bluuebunny/crossref_metadata_2025 huggingface dataset:
Testing a Modified Version of the Spenn-Fisher Codependency Scale
Authors: Berdichevsky A.A. , Padun M.A. , Gagarina M.A.
Published: April 2019

The article presents the adaptation process of the modified Spenn-Fisher code of co-dependence, which allows to measure the severity of co-dependency. The study was conducted on a sample of students (N=227) and cadets (N=38) of higher educational institutions. The theoretical construct of codependency as a psychosocial state, which includes an external locus of control, a tendency to suppress emotions and an increased importance of interpersonal relationships, confirmed by the data of cluster analysis. The questionnaire showed acceptable rates of both reliability-consistency and retest reliability. The constructive validity of the methodology was confirmed by significant correlations that substantiate underlying construct of codependency. The high level of codependency positively correlates with the external locus of control, the suppression of emotions, anxiety, and negatively correlates with the affective component of interpersonal relations, the benevolence of the external world and beliefs about control. The psychometric data obtained during the study are largely consistent with the results of the authors of the original scale and indicate a successful adaptation of the methodology in the Russian sample.
The problem of determining the criteria for speech disorders in modern preschoolers in the aspect of interdisciplinary interaction of specialists
Authors: Malkova Elena E. , Mashnina Elena M.
Published: April 2019

Based on Russian and foreign sources in the field of medicine, psychology and speech therapy, an overview of the main approaches to the systematization of speech disorders in childhood is conducted. It is shown that despite the long and winding path of research, there are numerous descriptions of phenomenology, but there is no consensus about the nature and mechanisms of speech disorders in children. Currently, there are two main directions in the study of speech pathology in children: clinical and psycholinguistic. In a clinical approach, impaired speech is considered as a pathological condition with certain symptoms, etiology and pathogenesis. Psycholinguistic approach to speech pathology involves the correlation of the observed violation with the normal functioning of the processes of generation and perception of speech, as well as an assessment of the degree of formation of language ability. As a result, the analysis of clinical, psychological and psycholinguistic studies shows a lot of contradictions, pushing for an active search for more accurate nominations and differential diagnostic criteria for distinguishing between different states of a child’s speech deficiency. Thus, a tendency is shown to move to a new level of professional reflection from a narrowly focused (clinical, speech therapy, psychological) to a systemic one, in which the focus of scientists will be not only the problem of determining the disadaptive development, but also the prospects for the mental and speech development of the child.
Capabilities of voxel based morphometry and diffusion tensor imaging in diagnostics of bilateral spastic forms of cerebral palsy
Authors: Lvov Viktor S. , Pozdnyakov Aleksandr V. , Ivanov Dmitry O. , Tashilkin Alexey I. , Makarov Leonid M. , Pozdnyakova Ol’ga F. , Melashenko Tat'yana V. , Bessonova Lyubov’ B. , Popov Pavel A. , Aleksandrovich Viktoriya Yu.
Published: April 2019

The aim of the study was to determine the capabilities of magnetic resonance morphometry and diffusion tensor imaging in the diagnosis of bilateral spastic forms of cerebral palsy in children. The main groups were 33 children aged from 1 year to 4 years 5 months. with bilateral spastic forms of cerebral palsy, the comparison group – 11 children who did not have movement disorders. The patients underwent magnetic resonance morphometry, diffusion tensor imaging. A comparison was made between the volumes of brain structures and diffusion values between groups. Significant differences (p < 0,05) were found in the volumes of the right lateral, 3rd ventricles, white matter, thalamuses, globus pallidus, putamen, hippocampus. Significant differences (p < 0,05) in diffusion values in the thalamuses and in the posterior limb of internal capsules were also identified. The correlation of the identified changes with the clinic of the disease was demonstrated. The obtained data demonstrate wide possibilities and high diagnostic value in the detection of bilateral spastic forms of cerebral palsy in children.
The frequency of postpartum hemorrhage in women with different somatotypes
Authors: Gaidukov Sergey N. , Tomaeva Kristina G. , Komissarova Elena N.
Published: April 2019

The aim of the study was to study the frequency of postpartum hemorrhage in women with different somatotypes and to develop a method for predicting the risk of this pathology.

