bluuebunny/crossref_metadata_2025 huggingface dataset:
Incidence of thrombocytopenia in neonates receiving phototherapy for indirect hyperbilirubinemia: a prospective cohort study
Authors: Shah Mubashir H. , Vedula Ramya , Roshan Reashma
Published: August 2019

Background: Thrombocytopenia as a side effect of phototherapy has not been mentioned in the standard literature but was described briefly as isolated case reports after the phototherapy came in vogue in 1958. The purpose of this study was to find the incidence of thrombocytopenia in neonates with uncomplicated indirect hyperbilirubinemia receiving phototherapy in a referral hospital.Methods: This was a prospective cohort study conducted in a referral hospital over a period of 18 months from June 1, 2013 to November 1, 2014.Results: A total of 103 babies were enrolled. The overall incidence of post-phototherapy thrombocytopenia was 45.6% while mild, moderate and severe thrombocytopenia was present in 66%, 21.3% and 12.8% of babies respectively. The lowest platelet count observed was 31,000/mm3 but none of the neonates showed bleeding manifestations. The incidence of thrombocytopenia following phototherapy was significantly higher in preterm babies, infants who received double surface phototherapy, babies who received phototherapy for >72 hours and in babies who received phototherapy on day 2 or 3 of life.Conclusions: Neonates requiring phototherapy for hyperbilirubinemia are at risk of developing thrombocytopenia, hence the treatment should be initiated based on the standard guidelines. Unnecessary use and prolongation of phototherapy should be avoided considering the possible side effects. Platelet count should be monitored particularly in pre-term neonates receiving phototherapy. Neonates receiving double surface phototherapy and those requiring phototherapy for longer duration require more frequent platelet count monitoring.
Prevalence of primary drug resistance to rifampicin and isoniazid in newly diagnosed sputum smear positive pulmonary Tuberculosis
Authors: Kumar Ashok , Joshi Jawahar Lal , Umathoor Abdurazack , Chopra Vishal , Kaur Komaldeep , Mittal Vidhu
Published: August 2019

Background: To determine the prevalence of primary drug resistance to either rifampicin or isoniazid alone or both in newly diagnosed sputum smear positive pulmonary tuberculosis patients.Method: A prospective study 100 newly diagnosed sputum smear positive pulmonary TB patients was conducted. The patients with an age of ≥15 years and who had either not taken anti TB treatment or who had taken ATT for less than 1 month were enrolled in this study. Two sputum samples (5ml each), including one early morning sample as per the RNTCP guidelines were collected and subjected to line probe assay (LPA).Results: Out of 100 cases 6 were having resistance to both rifampicin and isoniazid, 9 has resistance to INH alone and 1 had resistance to rifampicin alone.Conclusion: The prevalence of primary drug resistance is high. For early and rapid detection of DR-TB newer modality should be used  for the detection of primary drug resistance in sputum smear positive TB patients.
Relationship between mitotic index and Ki67 expression in meningioma
Authors: Yusriany Rini , Cangara Muhammad Husni , Kaelan Cahyono , Asyadi Gunawan , Sungowati Ni Ketut , Ihwan Andi , Rosyidi Rohadi Muhammad , Zainuddin Andi Alfian
Published: August 2019

Background: Meningioma is the most common primary central nervous system (CNS) tumor which covers 36.4% of all CNS tumors. Two important factors determining the prognosis of patients with a diagnosis of meningioma are the percentage of tumor resection and the degree of tumor histopathology. Because there are limitations to routine histopathological examination in predicting tumor progressivity, several examination techniques have been developed including cytogenetics and use of immunohistochemical examination.Method: Observational analytic study was carried out on 68 tumor samples in dr. Wahidin Sudirohusodo Hospital and the Makassar Pathology Diagnostic Center with diagnoses of meningioma from 2012-2018. The Sample size is determined by consecutive sampling method.Results: Sample Size were 68 people from Dr. Wahidin Sudirohusodo Hospital and the Makassar Pathology Diagnostic Center with diagnoses of meningioma which fulfilled the inclusion criteria and consisted of 19(27.9%) men and 49 (72.1%) women with an average age of 42 years. The most common location of the tumor was in the convexity area with an incidence of 29.4%. Grade I meningioma was found 41.2%, grade II of 32.4% and grade III of 26.5%. In grade I, the mean mitotic index was 0.25, grade II was (7.4) and grade III was 22.75. In grade I, the mean Ki67 expression was 1.01%. The highest expression was obtained in grade III with amean of 14.8% and the highest expression was 53%. The Spearman’s rho test results between the mitotic index and Ki67 expression show that there is a positive correlation of 0.490, which means that there is a moderate correlation.Conclusion: IHC expression of Ki67 increases proportionally to the degree of histopathology of meningioma. There is a positive correlation of 0.490 which means that there is a moderate correlation between the mitotic index and Ki67 expression.
Jejunoduodenal anastomosis as permanent biliary access loop post-hepaticojejunostomy: our experience
Authors: Baiomy Moustafa , Riad Mohamed , Saad Hassan A.
Published: August 2019

