plates.Results: Mean level of IgA in artificially fed infants was 20.72±3.82µg/100 ml. The diameter of precipitin ring using sample number 7 was 3.9 mm. The mean level of IgA in breast fed infants was 25.94±3.89 µg/100 ml.  The mean level of IgM in artificially fed infants was 31.690±3.504 µg/100 ml. The mean level of IgM in breast fed infants was 36.81±5.13 µg/100 ml. The mean level of IgG in artificially fed infants was 480.25±52.23 µg /100 ml. The mean level of IgG in breast fed infants was 517.59±56.72 µg /100 ml.Conclusions: It is evident from the results of immunoglobulin estimation (Ig A, Ig M and IgG) in infants with artificial milk and in infants with breast milk (vide table 5, 6, 7, 8, 9 and 10) that though the mean serum levels (Ig A, Ig M and IgG) in breast fed infants were slightly higher than that of artificially fed infants. There was no statistically significant difference in the serum immunoglobulin levels between these two groups.
Prevalence of carriage of community-acquired Methicillin-resistant Staphylococcus aureus among children attending the pediatric OPD at a tertiary care hospital
Authors: Radhakrishnan Vishnurajan , Ravichandran Saranya , Vadivelu Senthamarai Murugaiyan , Radhakrishnan Shankar
Published: August 2018

Background: Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infections are commonly recognized in persons without traditional risk factors. Nasal carriage of MRSA is an important risk factor for subsequent MRSA infection and transmission of this pathogen. The aim of this study was to estimate the prevalence of carriage of community acquired MRSA and to describe its antibiotic susceptibility pattern among the pediatric population.Methods: A prospective longitudinal study was conducted in our hospital for a period of 6 months. All pediatric patients age less than 15 years attending the pediatric OPD were included in the study. A total of 325 children were included in the study based on our inclusion and exclusion criteria. Nasal smear was collected by tilting back the child’s head and gently inserting a sterile cotton swabs pre-wetted with sterile saline and slowly rotating against the turbinate of both anterior nares. The following antibiotics were tested for sensitivity pattern: penicillin, pipercillin, erythromycin, clindamycin, cotrimoxazole, vancomycin, linezolid, rifampin, ciprofloxacin and daptomycin. Any S. aureus that is resistant to Cefoxitin was defined as MRSA.Results: The prevalence of Staphylococcus aureus was found to be 26.7% of the entire microorganism detected and 6.4% (n = 21) of the entire study subjects had methicillin resisitant Staphylococcus aureus. Of testing the susceptibility of the various antibiotics vancomycin was the only drug found to be 100% sensitive followed by linezolid and pipericillin (90%). 50% sensitivity was seen with erythromycin and very poor sensitivity was seen in cefuroxime and ciprofloxacin (<50%).Conclusions: CA-MRSA strains tend to replace HA-MRSA in health-care settings, making infection control measures less effective. Hospital based antibiotic policy has to be created and strictly followed to minimize the burden of antibiotic resistance.
Anaemia in HIV infected HAART naïve and HAART exposed children
Authors: Sule Ajey , Kulkarni Rajesh Kishanrao , Kinikar Aarti , Valvi Chhaya , Rajput Uday , Dawre Rahul
Published: August 2018