Materials and methods. 390 women were examined, 110 were mаcrosomatotype, 173 – mesosomatotype, and 107 – microsomatotype. Somatometry was performed according to R.N. Dorokhov for women in early pregnancy (before 9-10 weeks of gestation).

Results. It was found that postpartum hemorrhage was significantly more prevalent among the women of macro-and microsomatic body type compared with women with mesosomatotypes (p < 0.05). In the course of multiple regression analysis, we obtained a regression equation (formula) for predictive models, which predicts the development of postpartum hemorrhage in women of different somatotypes. The calculations according to the presented formula, allows to predict with high accuracy the prognosis of postpartum bleeding, and also allows to form among patients a high-risk group for the development of this disease in the first trimester of pregnancy when the pregnant woman is registered in the women’s consultation, long before delivery, which will contribute to more effective implementation of therapeutic and preventive measures to prevent the development of postpartum bleeding.
Contemporary placentography: harm or benefit?
Authors: Bezhenar Vitaly F. , Ivanova Lidiya A. , Grigoriev Stepan G. , Titkova Elena V.
Published: April 2019

Currently, pediatricians, neonatologists of maternity hospitals often take part in perinatal consultations. One of the indications for early delivery may be chronic placental insufficiency diagnosed during an ultrasound examination.

Objective: to evaluate the effectiveness of the main method of diagnosis of placental insufficiency at the present time – ultrasound evaluation of the placenta.

Materials and methods. An analysis was made of 357 birth histories, exchange cards, protocols for screening ultrasound in the third trimester of pregnancy and conclusions of pathoanatomical investigation.

Results. To substantiate the need for prenatal diagnosis of chronic kidney disease, a comparison was made of the evaluation of newborn babies on the Apgar scale and the state of the placenta according to histological data. With compensated chronic placental insufficiency, there was no difference in Apgar scores at the first and fifth minutes, whereas in the subcompensated stage, Apgar score on the Apgar scale was significantly lower in the first and fifth minutes than in the control group. To identify possible in practical use of the objective parameters of diagnosis of chronic kidney disease, the thickness of the placenta was measured during the screening ultrasound in the third trimester of pregnancy, as well as the thickness of the placenta after its separation. Significant differences in the thickness of the placenta or in the screening ultrasound, or when measuring the placenta after separation in patients with and without chronic placental insufficiency was not detected. When assessing a violation of the rate of maturation of the placenta in the third trimester of pregnancy, no significant differences were found in the presence and absence of placental insufficiency. An analysis of the amniotic index was carried out to determine the amount of amniotic fluid in patients of the main and control groups, which revealed no significant differences between the groups.

Conclusions. The authors believe that the main indicators currently used for diagnosis of chronic placental insufficiency (thickness of the placenta, degree of maturity of the placenta, appearance of structural changes in the placenta, change in the amount of amniotic fluid) are uninformative and modern placenography does more harm than benefit. The only parameter determined during the screening study in the third trimester of pregnancy and having significant differences in the main and control groups is fetal hypotrophy.
Contemporary concepts of uterine fibroids’ pathogenesis
Authors: Taits Anna N. , Ruhljada Nikolai N. , Matukhin Valeriy I. , Somova Aleksandra D. , Dudova Kristina A.
Published: April 2019