Background: Post-hepaticojejunostomy stricture is a common problem may result in liver cirrhosis and portal hypertension and death if not treated. Different modalities to repair it are available including endoscopic management that needs access loop (including jejuno-duodenal access loop) to reach the site of stricture.Methods: This prospective study was done in general surgery department, faculty of medicine, Zagazig University hospitals during the period from January 2016 to December 2018. The study included 23 patients (18 females and 5 males) all needed hepaticojejunostomy to treat biliary injuries during cholecystectomy, biliary stricture post-cholecystectomy or post-hepaticojejunostomy anastomotic stricture. Their ages ranged between 26 to 57 ys with mean age 37.3±5.1. The postoperative course of patients and the feasibility of postoperative endoscopic access to the hepaticojejunostomy and intrahepatic ductal system were assessed.Results: This study included 23 patients (18 females and 5 males) where 19 (82.6%) patients were presented post-cholecystectomy and 4 (17.4%) patients post-hepaticojejunostomy, with different modes of presentation postoperative complications included; 2 patients complicated with chest infection, 3 (13%) patients with wound seroma and infection, 2 (about 8.7%) patients complicated with biliary gastritis and 1 (about 4.4%) patient with mild attack of cholangitis. There was no anastomotic leakage or mortality in the studied group. The trial of access to the hepaticojejunostomy using gastroduodenoscopy was successful in all cases with ease including trial of balloon dilatation. The average hospital stay ranged between 5-7 days.Conclusions: Side-to-side jejunoduodenal anastomosis is a very useful technique as it provides good endoscopic access to hepaticojejunostomy and the intrahepatic ducts and needs more application and further evaluation.
Thyroid surgery in a major ambulatory surgery system in a third level hospital
Authors: Segovia Marina Jiménez , Segurado Cristina Alvarez , Pascual Jaime Bonnin , Bianchi Alessandro , Argente Xavier Gonzalez
Published: August 2019

Background: The thyroid surgery in CMA regimen has proven to be effective and safe, as long as there is an exhaustive selection of patients and it is performed by expert surgeons.Methods: We analyzed 12 patients who underwent hemithyroidectomy in the CMA regime between 2015-2017, who underwent surgery by the same team of specialized surgeons, and analyzed the complications, the characteristics of the patients, the characteristics of the piece, the definitive diagnosis, and the indicators of quality, readmissions in the first week and the rate of reinterventions.Results: There were no serious complications; 2 patients (16.6%) presented minor complications: 1 (8.3%) presented seroma of the surgical wound and in another (8.3%) a transitory dysphonia with complete recovery at 3 weeks. There was no readmission and in one case (8.3%) hospital admission was required due to poor control of postoperative pain. The operative time was 62.9±17.7 min and the blood loss was insignificant.Conclusions: Thyroid surgery limited to one lobe in selected patients and with an established protocol can be effective and safe in CMA regimen, provided it is performed by expert surgeons and finds very exhaustive selection criteria.
Laparoscopic management of non-palpable un-descended testes: our experience
Authors: Rather Zahid M. , Majid Nighat Ara , M. Raja Waseem , Islam M. Nazrull
Published: August 2019

Background: The purpose of the study was to determine the sensitivity and specificity of laparoscopy in localizing non-palpable testes, its therapeutic role, mean operative time, conversion rate, complications and hospital stay.Methods: A total of 52 patients were included in the study and was conducted from June 2012 to June 2017. These boys were examined as outpatients, at the time of admission and after general anesthesia to exclude palpable testes and were subjected to diagnostic and operative laparoscopy.Results: We identified 52 patients with 66 non palpable un-descended testes. The most common age of presentation was 1-4 years. Majority of patients i.e. 27 were on the left side. Ultra-sound identified testis >2 cm from deep inguinal ring in 20, near deep ring <2 cm in 20 and at inguinal canal in 6 patients. In the diagnostic laparoscopy, high intra-abdominal testis found in 34, low intra-abdominal testis in 24, blind ending of vas and vessels in 2 patients. The operative procedures performed are diagnostic laparoscopy, laparoscopic orchidopexy, laparoscopic orchidectomy, conversion to open orchidopexy and open orchidectomy. The mean operative time was 53.67±2.37 for unilateral and 102.76±5.38 for bilateral cases. The postoperative complications include surgical emphysema, wound infection and scrotal haematoma. The mean hospital stay was 14.23±2.37 hours for unilateral and 16.27±5.38 hours for bilateral.Conclusions: Laparoscopic orchidopexy appears to be a feasible, minimally invasive, less postoperative pain and trauma, faster convalesce and return to normal activity and an effective technique for the management of low intra-abdominal testes.
Bile spillage and bacterobilia as risk factors for surgical site infection after laparoscopic cholecystectomy: a prospective study at tertiary care hospital
Authors: Porwal Rekha , Soni Aakanksha , Singh Amit , Somani Shruti K. , Sagar Poornima
Published: August 2019