Background: The 2016 UNAIDS report estimates about 2.1 million people living with HIV in India, of whom about 7 per cent are children under the age of 15 year. The primary objective of this study was to analyze the prevalence of anaemia in HIV Infected HAART naïve and HAART exposed children. The secondary objectives were to analyze the type of anaemia and correlation of anaemia with dietary habits and associated opportunistic infections. Present study was a cross-sectional, observational study carried out in pediatric ART OPD and ward of a tertiary care teaching hospital, from June 2011 to May 2013.Methods: Complete haemogram, peripheral smear and CD4 counts were done on 130 children with confirmed diagnosis of HIV infection. CDC staging was used to stratify children. We used Chi square test to determine the association between CDC staging, HAART therapy, diet and opportunistic infection with anaemia. P-value <0.05 was taken as significant.Results: 80% (n = 27) of the children with no immunosuppression, 86% (n = 58) of the children with moderate immunosuppression and 84% (n = 24) children with severe immunosuppression were anemic. There was no statistically significant relation between worsening immunosuppression and prevalence of anaemia (p = 0.715). 88% of the children with no opportunistic infection (n = 72) were anemic, while 76% (n = 34) children with opportunistic infection were anemic. This difference was statistically significant (p = 0.016). 88% (n = 53) of the children on HAART were anemic while 74% (n = 51) of the children not on HAART were anemic. Children on HAART did not have significantly high prevalence of anaemia when compared to children not on HAART (p = 0.99). Anaemia was significantly more common in children consuming vegetarian diet (88%, n = 46) compared to children consuming mixed diet (74%, n = 58, p <0.01).Conclusions: Prevalence of anaemia is similar in children on HAART compared to HAART naïve children and at all stages of immunosuppression. Anaemia was more common in the presence opportunistic infections and in children consuming vegetarian diet. Microcytic hypochromic anemia was most common type of anaemia followed by normocytic normochromic anaemia.
Serum vitamin B12 levels in severe acute malnutrition hospitalized children between age group 6 months to 59 months in Kangra, India
Authors: Vaid Ajay , Sharma Milap , B. Jamunashree , Gautam Piyush
Published: August 2018

Background: Child malnutrition is a major global health problem contributing to childhood morbidity, mortality, impaired intellectual development, suboptimal adult work capacity and increased risk of diseases in adulthood. Severe acute malnutrition, among children below five years of age remains a major embarrassment, and impediment to optimal human capital development in India.Methods: The study was an observational study conducted in the Department of Pediatrics and Biochemistry at Dr. RPGMC Kangra at Tanda, Himachal Pradesh. All children aged between 6 to 59 months presenting in the Department of Pediatrics with SAM (Severe Acute Malnutrition) and fulfilling the inclusion and exclusion criteria were included in the study after taking the informed consent from the guardian in local language.Results: Out of 48 children included in the study, 28 (58%) children were Males and 20 (42%) children were females with male to female Ratio 1.3:1. Out of 48 children 28 (58%) were vitamin B12 deficient and 20 (42%) were non-deficient. In the present study 53.5% (15) of males were vitamin B12 deficient. Out of 20 females 65% (13) of females were vitamin B12 deficient, showed slight preponderance of females over males. It has been observed that younger age group children mostly <2-year-old were, the most vulnerable group as far as vitamin B12 deficiency is considered (16%)Conclusions: Micronutrients play a central part in metabolism and in maintenance of tissue functions. All severely malnourished children have vitamin and mineral deficiencies. The most common type of anemia was microcytic followed by megaloblastic anemia.
Osteoblastoma with secondary aneurysmal bone cyst in the proximal femur of a 6-year-old boy: a rare case report
Authors: P. Umasankar , U. Lakshmi Priya , Zainudeen Fadiya
Published: August 2018

Osteoblastoma is a rare bone forming neoplasm. It is extremely rare for osteoblastoma to present with secondary aneurysmal bone cyst. Authors present a case of a 6-year-old boy with osteoblastoma of the femur with secondary aneurysmal bone cyst. To the best of the knowledge, this is the first such case report of the lesion presenting in proximal femur.
Relation between serum uric acid and diabetes type II
Authors: Banjar Ghadeer , Abdulrahim Hanadi , Alomari Jawaher , Aldeijy Reem , Almalki Azzam , Alrabghi Sultan , AlMuhanna Rawan , ALAMA Abdulhamid , Albalawi Anwar , Almazrui Osama
Published: August 2018

Incidence of diabetes mellitus type 2 has been increasing worldwide, making the disease of extreme importance. Several reports have suggested a possible association between serum levels of uric acid (SUA) and higher incidence of diabetes mellitus type 2. On a biological basis, uric acid can negatively affect insulin resistance in animals. This occurs due to the inhibition of nitric oxide which is crucial to achieve glucose uptake. In this study, we aim to: report on previous literature on relation between serum uric acid and diabetes type II in Saudi and prevalence of association between them. PubMed database and EBSCO Information Services were used for articles selection. All relevant articles to our review with the topics regarding the relation between serum uric acid and diabetes type II, and other articles have been used. We excluded other articles, which are not related to this field. The data will be extracted according to specific form in which it is going to be reviewed by the group members. In this meta-analysis we found that SUA levels positively correlate with diabetes mellitus type 2. Future studies should try to determine the reliability of using SUA levels to predict diabetes mellitus type 2 and improve prevention.
Non-medical university students are not more knowledgeable than general population concerning serious diseases
Authors: Elshambaty Yasir B. , Gismalla Mohamed D. , Alomari Ahmed S. , Alghamdi Abdulkareem A. , Almalki Abdulelah F. , Alzahrani Ahmad S.
Published: August 2018