Uterine myoma is the most common benign tumor among women which affects mainly those of reproductive age. Moreover, the frequency of emergence of this pathology in population is growing while the age of patients is steadily decreasing. Despite the enormous prevalence of this disease, its pathogenesis has not been studied properly. This article is concerned with an analysis of publications devoted to the study of the mechanisms of growth and development of uterine fibroids, it provides some data on the role of various factors in its extension. The article concerns the most popular concepts of the pathogenesis of this disease according to which the illness may be caused by increased levels of sex hormones (estrogens and progestins), enhanced expression of their receptors, impaired apoptosis, the effect of growth factors (e. g. epidermal growth factor, heparin-binding epidermal growth factor, acid and basic fibroblast growth factors, vascular endothelial growth factor, insulin-like growth factor, platelet-derived growth factor, transforming growth factor-β, activin, myostatin), abnormal deposition extracellular matrix, genetic (chromosomal aberration and various MED12 gene defect) and epigenetic mechanisms (such as action microRNA), circulatory disorders and impairment of cell differentiation from a population of accessory stem cells. However, it is noted that the pathogenesis of this pathology requires further detailed study, as the understanding of the processes leading to its development could greatly contribute to the improvement of the tactics of treatment and possibly allow to elaborate some preventive measures to avert the development of fibroids.
Selection of Patients with Resistant Arterial Hypertension for the Catheter-Based Renal Sympathetic Denervation
Authors: Frolova E. V. , Vachev A. N. , Morkovskikh N. V. , Koryttsev V. K.
Published: April 2019

Purpose: elaboration of algorithm for selection of patients with resistant arterial hypertension (AH) for Catheter-Based Renal Sympathetic Denervation (CBRSD). Materials and methods. We examined 284 patients with resistant AH. On stage 1 we excluded most frequent causes of secondary AH. In 247 patients (86.9 %) we established secondary character of AH, in 37 patients (13.1 %) AH was found to be essential. On stage 2 patients with essential AH were given 3–5 component hypotensive therapy. At the background of this therapy we conducted 24‑hour ambulatory blood pressure monitoring (ABPM). CBRSD procedure was considered indicated if according to ABPM average 24‑hour blood pressure (BP) was above 150 and 100 mm Hg, and 24‑hour elevated BP load exceeded 60 %. In 13 of 37 patients (35 %) BP level satisfied these conditions. For CBRSD we used high frequency generator. Ablation was performed using the Symplicity Catheter. Results were assessed in 1, 2, 9, 12, and 28 months. Results.Target BP level at the background of minimal doses of hypotensive drugs was achieved in 11 patients (85 %), what was confirmed by ABPM data. Levels of mean 24–4 hour systolic and diastolic BP significantly decreased from 173.9±14.9 to 143±21.3, р<0.05, and from 108.2±8.7 to 91.4±13.8 mm Hg., р<0.05, respectively. Index of elevated systolic BP time decreased from 78.2±14.6 to 49.8±29.6 %, р<0.05. Best effect was achieved in patients with AH duration before the procedure less than 7 years. None of the patients had episodes of cerebral vascular insufficiency or heart failure progression. Conclusion. While determining indications to bilateral CBRSD one should be governed by such criteria as exclusion of symptomatic AH and objective proofs of AH resistance (according to ABPM at the background of hypotensive therapy).
Decreased Heart Rate Variability in Sickle Cell Anemia as Effect of Pulmonary Arterial Hypertension
Authors: Akgul F. , Batyraliev T. A. , Fettser D. V. , Seyfeli E. , Arystan A. G. , Seydaliyeva T. , Gali E. , Yalcin F. , Sidorenko B. A.
Published: April 2019

Decreased heart rate variability (HRV) is associated with increased mortality risk in various diseases. Theobjective of this investigation:to study HRV in patients with sickle cell anemia (SCA) and to assess the effect of pulmonary arterial hypertension (PAH) on HRV in these patients.Materials and methods. HRV registration and Doppler echocardiographic assessment of systolic pulmonary arterial pressure (PAP) was carried out in 61 stable patients with SCA and 24 healthy subjects.Results. Low frequency power (LFP) and high frequency power (HFP) were decreased in SCA patients compared to healthy subjects. Among SCA patients, PAH patients had lower  LFP and HFP than patients without PAH. In SCA patients, systolic PAP showed significant negative correlation with LFP and HFP. Conclusion.HRV is significantly decreased in SCA patients, especially in those with PAH. HRV may be particularly useful in early detection of PAH patients who may have worse prognosis and higher mortality risk.
Non-Central Influences of α2-Adrenergic and Imidazoline Agonist Interactions in Isolated ardiomyocytes Cardiac Cells
Authors: Maltsev A. V. , Kokoz Y. M.
Published: April 2019