Background: Surgical site infection (SSIs), a significant postoperative complication, can lead to considerable patient’s morbidity and mortality.Methods: The study was conducted in the Department of Surgery, J.L.N. Medical College and Hospitals, Ajmer from January 2017 to September 2018. The study population constituted cases of cholelithiasis diagnosed by ultrasonography that underwent laparoscopic cholecystectomy and fulfilling the inclusion and exclusion criteria. Surgical site infection was graded according to Southampton grading system.Results: The overall frequency of SSI infection in laparoscopic cholecystectomy was 6%. The occurrence of surgical site infection in patients with bacterobilia was 14.28% which was found to be statistically significant. The SSIs in patients with gall bladder content spillage was found to be statistically insignificant.Conclusions: The frequency of SSI was more in patients with bacterobilia. The gallbladder content spillage does not lead to an increased occurrence of SSI.
A study on the feasibility of axillary reverse mapping with blue dye only in breast cancer patients
Authors: Shanmugam Subbiah , Husssain Syed Afroze , . Muralikannan
Published: August 2019

Background: Axillary reverse mapping is (ARM) the concept of visualization of the nodes in axilla that drain the arm and preserving them. Literature describes this procedure being done with blue dye (methylene blue) and 99mTC technetium sulphur colloid. This study was undertaken to look for the feasibility of axillary reverse mapping using blue dye alone as there is lack of availability of the radio colloid in many centres in India.Methods: 30 breast cancer patients who underwent axillary dissection as part of their surgery were included in the study. 2.5–5 ml of methylene blue was injected in the medial upper arm in the intermuscular groove region. The number of blue nodes identified, their location, pathological status and procedure related complications were analysed.Results: The ARM blue node was identified only in 7 out of the 30 patients (sensitivity– 23%) and none had a pathologically positive blue node. In those 7 patients, only 1 blue node was identified. All the nodes were in level 1 and the largest node measured 2cm in largest dimension. The complications associated with the procedure included pain, pigmentation, induration and skin necrosis. 16 (53.3%) had pain, 10 (33.3%) had induration, 6 (20%) had pigmentation and 1 (3.33%) had skin necrosis.Conclusions: The feasibility of ARM being done using blue dye alone needs to be questioned in view of its poor sensitivity. Added to this, the complication rates are higher. However, larger studies are needed to validate the same or otherwise.
A prospective comparative study of detection of colonic polyposis by magnetic resonance colonography versus conventional colonoscopy
Authors: Ramana Kada Venkata , Kumar Tripuraneni Rajesh
Published: August 2019

Background: Colorectal cancer mostly arises from adenomatous polyp and the transition time to convert into carcinoma is around ten years. As the progress to adenocarcinoma is a slow process so, early detection and endoscope resection is claimed to be effective in decreasing incidence and mortality by colorectal cancer. MR colonography is a non-invasive method for evaluating entire colon. It can detect precancerous lesion, cancer and staging. It is non-invasive tool for screening. Acceptability of the patient is better for MR colonography.Methods: Present study is a prospective comparative evaluation of magnetic resonance colonography verses colonoscopy conducted in the Department of Radiology, Konaseema Institute of Medical Science, and other establishments from August 2015 to January 2018. The sample size was calculated to be 112. Specificity, sensitivity and predictive value were calculated by medical statistical software.Results: For all size of tumours, sensitivity was 85.71%, specificity was 92.85%, positive predictive value was 92.30%, negative predictive value was 86.66% and accuracy was 94.34%. The positive predictive value was 90.00% negative predictive value was 92.68% and accuracy was 92.16%. For 1 mm to 4 mm size of polyp the sensitive was 28.57%, specificity was 92.31%, positive predictive value was 66.67%, negative predictive value was 70.59% and accuracy was 70%.Conclusions: In present study we have found that there was male predominance in patient and gastrointestinal bleeding was common clinical presentation. We have also observed that all size of poly MR colonography as having sensitivity and specificity around 90% but MR colonography is highly sensitive and specific for polyp size above 8mm but it is less sensitive for size below 4 mm.
Rapunzel syndrome trichobezoar in a twelve year old girl: a case report
Authors: Pipal Dharmendra Kumar , Pipal Vibha , Pipal Rajendra , Yadav Seema , Kothari Saurabh
Published: August 2019

A bezoar refers to a mass of undigestible foreign material found in the gastrointestinal tract, mainly stomach. The second most common bezoar is the trichobezoar, which usually occurs in the young psychiatric female patients with history of trichotillomania and trichophagia. A 12-year-old female psychiatric patient came with complains of diffuse abdominal pain, vomiting, fever, and constipation. Ultrasonography and CT scan were done, which suggested trichobezoar. Thus, trichobezoar should be considered as differential diagnosis of abdominal pain in young psychiatric female patients. In the literature several treatment options are proposed, including removal by conventional laparotomy, laparoscopy and endoscopy. According to our experience and in line with the published results, conventional laparotomy is still the treatment of choice. In addition, psychiatric consultation is necessary to prevent relapses. We here report a case of 12 years old girl presented with complain of vomiting, pain and lump abdomen, loss of appetite and on laprotomy a large, approximately 156 cm trichobezoar was removed which was extending from stomach to ileocaecal junction. Trichobezoar, an underdiagnosed entity, has to be considered in the differential diagnosis of abdominal pain and a non-tender abdominal mass even in young children.
Gall stone abscess, a delayed complication following laparoscopic cholecystectomy
Authors: Aruni Amaresh , Kumar Hemanth , Singh Harjeet , Nagaraj Satish Subbiah
Published: August 2019