Background: The aim of this study was to know the level of awareness of non-medical university students of risk factors and symptoms of colorectal cancer.Methods: This is a cross-sectional study conducted at Al Baha University among non-medical students between 1st of May and 30th of June 2017.Results: The study comprised (n=463) students. Smoking and sedentary life as risk factors to CRC was known by (55.3%) and (51.0%) respectively. less than half (42%) knew that alcohol is a risk factor. The vast majority of our students (68.7%) had known that fruits and vegetables can decrease the incidence of CRC. The symptoms of CRC that more recognized by participants were abdominal pain (43.2%) and bleeding per rectum(45.5%).Conclusions: We concluded that the overall knowledge of non-medical University students concerning the awareness of risk factors and symptomatology of colorectal cancer is poor and nearly similar to general population knowledge concerning this problem.
Knowledge, attitudes and practices of faculty members' about computer vision syndrome, Majmaah University, Saudi Arabia
Authors: Aldawsari Saad Abbas , Alotaibi Abdullah Ayidh , Alabdulwahhab Khalid Mohamed , Mohamed Elsadig Yousif , Abdelmajid Sharafeldin
Published: August 2018

Background: Computer vision syndrome (CVS) is a group of eye problems that result from using the computer for a long time, it became a health problem. This syndrome is characterized by several symptoms including eyestrain, headaches and neck pain. The aim of the study was to investigate the knowledge, attitude, and practice of faculty members' about computer vision syndrome, Majmaah University, Saudi Arabia.Methods: The present study is cross-sectional study, which was conducted in Majmaah city in Sudair area in the north of Riyadh region. The study included faculty members of the College of Medicine and medical science college, Majmaah University.Results: There were 86 (74.8%) males, and 29 (25.2%) females participated in this study. The mean±SD of years using a computer by participants was 14.78±5.69 years and the mean±SD of hours spent using a computer daily was 5.25±2.2. There were 91.3% knew the bad effects of computer on the eyes, the most common symptoms resulted from long period of using computer were eyestrain 28.7% and headache 14.8%. The mean±SD score of attitude was 67.75±7.72.Conclusions: There is good knowledge, attitude and practice among faculty members about computer vision syndrome.
Alcohol consumption among immigrant construction workers and its correlates, a need for action
Authors: S. Rajeshkannan , P. Parthiban , Reddy G. Murali Mohan
Published: August 2018

Background: In developing countries, although the construction industry is making rapid strides, the health of the migrant construction workers is almost neglected. Among the major industries, construction workers have one of the highest alcohol abuse rates. Their working patterns, lack of recreational activities, lack of education, misconceptions and taboos make construction workers indulge in Alcohol abuse.Methods: A cross-sectional community-based study was done in old Mahabalipuram road of Chennai on 300 immigrant construction workers working in the construction field at least for the past one year using WHO recommended AUDIT (alcohol use disorders identification test) questionnaire to estimate the prevalence of alcohol use and associated factors.Results: The prevalence of alcohol consumption was 55.7%. The majority (56%) of alcoholics consumed alcohol once or less in a month. 81% of alcoholics had AUDIT scores below 8, 17% between 8 to 15. None scored more than 20. There was no statistically significant difference between the educational qualification, age with regards to prevalence of alcohol consumption. Male gender (p<0.001) influenced substance use.Conclusions: The prevalence of alcohol use (55.7%) among construction workers was very high compared to the general population. Specific intervention programs are warranted to reduce the future burden of alcohol use related morbidity among these workers.
Assessment of patient satisfaction in outpatient department of a tertiary care hospital in West Bengal, India: a questionnaire based study
Authors: Kumar Pankaj , Adhikari Anjan , Ray Moumita , Indu Rania , Bhattacharya Sangita , Das Anup Kumar
Published: August 2018