Aim: to investigate the functional interaction of α2-adrenergic and imidazoline receptors recently identified on the sarcolemma of isolated cardiomyocytes for regulation of the intracellular calcium and the production of the signal molecule of nitric oxide (NO).Materials and methods:experiments were performed on isolated left ventricular cardiomyocytes of Wistar rats. Potential-dependent Ca2+-currents were measured from the whole-cell by the patch-clamp method in “perforated-patch” configuration. The intracellular calcium and the production of nitric oxide were estimated from the changes in fluorescence intensity of the Ca2+-specific and NO-sensitive dyes at fluorescent or confocal microscope.Results:It has been shown that α2‑adrenergic and imidazoline receptor agonists inhibit L-type Ca2+-currents by themselves, but their effects do not develop against each other’s background. The blockade of key effector molecules: protein kinase B (Akt kinase) for α2‑adrenergic receptors, and protein kinase C for imidazoline receptors causes the action of agonists to become additive. Both the selective α2‑agonist, guanabenz, and the specific agonist of the first type imidazoline receptors, rilmenidine, show an additional inhibition of Ca2+-currents against the basal background already reduced by the activation of one of the two receptor systems. Wherein rilmenidine increases the level of free  Ca2+in the cytosol, and guanabenz, on the contrary, decreases it. The action of guanabenz does not develop against the background of rilmenidine, although it, in turn, effectively increases the intracellular level of calcium in guanabenz-pretreated cardiac cells. Activation of α2‑adrenergic receptors leads to significant stimulation of the endothelial isoform of NO-synthase, and as a result to an increase in the NO level. Activation of imidazoline receptors itself does not affect NO synthesis but it prevents the production of NO induced by α2‑agonists.Conclusion:obtained data make it possible to formulate a number of useful recommendations for clinical practice, and also to clarify the non-central peripheral effects arising from the activation of α2‑adrenergic or imidazoline systems under conditions of endogenous hyperactivation on of the two systems.
Progression of Chronic Heart Failure: Prognostic Criteria and Non-Drug Prevention
Authors: Kurlyanskaya E. R. , Denisevich T. L. , Mrochek A. G.
Published: April 2019

Purpose: to study frequency of progression of chronic heart failure (CHF), to develop multifactorial models for evaluation of risk of progression, and measures of non-drug secondary prevention of CHF. Materials and methods. We included in this study 531 patients with functional class (FC) I–III CHF (FC I – n=254, FC II – n=255, FC III – n=22). Examination included clinical-instrumental, clinical-functional, and laboratory (with determination of NT-proBNP concentration) investigations, use of the AUDIT and Morisky Green questionnaires. Results. Rate of CHF progression for 24 months was 11.7 % (FC I – 16.1, FC II – 7.8, FC III – 4.5 %). Irrespective of FC significant factors of CHF progression were history of myocardial infarction, and low adherence to treatment. Additional prognostic criteria of increase of CHF FC I to FC II were age >74 years, excessive body mass, disturbance of carbohydrate metabolism, arterial hypertension, and frequent intake of alcohol. FC II CHF progression was associated with such factors as type 2 diabetes, 3‑degree arterial hypertension, permanent atrial fibrillation, and smoking. Using these prognostic criteria, we developed multifactor models, based on which scales for assessing the risk of FC I and II CHF progression were created. These models demonstrated high accuracy of prognosis and good reproducibility (on independent test samples of patients with CHF FC I and FC II prognostic accuracy was 86.3 и 85.5 %, respectively). We also developed a program of secondary non-drug prevention of CHF progression,  with inclusion of structured dynamic education of patients with organization of control and self-control of knowledge quality. After this therapeutic education progression CHF in high risk patients was 2.2 %. Conclusion. Complex application of scores for evaluation of risk of FC I–II CHF progression and the program of secondary non-drug prevention determined lowering of frequency of increases of class of CHF severity from 11.7 to 2.2 %.
The Role of Endothelial Dysfunction in the Development of Cardiotoxic Action of Cytostatics in Patients with Lymphoproliferative Diseases
Authors: Budanova D. A. , Belenkov Yu. N. , Sokolova I. Ya. , Antyufeeva O. N. , Ershov V. I. , Ilgisonis I. S. , Gadaev I. Yu.
Published: April 2019