In the current era of minimally invasive surgeries, laparoscopic cholecystectomy being the popular surgery for the symptomatic cholelithiasis and complications pertaining to these minimally invasive surgeries, here we report a complication related to gall stone spillage after 4 months of surgery in 80-year male patient presenting as abdomen lump. The risk of stone spillage and complications related to it are more than open cholecystectomy. Careful dissection, extraction and complete retrieval of all the spilled stones can avoid these complications and hence complication related to stone spillage can be potentially avoided, and intra-operative documentation of the gall stone spillage can help to think for early diagnosis and treatment of the complications.
Non operative management of a patient with splenic trauma with angioembolisation after delayed presentation
Authors: Paul Deepak , Thomas Thomas K. , Babu Dayananda , Janardhanan Rajan , Christhudas Ribin
Published: August 2019

Road traffic accidents are one of the most common causes of death in India. Those involved in RTA’s frequently suffer from solid organ injury, spleen being the second most common organ involved. Splenic injuries are associated with great deal of mortality and morbidity. Splenic injuries were classically treated with splenectomy but there has been a paradigm shift to non-operative management in recent times leading to splenic salvage and preservation of function of the spleen. This report is about a lady who was managed successfully with angioembolization in spite of the fact that the patient presented late after RTA.
Impacted foreign body in oesophagus video assisted thoracoscopic surgery approach
Authors: Gajbhiye Raj , Tirpude Bhupesh , Akulwar Vikrant , Bhanarkar Hemant , Chavan Aashish R.
Published: August 2019

Ingested foreign body in oesophagus is very common in emergency department. The most frequently ingested foreign bodies in children are coins, alkaline batteries while in adults’ meat, fish bones, denture. Most of the ingested foreign bodies pass spontaneously but 1% or less will require surgery. Here we report an interesting case of a mentally retarded young girl with impacted large stone in the lower oesophagus in whom endoscopic approach had failed. Then video assisted thoracoscopic surgery was done successfully to extract the impacted foreign body. A thoracoscopic approach is much safer and feasible in such cases.
Complicated pseudodiverticulosis of small intestine: a rare case report
Authors: M. Kamal Raj , Venkatachalam V. , A. Manasa
Published: August 2019

Diverticular disease though being a common entity in large bowel is recently noted to occur more proximally as well. In the jejunum, the mucosal outpouchings, called as pseudo-diverticulae, occurs with an incidence of 0.5-1.5%.Diagnosed incidentally as majority of them remain asymptomatic. When they are symptomatic, dyspepsia and bloating, recurrent abdominal cramping, malabsorption and megaloblastic anemia occurs. On occasions it is not uncommon for patients to present with hemorrhage, infections, obstruction or perforation. Perforation, being a rare presentation occurs in less than 6% of the cases. We present a case of a 70 year old male, who presented as acute abdomen, found to have isolated jejunal diverticular perforation intraoperatively.
Acute intestinal obstruction due to appendicular tie syndrome: a rare case report
Authors: Agrawal Akash , Vora Palak
Published: August 2019

Acute intestinal obstruction is one of the most common surgical emergencies encountered by surgeons on daily bases. Most common causes for small bowel obstruction includes postoperative adhesions and hernia. One of the rarest cause of intestinal obstruction is appendicular band syndrome. Here we report a case of small bowel obstruction due to appendicular tie syndrome in a 70 years old male patient at GMERS hospital, Dharpur, Patan, Gujarat, India.
Study of gastrointestinal manifestations in Dengue fever
Authors: N. Prashanth V. , G. Manasa
Published: August 2019

Background: Dengue is an arthropod borne viral haemorrhagic fever. In India between 2015-2017, 790 deaths have been recorded according to NVBDCP data. Gastrointestinal manifestations are among the most common manifestations in dengue fever, and are most often missed due to lack of awareness. This study aims to find the spectrum of Gastrointestinal manifestations and correlation of GI manifestations with severity of Dengue.Methods: A cross-sectional observational study was conducted on 100 consecutive cases of serologically confirmed Dengue fever. Patients were examined clinically, and laboratory data was assessed till they got discharged. Gastrointestinal manifestations of dengue fever were noted and analyzed.Results: This study included 100 consecutive cases of dengue fever. Mean age of the study population was 32.48+12.40 years of them 77 were males and 23 were female patients. Gastrointestinal manifestations were noted in 96% of the patients. GI manifestations noted were Nausea in 71%, Elevation of transaminases in 59%, vomiting in 54%, pain abdomen in 31%, Ascites in 24% hepatomegaly in 14%, diarrhoea in 13%, Acalculous cholecystitis in 13%,  Acute fulminant hepatitis in 6%, Upper GI bleed in 6%, splenomegaly in 5%, and Acute pancreatitis in  4% of patients. Of these, GI manifestations like nausea, vomiting,  pain abdomen, GI bleed, ascites, jaundice, elevation of transaminases, acute fulminant hepatitis and acute pancreatitis correlated with severity of Dengue fever .     Conclusion: Gastrointestinal manifestations in Dengue fever are much more common than once thought of. In our study it was found in 96 percent of patients making it most common manifestations in dengue fever. Transaminitis and Atypical GI manifestations like acute pancreatitis, acute fulminant hepatitis may indicate severe Dengue. The differential diagnosis of an acute febrile syndrome with abdominal pain or gastrointestinal symptoms in patients living in endemic areas should include Dengue fever.
A study on incidence of vitamin B12 deficiency in patients with pancytopenia
Authors: Kumar G. Sathish , . Swetha , Rajendran V.
Published: August 2019