Background: Feedback is an important and integral part of any system. Perception of the beneficiaries in any healthcare setup provides impact for refining the system. The assessment of the patients’ satisfaction on different issues regarding healthcare services provides insight about the drawbacks of different healthcare systems. This could assist to upgrade the quality of services through different interventional measures. Present study evaluated the patient satisfaction in outpatient departments (OPD) of a tertiary care hospital, Kolkata, West Bengal.Methods: A total of 500 patients, attending different OPD in a tertiary care hospital were randomly selected for an observational, questionnaire based interview study, initiated in 2016. Some predictors for patients’ satisfaction like ‘outpatient department services’, ‘waiting time’, ‘cleanliness’, ‘privacy’ and ‘any problem faced during health checkup’, ‘overall satisfaction’ were evaluated.Results: Present study showed 78% of the study population was satisfied with the service received and 81% opined that clean environment was effectively maintained in the hospital premises and different outpatient departments. 83%, 84% and 75% of the patients were satisfied regarding the registration process, services received from the doctors and pharmacy, respectively. However, waiting time was too long and privacy was not maintained properly.Conclusions: Present study regarding patients’ satisfaction towards quality health care concluded that optimal care can be provided by combining both medical and social aspects, influencing the psychological factors of the patients. A separate system should be developed on assessment of “need of the patient” as well as guiding the patient for proper use of the health facilities.
Information gap amongst animal bite victims and their care givers: a study conducted at anti rabies centers of a city in North India
Authors: Singh Amudeep , Singh Amarjeet
Published: August 2018

Background: Animal bites are a neglected public health problem. The irony is that majority of mortalities are due to unawareness of wound management procedures and prevailing various myths and misconceptions. There is dearth of evidence pertaining to it thus we aim to ascertain the information gap amongst victims regarding various aspects of managing animal bites.Methods: A cross sectional study was undertaken at ARCs of Chandigarh. 100 purposively selected animal bite victims were interviewed from January 2015 to April 2015. Information Gap was ascertained by using pre tested semi structured questionnaire. Data was analyzed using EpiInfo and MS Excel.Results: An overall high information gap of 63.5% was seen amongst the knowledge of respondents’ i.e. materials to be used, time and duration for wound washing; place of reporting; knowledge pertaining to disease caused by animal bites and it’s prevention strategies; vaccination related information; location and timing of ARCs.Conclusions: A definitive information gap needs to be addressed through to implementation of public health promotion based programmes.
Knowledge of basic life support among health care professionals in a tertiary care hospital in Chitradurga
Authors: Rajashekar Somarouthu , M. R. Nagendra Gowda , Anthony Ajith
Published: August 2018

Background: Cardiovascular diseases are the major public health concern worldwide.Survival after cardiopulmonary arrest is usually low and depends on early intervention, quality of cardiopulmonary resuscitation (CPR) and time of initiation of defibrillation post cardiac arrest. Basic life support (BLS) is a key component of chain of survival. The aim of the study was to assess the knowledge of medical students, doctors, nursing students, nursing staff in Basic Life Support.Methods: A cross sectional study was conducted in Basaveshwara Medical College and Hospital. Those who were willing to participate in the study and who gave informed consent, were administered a self-filling written questionnaire. A total of 400 people were administered the questionnaire, out of which 388 filled the Performa completely.Results: This study was conducted to evaluate knowledge of basic life support among 388 health care professionals took part in the study of which 64.5% were medical students, 8.7% were doctors, 10.3% were nursing staff and 16.5% were nursing students. The study revealed that there is poor knowledge of basic life support among the respondents and 76% of them wanted basic life support to be included in the curriculum.Conclusions: Awareness and knowledge about basic life support is mandatory among health care professionals as they encounter such situation on a daily basis and will help them a long way in saving lives, thus knowledge in basic life support is very essential as health care professionals will get exposed to such situation more often.
Breastfeeding and complementary feeding practices and nutritional status of children under 5 years in a tribal community of Nandurbar district, Maharashtra
Authors: Patil Sanika R. , Tambe Murlidhar P. , Parande Malangori A. , Patil Aditi M. , Jeurkar Rigved V.
Published: August 2018