Understanding mechanisms of chemotherapy cardiotoxicity is an important problem due to the lack of clear understanding of its occurrence. Development of endothelial dysfunction is considered to be one of possible ways in implementation of these side effects. The analysis of endothelin-1 and e-selectin levels in 26  patients with lymphoproliferative diseases before and after the completion of the treatment program was been performed. The results of the study showed normal values of E-selectin level and increased level of endothelin-1 in the whole group of patients before treatment. After completion of chemotherapy program, in the whole group, there was a decrease of these two markers. However, values of level of endothelin-1 with vasoconstrictor effect remained high even after the end of therapy. It is imp ortant that at detailed analysis the dynamics of investigated markers in patients of older age group (median age 64 years) was associated with worsening of endothelial dysfunction.
Myocardial Contractile Function in Patients with Liver Cirrhosis and Syndrome of Bacterial Overgrowth Syndrome
Authors: Ivashkin K. V. , Shirokova E. N. , Ivashkin V. T. , Plyusnin S. V. , Zharkova M. S. , Maslennikov R. V. , Skhirtladze M. R. , Maevskaya M. V.
Published: April 2019

Objective: to study myocardial contractile function in patients with liver cirrhosis and ascites in the presence of bacterial overgrowth syndrome (BOS) and pathological bacterial translocation. Materials and methods. We included in this study 59 patients with Child-Pugh class B and C liver cirrhosis (LC) of various etiology and ascites. Control group comprised 12 patients with ischemic heart disease complicated by chronic heart failure (CHF). Examination included history taking and laboratory and instrumental investigation. LC was diagnosed basing on clinical symptoms and instrumental studies. Child-Pugh and MELD scores were used for assessment of LC severity and prognosis. International ascites club grading system was used for evaluation of severity of ascites. Hydrogen breath test was applied for diagnosing BOS. Syndrome of pathological bacterial translocation was established based on blood levels of lipopolysaccharide-binding protein and detection of bacterial DNA in ascitic fluid. Structural-functional parameters of the myocardium and hemodynamics were assessed by echocardiography. Brain natriuretic peptide (BNP) concentration was measured in blood serum and ascitic fluid. Results. In 13 of 59 patients with LC the hydrogen breath test was negative, in 33 positive and in 13 patients the positive hydrogen test was combined with the presence of BOS and pathological bacterial translocation. Blood serum and ascitic fluid BNP concentrations in LC patients were low and within normal limits (62.5±4.1 and 53.3±4.9 rg / ml, respectively), what contrasted with high BNP concentrations in patients with CHF (1820±95.5 and 497.1±39.6 rg / ml, respectively). Total protein level in ascitic fluid also was significantly lower in patients with LC than in patients with CHF (1.77±0.1 and 4.43±0.35 mg / dL, respectively). The serum-ascitic albumin gradient (SAAG) in both groups of patients exceeded 1.1 (1.58±0.13 in patients with CHF and 1.88±0.19 in patients with LC). Conclusions. In patients with liver cirrhosis the presence of BOS and bacterial translocation did not produce a distinct negative impact on contractile function.
Comparison of commonly used vasopressors for treating hypotension after spinal anaesthesia in elective lower abdominal surgery: a randomized, observational, case-control study
Authors: Kumari Pradeep , Tahir Sifna , Kumari Haveena , Mir Altaf Ahmad
Published: April 2019