Background: Pancytopenia is a serious and life threatening illness presented with multiple etiologies. The current study was done with the objective to evaluate the clinic-pathological factors responsible for incidence of pancytopenia in patients with vitamin B12 deficiency and their response to the therapy with vitamin B12.Methods: It was an observational study carried out at Department of Medicine, Mahatma Gandhi Memorial Government Hospital, Trichy, Tamilnadu during the period between December 2016 to December 2017. A total 50 patients with pancytopenia were clinically evaluated along with hematological parameters and bone marrow aspiration.Results: A total of 50 patients were included in the study. The mean age of the patients was 32.84 years with a male to female ratio of 1.5:1. All patients had history of fatigability. Commonest physical presentation was pallor (100%). Megaloblastic anaemia was the predominant blood picture in 58% patients. The common bone marrow finding was hyper cellular marrow with megaloblastic picture. Management with cyanocobalamin preparations and folate supplementations, significantly improved the reticulocyte count percentage in patients with pancytopenia (p=0.01)Conclusion: The study concluded that the most common cause of pancytopenia was megaloblastic anaemia. Detailed haematological investigations along with bone marrow aspiration in patients with cytopenia provided a clear understanding of disease process to identify the etiologies of pancytopenia.
Prevalence of dry eye in college students at Uparwara community in Raipur
Authors: Kolla Andrea , Dahariya Devesh , Ram Male Shiva , Kolla Varaprasad
Published: August 2019

Background: The study aims to investigate the prevalence of dry eye in college students in the Uparwara community.Methods: This pilot study was conducted tenure to declaration of Helsinki rules with n=240 (males 200 and females 40) with in the age group of 18-25 years, OSDI questionnaire was used to assess the prevalence among the college students of Uparwara community at Raipur.Results: Data from 240 subjects were analyzed with a mean age group of 19.41±0.70 mean±SD. This OSDI questionnaire study with subscales for dry eye symptoms were measured in both the genders males 213 (89%), females 27 (11%). The percentage distributions among the subjects showed that 116 (48.3%) participants reported dry eye symptoms and 124 (51.6%) was normal.Conclusions: This study emphasized on the prolonged usage of VDT and electronic devices i.e., >4 hours as a compliance factor for dry eye, our data suggest that VDT usage less than 4 hours also can be a risk factor for dry eye since all our 116 participants with dry eye symptoms are VDT users and interestingly 78% (90) of them are <4 hours VDT users but still have dry eye symptoms.
A cross sectional study conducted to assess knowledge and awareness regarding HIV/AIDS among attendees of integrated counselling and testing centre at Sagar, Madhya Pradesh
Authors: Mishra Shraddha , Guleri Sunil K.
Published: August 2019

Background: Acquired immunodeficiency syndrome (AIDS) has emerged as one of most serious public health problem in the country. ICTC (integrated counseling and testing centre) provides a key entry point for the 'continuum of care in HIV/AIDS' for all segments of the population. This study was conducted to assess knowledge and awareness regarding HIV/AIDS among attendees of ICTC because awareness is only means to reduce prevalence of any disease in absence of availability of treatment and cure.Methods: The study was conducted among attendees of integrated counseling and testing centre who were visited at the centre for HIV testing. It was a cross-sectional, observational study and conducted at ICTC attached to Microbiology Department of Bundelkhand Medical College, Sagar.Results: Majority of study subjects (34.96%) had a relatively poor knowledge about HIV/AIDS. In spite of having awareness, the respondents had lack of complete knowledge about the root cause of HIV/AIDS and had misconceptions about the mode of transmission.Conclusions: Gender, education, residence, caste and socio-economic status showed the significant association with knowledge score regarding HIV/AIDS. IEC activities should be planned in local language incorporating locally derived data pertaining to various social norms, cultural beliefs and sensitivities of community.
Assessment of family planning practices of women of reproductive age group in rural area of Jammu region
Authors: Dewan Deepika , Nazir Heena , Kakkar Tania
Published: August 2019