Background: Breastfeeding is the single most effective preventive intervention for improving the survival of children. Hence, the purpose of this research study to capture the firsthand breastfeeding perceptions and practices and nutritional status of children in tribal community of Nandurbar district (Maharashtra, India).Methods: This was community based cross-sectional study carried out on parents of 100 children. A house to house survey was conducted and either one or both the parents were interviewed regarding ‘Early initiation of breastfeeding, exclusive breastfeeding and complementary feeding’ using a pretested, predesigned questionnaire after obtaining written informed consent. Every child below 5 years went through anthropometric measurements like mid upper arm circumference (MUAC), length/height and weight and was categorized as normal/MAM/SAM. The data was analyzed using Microsoft Excel and ENA (Emergency Nutrition Assessment) for SMART software.Results: 85% mothers were aware of right breastfeeding practices but only 30% babies received breastfeeding within first hour of birth and 72% children were exclusively breastfed till 6 months. Practice of healthy breast feeding was significantly associated with education of mother and awareness of breast feeding. It was found that prevalence of malnourishment was more among children not receiving exclusive breast feeding.Conclusions: The importance of breastfeeding is not well recognized by the people living in tribal area as there was a gap between knowledge and practice. There were various medical, social and psychological barriers for breastfeeding. Doctors, family members, television and ASHA have majorly contributed in spreading awareness.
Assessment of knowledge of AWWs regarding growth monitoring and impact of training on their knowledge in Amritsar district of Punjab, India
Authors: Kaur Harpreet , Gill Kanwal Preet K. , Devgun Priyanka , Kaur Harpreet , Kaur Amanpreet
Published: August 2018

Background: Present study was planned to assess the existing knowledge and awareness among AWWs about growth monitoring and nutritional status of children and also to evaluate the impact of training on their knowledge.Methods: The study was carried out in the department of community medicine, SGRDIMSAR, Amritsar. A sample of 405 AWWs was selected by using simple random sampling technique. The data was collected by administering a predesigned and pretested Performa to the AWWs before and after each training session. Pre-test and post-test assessment was done to assess the existing knowledge of AWWs and also to evaluate impact of training on their knowledge regarding growth monitoring and nutritional status of children. The data collected was analyzed using SPSS 20.0 version.Results: The study revealed that majority (72.1%) of the workers fell into the category of poor knowledge and only 4.2% had good knowledge regarding growth monitoring and nutritional status of children before the training session. Age, educational status and work experience of AWWs were found to be significantly associated with their pre-test knowledge. There was statistically significant improvement in the knowledge of AWWs after training. Also, association between education level and post-test knowledge of AWWs was found to be significant.Conclusions: Regular in-service training or refresher training programmes should be organized for AWWs to enhance their knowledge regarding different aspects of ICDS especially growth monitoring and nutritional status.
Assessment of knowledge and menstrual hygiene management among adolescent school girls of Nelamangala
Authors: M. Kavitha , Jadhav Jyothi , T. S. Ranganath , . Vishwanatha
Published: August 2018

Background: Menstruation is a physiological process but generally it is considered as unclean in the Indian society. Hygiene related practices of menstruation are of considerable importance as it has health impact in terms of increased vulnerability to reproductive tract infections (RTI) and drop outs from school. A good knowledge regarding menstrual hygiene is important during adolescence age which helps to practice good hygiene, minimize the sufferings of women and to manage their menstruation without any hesitation.Methods: A cross sectional study was undertaken in a rural field practice area of BMCRI, Bengaluru. Data was collected from 311 adolescent girls by using predesigned semi structured questionnaire.Results: It was evident that 38.3% participants were aware about menstruation before their menarche and among them; mothers were the main source of the information for 72.3% girls. It was found that 80.4% respondents used sanitary pads and 73.6% girls did not have practice of changing the adsorbent in the school. Only 27.7% had the practice of changing ≥4 pads/cloths per day during the menstruation. Majority of the girls were restricted to enter the place of worship (73.3%) and to attend the religious functions (41.5%) and also restriction to eat certain food items among 20.3% girls. There was a significant association between the religion and the frequency of changing the adsorbent and cleaning the external genitalia during the menstrual period.Conclusions: This study could found that majority of the girls had no information about menstruation before menarche. Menstrual hygiene management (MHM) was very poor.
Grafting to denuded nasal cavity for prevention of recurrent nasal polyposis by endoscopic sinus surgery
Authors: Amin Hany , Mandour Yasser Mohammed Hassan , Elrefai Ahmed
Published: August 2018

Background: The objective of the study was to avoid nasal polyposis occurrence after recurrent FEES.