Background: During caesarean section hypotension due to spinal block is secondary to the sympathetic blockade and aorto-caval compression by the uterus. It can have important consequences for the mother and may affect neonatal outcome. The present study was aimed to compare intravenous bolus doses of phenylephrine and ephedrine to treat maternal hypotension during spinal block for elective caesarean section.Methods: After fulfilling the inclusion criteria, 100 parturient were randomly allocated into two groups of fifty each. For spinal anesthesia lumber puncture was done and 12.5mg, 0.5% hyperbaric bupivacaine was given intra-thecally. In this observational study, patients who developed hypotension under spinal anesthesia were selected for the study. According to their group, patients received either ephedrine 6mg (Group E) or phenylephrine 75µg (Group P) as vasopressor. During the study, number of vasopressor boluses, hemodynamic response and time taken to recover from hypotension was noted.Results: Ephedrine and phenylephrine were used in the mean doses of 6.72±1.97mg and 91.5±31.38µg respectively. In 88% parturient single bolus dose of ephedrine was effective in treating hypotension while phenylephrine was effective in 78% parturient. There was no significant difference observed in total number of boluses used. No significant difference was seen in mean systolic blood pressure, mean diastolic blood pressure and mean arterial pressure over a given period of time in Group E and Group P. Mean systolic BP was less than 20% when compared to baseline in both the groups at different time intervals. In Group P the mean heart rate was significantly lower as compared to the Group E (p<0.05).Conclusions: Intravenous phenylephrine and ephedrine are both similar in performance in treating hypotension after spinal anesthesia for elective caesarean section and the hypotensive control offered is comparable.
Prevalence of respiratory morbidity among brick kiln workers: a cross sectional study from rural north India
Authors: Gupta Rushali , Gupta Riya , Jan Rayaz , Langer Bhavna , Gupta Rajiv K. , Singh Parveen
Published: April 2019

Background: Fired clay bricks, an important construction material, are manufactured in non-mechanized, labour intensive brick kilns which mostly employ unskilled men and women. The workers, as an occupational hazard, are exposed to dust and air pollution leading to respiratory diseases.Methods: This cross sectional study was conducted among brick kiln workers in RS Pura block of Jammu district. The workers were assessed regarding respiratory symptoms and illnesses using translated version of American Thoracic Society Division of Lung Disease questionnaire (ATS-DLD-78A).Results: 692 brick kiln workers were interviewed during the course of survey and 58.8%of them were males. 45% of the respondents were working since last less than three years. Among the respiratory symptoms chronic cough, was present in 23.55% and phlegm in 22.83% of the respondents. Chronic bronchitis was present in 20.52% of the respondents. Association of respiratory symptoms in relation to sex of the respondents was found to be statistically significant (p<0.05).Conclusions: Respiratory symptoms and illness were found to be quite prevalent in the brick kiln workers. More research needs to be conducted to assess other health risks besides respiratory morbidity. Health planners need to plan for their basic sanitation facilities and periodic check ups.
Evaluation of renal function in subclinical and overt hypothyroidism
Authors: Badyal Ashima , Kumar Sanjeev , Chander Kailash
Published: April 2019

Background: Thyroid hormones can cause significant changes in renal function such as decrease in sodium re-absorption in the proximal tubules, impairment in the concentrating and diluting capacities of the distal tubules, a decrease in the urinary urate excretion and a decrease in the renal blood flow and glomerular filtration rate (GFR). This study was therefore planned to analyse the changes in biochemical markers of renal function in patients with subclinical and overt hypothyroidism and to correlate these values with the thyroid profile of the patients with an aim to determine whether thyroid dysfunction has deleterious effects on renal function.Methods: Study was conducted on 200 patients, in the age group of 20-70 years, in the Department of Medicine, in collaboration with Department of Biochemistry, GMC Jammu over a period of 6 months. After centrifugation, the serum was divided into 2 aliquots: one for renal function tests and the other for thyroid function tests.Results: Age wise, mean was found to be 33.2±9.3 years for euthyroid group and 42.8±8.7 years for hypothyroid group. Patients with both subclinical hypothyroidism and overt hypothyroidism showed statistically significant rise in TSH levels as compared to controls.Conclusions: It was seen that primary hypothyroidism is associated with a reversible elevation of serum creatinine in adults as well as children. It is believed that renal impairment with hypothyroidism is due to reduced cardiac output and increased systemic and renal vasoconstriction leading to reduced renal blood and plasma flow and decreased GFR.
Saline dressing versus povidone iodine dressing in chronic diabetic foot ulcer healing: a prospective comparative study
Authors: Kulkarni Srinivas B. , S. Venkatesh , R. Kruthi S.
Published: April 2019