Background: Despite more than fifty years of implementation of National Family Planning and Welfare programme, unmet need for family Planning is still high which poses a big challenge for family planning programme. The aim is to reach all women whose reproductive behaviour requires one or the other forms of contraception but for various factors are not practicing them.Methods: A cross-sectional descriptive study was carried out amongst women of reproductive age group in the field practice area of Rural Health Training Centre of Dept. of Community Medicine of a Government Medical College, Jammu during the period of January to June 2018. Ethical clearance was obtained from the Institutional Ethics committee prior to the start of the study. Total of 541 eligible couples attending the family welfare section were interviewed by the trained staff using the pre-tested questionnaire. The information about various family planning methods adopted by couple was elicited. Data was analysed by using appropriate test whenever necessary.Results: A total of 541 eligible couples were interviewed. Maximum couples were in the age group of 30-34 years. 300 (55.4%) couples were using one or the other method of family planning. Condoms were most commonly used method by 148 (49.3%) couples followed by oral contraceptive pills (30.6%). Among permanent methods of family planning, tubectomy was adopted by 10 (3.3%) and vasectomy only by 4 (1.3%) couples. No one was practising any miscellaneous method of contraception. The percentage of family planning methods used by Hindus was maximum (65%). Difference was also observed in the context of socio-economic status.Conclusions: Nearly half of eligible couples were not practising any method of contraception. There is need to increase motivation among eligible couples to increase adoption of permanent methods of contraception especially vasectomy.
Can personal hygiene act as a proxy indicator of morbidity profile? A study on orphans of Uttarakhand region
Authors: Ahlawat Parul , Vyas Shaili , Sharma Neha , Srivastava Abhay , Srivastava Ashok , Semwal Jayanti
Published: August 2019

Background: A healthy childhood is essential for future growth and development. It is greatly influenced by parent, family, society and environment which formulate attitude, behavior, manner and emotions. Millions of children across the world are deprived of this crucial phase of life; those are the orphans and abandoned children.Methods: This institution-based cross sectional study was carried out with the help of pre-designed semi-structured questionnaire amongst 193 orphans aged 5-14 years to assess the personal hygienic practices and morbidities among orphans and to find out the association between the morbidity with personal hygiene and other risk factors.Results: The leading morbidities observed were poor oral hygiene (57.51%) as a morbidity followed by dental caries (50.58%) and pallor (30.57%). The average morbidity per child was found to be 2. There was significant association between ages, education, personal hygienic practices with the presence of morbidity in the orphans.Conclusions: Practices related to personal hygiene was not satisfactory. There was a significant association between morbidity and personal hygiene. Despite of the fact that these children are highly vulnerable; their health needs are poorly understood and ill served.
A study on assessment of knowledge, attitude and practice on handwashing among nursing students of Sree Venkateswara College of Nursing, Chittoor, Andhra Pradesh
Authors: Muthyala Sudhakara Reddy , V. Venkateswarlu
Published: August 2019

Background: Handwashing is the act of cleaning one's hands for the purpose of removing soil, dirt & microorganisms. Through review of literature it is understood that the most nosocomial infections are thought to be transmitted by the hands of healthcare workers, handwashing is considered the single most important intervention to prevent nosocomial infections. This study is conducted to assess the knowledge, attitude and practices (KAP) on handwashing among the nursing students and to identify the areas of gap in their KAP along with the provisions for handwash.Methods: A descriptive, cross-sectional study was conducted among 192 nursing students at S.V. College of Nursing, Chittoor during October 2018 using pre-validated self-reported questionnaire. Statistical analysis was done with SPSS 20.0 software and Chi square test was used with “P” value<0.05 taken as statistically significant.Results: Among all respondents 85% were aware about washing their hands during all common critical times, but practicing was observed in 08% only. 50% felt that alcohol based hand rub is effective than hand wash with soap and water, but facilitated 10% only. While the final year students all (100%) are well aware about all critical times of handwashing, whereas 1st and 2nd years 71% and 3rd year students 87% are aware (P=0.002).Conclusions: There is a need of orientation and arrangements for proper hand wash to be improved.
Determination of prevalence, knowledge, attitude and practices of contraceptive use in an urban population in South India: a community based study
Authors: Kumar Yeshvanth , Mukherjee Pavan , Frankline Augustin , Rahman Sajitha M. F. , David Kirubah V. , Pricilla Ruby Angeline
Published: August 2019

Background: Family planning influences mothers and infant’s health, population growth and regional and national development. Studying the knowledge, attitude and practice of contraceptive methods of a region aids in overcoming the barriers in the utilization of the services providing them.Methods: A community based cross sectional study was done among 350 married women of an urban population by systematic random sampling using a structured questionnaire.Results: From a total of 350 women enrolled, majority were of the Hindu religion (84.9%) and from the lower socio-economic status (68%). The prevalence of use of contraceptive methods was 75.4% and it was predominantly female sterilization. It was significantly higher (p<0.001) in women aged above 32 years, married for more than 10 years, having more than two children and last child birth of more than seven years. Only 142 (40.6%) of the participants had adequate knowledge of contraceptive methods. However, 299 (85.4%) had a positive attitude to contraception and 296 (84.6%) had good practice of family planning (FP) methods.Conclusions: The knowledge and use of contraceptive methods especially temporary methods needs to be improved in our community. The utilization of media can be improved in addressing this shortfall. Health care providers being the bulk source of information on contraceptive methods must be pro-active in every interaction with women and men of reproductive age group by providing information on the various methods.
Rural population at risk of development of diabetes mellitus: a cross sectional study using Indian Diabetic Risk Score in Bengaluru
Authors: K. R. Vidya , K. Lohit , P. Naveen Kumar
Published: August 2019