Methods: 87 patients undergoing recurrent FESS due to recurrent nasal polyposis, after completing all steps of FESS the placement of normal nasal mucosa from inferior turbinate or nasal septum instead of the mucosa of the fovea ethmoidalis and lamina papyracea was done.  

Results: There were nasal obstruction improvement in 79 patients (90.8%), but there were 8 patients (9.2%) had recurrent nasal polypi causing nasal obstruction. There was smell improvement in 38 patients (71.7%) out of 15 patients (28.3%).

Conclusions: The nasal cavity grafting in FESS of recurrent nasal polyposis with nasal septal or inferior turbinate mucosa had promising results in prevention of nasal polyposis recurrence. These results made a recommendation of nasal cavity grafting during primary FESS of nasal polyposis.
Squamous cell carcinoma of maxillary sinus: a comparison of clinico-radiological staging with pre-operative staging
Authors: Sudheer C. P. , Singh T. Dinesh
Published: August 2018

Background: The nasal cavity and paranasal sinuses are the site of origin of more complex, histologically diverse group of tumors which include neoplasms derived from mucosal epithelium, seromucinous glands and haematolymphoid cells. This study aimed to assess the incidence and prognosis of maxillary sinus malignancy.

Methods: A total 25 (16 males, 09 females) malignancy cases between age group 11-70 years. All the cases were undergone with detailed clinical examination. The TNM staging system was followed to detect and standardize the disease stage. CT scan was used to identify the growth and extent of tumor.  

Results: Majority cases were between the age group 41-50 years (40%). Epistaxis was the commonest clinical symptom in 72% cases followed by nasal obstruction (68%), oral related symptoms (56%), oedema in cheeks (44%) and auditory disturbances in 16% cases. The TNM Staging system showed that 76% cases had T3 lesions, 16% had T4 lesions and 8% had T2 lesions. Nasal symptoms are commonly associated with malignancies and were belongs to T3 stage and few under T4.

Conclusions: Maxillary si­nus malignancy is an aggressive tumor normally diagnosed at the advanced stage, with minimal prognosis and reduced survival rate. Surgery in combination with radiotherapy followed by chemotherapy remains the best treatment modality.
Fungi in association with chronic bacterial rhinosinusitis; relationship with a synergistic effect: a prospective study
Authors: Singh Namit Kant , Garg Lakshmi Narayan , Shekhar Shubhranshu , Rao Naiya , Kour Chandpreet , Singh Anshul , Kuhar Hitesh
Published: August 2018

Background: The role of fungi as an etiological factor in the causation of chronic rhinosinusitis remains uncertain. The interaction of Fungi with bacteria can result formation of mixed biofilm which provide symbiotic relationship along with resistance from antimicrobials with an increased severity of symptoms.

Methods: The cases of chronic rhinosinusitis were diagnosed and the grading of the symptom severity was done by visual analog scale in which symptoms of nasal blockage, rhinorrhea or post nasal drip, facial pain/headache, loss of smell, sleep disturbance/ fatigue were taken into consideration and each of the symptoms was graded from 1 to 10.  

Results: A strong association was detected between bacteria and fungi as 37 out of 40 (92.5%) amongst cases and 31 out of 40 (77.5%) amongst controls showed growth of both the organisms. Cases who were detected of having Fungi with Bacteria were having an average score of 8.364 and cases with bacteria alone were having an average score of 6.36. taking into consideration the individual symptom score and analyzing the data, the comparison between cases having both bacteria and fungi and cases with bacteria alone was found to be statistically significant with a p one-tail= 0.010221 and p two-tail= 0.020442.

Conclusions: In chronic rhinosinusitis there is a higher incidence of poly microbial infection, and bacteria along with fungi co-exist with a synergistic effect leading to a higher morbidity.
Short versus standard PFN outcome analysis in unstable intertrochantric fracture
Authors: Jangde Pravin Kumar , Singh Anant Kumar
Published: August 2018

Background: Hip fractures in the elderly are frequent. Intertrochanteric hip fractures account for approximately half of all hip fractures in the elderly; of these, from 50% to 60% are classified as unstable. In our study we tried to compare outcome of unstable trochantric fracture in terms length of PFN (180 vs 240 mm).

Methods: 80 patients of unstable trochanteric fracture were randomly allotted to 2 groups who were treated with closed reduction and internal fixation with proximal femoral nail of size 180 mm(group A) and 240mm (group B). Patients in both the group were compared right from the fracture configuration till the one year post-operative period.

Results: In the study of 80 patients there were 18 males (45%) and 22 females (55%) in group 1, and 23 male (57%) and 17 female (42.5%) in group 2. Group 1 patient had a better range of movements than group 2. Femoral canal impingement was present in 6 (15%) of patients of group 1 and 28(70%) patients of group 2 showed femoral canal impingement.

Conclusions: There are very few studies which compare the length of PFN to the outcome. The standard PFN group presented with complications like femoral nail impingement and hence more thighs pain and less range of movements even after one year of follow up. We conclude that for Indian group of population who have a relatively short femora gives a better result with a shorter length implant.
A study on the outcome of arthroscopic synovial biopsy and synovectomy in the management of chronic synovitis of the knee
Authors: Abraham Vineet Thomas , Gokul Anand M. , Krishnagopal R.
Published: August 2018

Background: Synovitis of the knee can be very difficult to treat especially when the diagnosis remains elusive. Synovitis occurs because of various causes. We assess the patients presenting to our hospital with synovitis of the knee, who underwent arthroscopic synovial biopsy and partial arthroscopic synovectomy and did a review of literature.

Methods: This retrospective study included 25 patients with chronic synovitis of the knee presenting to our institution between July 2012 to January 2016. Inclusion criteria were patients presenting with persistent swelling of the knee; not responding to conservative measures. We excluded patients who had recurrent synovitis, patients who had septic arthritis. All patients underwent Arthroscopic synovial Biopsy and partial synovectomy. Preoperative and postoperative VAS score was calculated.

Results: In n=6 patients the histopathological diagnosis was Tuberculosis, which improved with Anti tuberculous drug treatment. In n=1 patient the diagnosis was lipoma arborescens, in n=1 patient the diagnosis was plant thorn synovitis, in n=3 patient the diagnosis was Juvenile rheumatoid arthritis; all 5 patients improved with synovectomy and NSAIDS. In n=14 patients the biopsy report came as chronic non-specific synovitis, 8 of these patients did well with arthroscopic synovectomy while the other 6 had a recurrence. The average VAS score improved from 8.8- pre surgery to 4.7 post surgery.

Conclusions: Arthroscopic synovial biopsy and synovectomy gives good results in patients with chronic synovitis of the knee. It may be recommended as a treatment for chronic synovitis of the knee, which is not responding to conservative measures of treatment.
Combined free flap and ilizarov bone reconstruction in complex lower limb trauma: our experience
Authors: Mahajan Ravi , Singh Inderdeep , Singh Avtar , Singh Mahipal , Kansal Sandeep
Published: August 2018

Background: Reconstruction of complex lower limb trauma is a major concern for both plastic and Orthopedic surgeons. The use of free flap with Ilizarov method for soft tissue coverage and bone reconstruction not only gives the patient near normal shape and function but also allows early mobilization of the patient, even during the process of distraction with Ilizarov method.

Methods: In this study patients with bone and soft tissue defects of the lower leg were included in the study. Our protocol was immediate wound debridement along with application of external fixator and early free flap coverage within 48-72 hours. After 3-4 weeks of the free flap transfer definitive bone reconstruction is done with Ilizarov method.

Results: 122 flaps survived fully and distal flap necrosis occurred in 4 patients. Necrosis of flap occurred before the start of bone reconstruction with Ilizarov and was managed conservatively or with skin graft. Pin tract infection occurred in 45 (35.71%) patients and was treated by pin care and antibiotics. Other complications in treated patients included pain due to distraction (33.33%). delayed union at docking site (11.90%), discrepancy of limb size (9.52%) and union with deformity (6.35%). The functional outcome was satisfactory in majority of the cases.

Conclusions: Combined use of free flap and Ilizarov provides a more reliable soft tissue coverage and bone reconstruction with almost near normal shape and function. It has advantages like regenerating same quality bone and allowing the early mobilization of the patient with acceptable rate of complications.