Background: Prevalence of diabetes mellitus is increasing in an alarming way throughout the world. More than 50% of the diabetic subjects in India remain unaware of their diabetes status and screening for risk factors of diabetes mellitus enable us to initiate appropriate control measures. This study was undertaken to identify the people who are at risk of diabetes mellitus in rural area of Bengaluru.Methods: It was a community based cross sectional study in which 1750 study subjects were randomly selected using multi stage random sampling method. Selected individuals were examined and interviewed using a semi structured questionnaire. Indian diabetic risk score was used to assess risk of developing diabetes. Data entry and analysis was done using SPSS version 20.0.Results: According to IDRS, 46.2% of respondents were in the moderate risk group and 33.1% were in the high risk group. Family history of diabetes, low physical activity and abdominal obesity were found to associate with high risk group.Conclusions: The prevalence of high risk for diabetes according to IRDS was 33%. Primordial and primary preventive actions are very much necessary.
Attitude towards and utilization of health insurance in a metropolitan city: a cross-sectional study
Authors: Thampi Jerome G. , Hadaye Rujuta
Published: August 2019

Background: Data on attitudes towards and utilization of health insurance in Mumbai is lacking. The aim of the study was to assess the level of awareness about health insurance, the factors influencing the decision to subscribe and the patterns of utilization of health insurance.Methods: 201 principal earning members of households belonging to the 25-45 years age group were interviewed in a community-based household survey in a conveniently selected ward in Mumbai with the help of a pretested, semi-structured interview schedule.Results: The level of awareness about health insurance was 65.3%. 33.8% of the respondents had utilized or subscribed to some form of health insurance. 27.9% had used Government health insurance while 13.4% had used private health insurance. 7.5% had access to both Government and private health insurance.Conclusions: A concerted effort is necessary to sensitize the public about health insurance with strategic use of sentiment regarding community risk pooling.
Perception of Indian physiotherapists about awards: a survey
Authors: Mehta Ruchi , Chaudhari Priyanka , Khatri Subhash M.
Published: August 2019

Background: World has become more awards centric probably because of the desire to recognize achievement is an integral part of being human. Awards and trophies are big business in 21st century and they are given to people of all ages by all kind of organizations. Physiotherapy profession has a long history of awards all over the globe but the current status of physiotherapy awards in India is hardly studied, documented or published in recent times and hence to get an insight of the same this survey research was done by inviting physiotherapy professionals with varying work experience, professional qualifications and achievements across the country.Methods: A qualitative research approach was used to conduct an online survey of physiotherapists in India. A brief questionnaire with basic information and strategic questions about awards and perception of physiotherapists were used for this purpose.Results: Informants reported that there hardly any award given by government to recognize the contribution of physiotherapists to the society. Most of they believed that it’s because of lack of political will and absence of central regulatory authority or council for physiotherapy profession in India. Most of them were happy about the award given by nongovernmental organizations but were not satisfied with its credibility, transparency in the process and selection of winners and felt mostly it’s a biased practice.Conclusions: There is need for some sort of awards and recognition of physiotherapists’ contribution to health care and the society by government and the process of selection for some nongovernmental awards need to be more transparent and unbiased.
Study of socio-demographic profile and causes of street vending in urban area, Aurangabad, Maharashtra
Authors: Doibale Mohan K. , Mohite Seema Digambar , Sawase Gautam B. , Pagadal Pallavi H.
Published: August 2019

Background: Street vending as a profession has been in existence in India since times immemorial. Poverty and lack of gainful employment in the rural areas and in the smaller towns drive large numbers of people to the city. Thus the present study is conducted to study socio-demographic profile, causes, addiction, morbidity pattern among street vendors. The objective of the present study is to study socio-demographic profile of street vendors, causes of street vending, addiction among street vendors, health problems faced by street vendors.Methods: The study was conducted in Shahagunj, where urban health training centre of Government Medical College Aurangabad is situated, for period of 2 months duration. All street vendors in the Shahagunj were included in the study. The purpose of study was explained to them. The survey was carried out with predesigned pretested questionnaire. The question related to socio-demographic characteristics, causes of street vending, addiction of smoking were asked.Results: About (29.6%) vendors belongs to age group 30-39, male participants are more in number, illiterate or educated up to primary school. Most of the vendors belongs to nuclear family, 71.25% vendors are migrated from other cities to seek employment, 73.6% vendors works with no holiday in a week. Vendors are addicted of tobacco chewing (27%), pan (6%) and cigarette (6%). Causes to become in informal sector are unable to fulfill requirement of formal sector 54%, only source of income 44% avoid tax is 2%. About 30% vendors are having health issues; maximum was musculoskeletal morbidities contributing 8.8%.Conclusions: Unable to fulfill requirement of formal sector and no other source of income are the major causes to be in the street vending.
Profile of dog bite cases reporting to ARV OPD of a tertiary care hospital
Authors: Subramanya Saurabha Urmi , Kembhavi Ravindra S.
Published: August 2019

Background: Animal bites pose a major public health problem in children and adults worldwide. Rabies is a viral zoonosis caused by bite of a rabid dog that occurs in >100 countries and territories. India accounts for 60% of all the world burden of rabies related deaths. The objective of the present study is to analyse the profile of dog bite victims reporting to ARV OPD of a tertiary care hospital.Methods: This was a cross-sectional study conducted in the ARV OPD of a tertiary care hospital. A total of 228 victims of dog bite were interviewed. They were selected using systematic random sampling technique. Analysis of data obtained was done using SPSS.Results: Majority of the participants belonged to the age group 20-30 years. The proportion of male was higher than female. Most of the victims had suffered category II type of dog bite (66.2%). A statistically significant association was seen between age group and nature of dog bite, sex of victim and type of dog, type of dog and category of dog bite and the category of bite and history of dog biting other individuals.Conclusions: The burden of dog bite seems to be borne by the economically productive age group. All individuals need to be educated on how to behave around animals so that they can avoid animal bite.
An update on osteoporosis research: effect of calcium plus vitamin D supplementation
Authors: Shill Lincon Chandra , Purba Nafisa Habib , Sultana Marjia , Hasan Towhid , Rahman Mahmudur , Sultana Nahid
Published: August 2019

Osteoporosis is the most common systemic skeletal disease characterized by increased bone fragility. There lies an incongruity among research regarding combined supplementation of calcium (Ca) plus vitamin D and loss of bone health. Hence, the present review is aimed to highlight the current development of osteoporosis research and try to solve the inconsistency among the present knowledge. Electronic databases like PubMed, Cochrane Library, and EMBASE were searched from their inception to December 2018 using terms “calcium,” “vitamin D,” and “osteoporosis.” A systemic approach was followed to reach a final of 23 studies assessing the synergetic effect of calcium and vitamin D on osteoporosis and fractures risk. Among the included studies, nineteen have revealed that calcium and vitamin D decrease bone resorption, reduce the incidence of fractures, increase bone mineral density (BMD) and overall bone health. However, no significant osteogenic response was reported in five trials after supplementation with calcium and vitamin D together. Osteoporosis results in a reduced quality of life, increased disability-adjusted life span, and big economic burden to health care systems of countries. Early diagnosis before the occurrence of fractures and by assessing BMD and with early treatment, osteoporosis can be prevented. It is not entirely possible to draw a conclusion regarding beneficial effects of calcium plus vitamin D supplementation; future research based on the fundamentals of bone biology focusing on molecular genetics, and influencing factors of the acquisition of bone mass during growth and bone loss can alleviate present controversies.
A prospective study of the prevalence of Kuhn’s frontal cells and their relation to frontal sinus disease
Authors: Krishnasamy Raam Deepak , Padmanabhan Karthikeyan
Published: August 2019

Background: The involvement of frontal cells in the frontal sinus disease pathology remains an understudied area. There are very few reports on the prevalence of frontal recess cells in India. In this context the present study was designed to determine the frequency of occurrence of Kuhn frontal cells and to determine whether the size of the frontal isthmus or the presence of frontal cells is related to the presence of frontal sinus disease.

Methods: This study included 80 patients who presented with signs and symptoms of chronic rhino-sinusitis after satisfying the inclusion criteria to the Department of ENT in a tertiary care centre (Mahatma Gandhi Medical College and Research Institute) in Pondicherry from January 2017 to April 2018. The patients were subjected to detailed clinical history, basic preoperative blood investigations, diagnostic nasal endoscopy and High Resolution Computed Tomography of nose and para-nasal sinuses after which the diagnosis was established.

Results: Out of the 80 study participants subjected to our study the number of individuals who had frontal sinusitis was 50%. The association between frontal sinusitis and Kuhn cells was insignificant. The mean value of anteroposterior diameter of the naso-frontal isthmus in case of patients with and without frontal sinusitis was 0.705-0.735. In case of transverse diameter it was 0.725-0.720 and in case of the area of the frontal isthmus it was 30.86-31.12 which had a p value of 0.49

Conclusions: Therefore in our study we concluded that there is no significant relation for any particular frontal recess cell or the size of the nasofrontal isthmus for being the sole cause for chronic frontal sinusitis.
Crooked nose correction: an institutional experience
Authors: Das Anandita
Published: August 2019

Background: Crooked noses pose a particular challenge in nasal reconstruction, even for the most experienced of surgeons, as there is inevitably a combination of functional and aesthetic abnormalities which need to be addressed. Crooked nose deformity is a common presentation in the ENT clinic due to raise in the road traffic accidents.

Methods: This was a prospective study conducted in the Department of ENT, GMCH. All the cases of crooked noses presenting to our department was included in the study. The patients were subjected to a proper history and thorough physical examination. Preoperative nasal analysis was done using photography and nasal endoscopy. The type of intervention for each patient and their outcome was analyzed.  

Results: The majority of the crooked nose was due to blunt force trauma sustained during road traffic accidents (RTA) or during physical violence. In all crooked nose with an external deformity, there is an underlying septal deformity. The aim of the surgery is to achieve an aesthetically pleasing and a physiologically functioning nose.

Conclusions: From the present study, we can conclude that the majority of the crooked nose was due to blunt force trauma sustained during road traffic accidents or due to physical violence. Besides having a considerable external deformity, majority of the cases also had functional problems too and this two aspects could be addressed properly by doing a septorhinoplasty. 