Background: Numerous topical agents are used for chronic diabetic foot ulcer (DFU) care and healing. In most of the hospitals in India povidone iodine is used topically for DFU dressing, however few other agents are more efficacious; the present study was aimed to compare the effect of povidone iodine and normal saline dressing in healing of DFU.Methods: A total of 50 patients (25 patients in each arm of povidone Iodine and Saline dressing group) with complaints of chronic DFU attending surgery outpatient department of Rajarajeswari Medical College and Hospital were considered in this prospective comparative study from July 2017 to December 2018. Dressings were done on daily basis for a period of 6 weeks, and the results were compared on 2nd, 4th and 6th week, using reduction in surface area of chronic DFU as parameter of healing process.Results: The mean surface area of wound in povidone iodine group was: baseline- 12.2 sq.cm, 2nd week- 11.7 sq.cm, 4th week- 10.6 sq.cm, 6th week- 9.8 sq.cm; While in saline group was: baseline- 13.3 sq.cm, 2nd week- 11.6 sq.cm, 4th week- 10.8 sq.cm, 6th week- 9.6 sq.cm. After 6 weeks, the mean reduction in surface area of wound is more in the saline dressing group compared with the povidone iodine dressing group and the results are statistically significant at a p<0.05.Conclusions: Saline dressing is more effective than povidone iodine dressing in achieving complete healing, reducing wound surface area, and increasing comfort in subjects with chronic DFU.
Comparison of tension free Desarda technique with Lichtenstein for inguinal hernia repair
Authors: Gupta Abhishek , Sharma Subash Chandra , Sharma Janmejai Prasad , Singhal Pradeep
Published: April 2019

Background: Inguinal hernia is common surgical problem for which mesh based technique, particularly Lichtenstein repair is considered gold standard. However it has its own limitation such as foreign body sensation, wound infection, cord fibrosis, chronic pain, etc. Desarda technique for hernia repair is emerging technique for inguinal hernia repair known for its low cost procedure, less recurrence rate and feasibility of the procedure. The objective of the study was to compare treatment of primary inguinal hernia repair with these methods in terms of various operative and post-operative parameters.Methods: 64 patients included in the study and operated after randomization. Intra-operative time, local complication, return to everyday activity, post-operative pain, foreign body sensation and early recurrence were analysed.Results: 51 patients were analysed with a minimum follow up period of 3 months and rest were lost on follow up. Operative time was less in Desarda’s repair (28.24 vs. 30.88 min). Desarda repair was cost effective, return to everyday activity was early in Desarda group, there was significantly (p<0.001) less post-operative pain measured on VAS on 2nd POD, 7th POD and 1 month. No recurrence observed.Conclusions: Desarda repair is easy to perform and takes less time to perform, it is also cost effective. Desarda repair when compared with Lichtenstein was superior in terms of postoperative pain, return to everyday activity and no foreign body sensation. Desarda repair is superior to mesh based technique in terms of outcome.
Clinicopathological evaluation of acute appendicitis and the role of ultrasound in diagnosis: a prospective study
Authors: Mathew Tony , Ammanagi Amit Shivshankar
Published: April 2019

Background: Acute appendicitis is the most common acute surgical condition of the abdomen. Delay in treatment of acute appendicitis causes lot of complication. Study was done with the objective to study the clinical and pathological presentations of acute appendicitis, to evaluate the role of ultrasound in early diagnosis of acute appendicitis and to reduce negative appendicectomy in patients.Methods: This is a prospective study done on 100 patients with acute right lower abdominal pain clinically presumed to be of appendicular origin. A thorough history, clinical examination and ultrasound scan, was done for all cases. All ultrasound positive cases were subjected to surgery and some negative cases were also taken for surgery based on clinical suspicion. The ultrasound diagnosis was compared with clinical findings, operative findings and histopathological examination reports.Results: The overall accuracy of clinical diagnosis (Alvarado scoring system) with histopathology findings was 72%. The overall sensitivity and specificity was 70.3% and 81.3% respectively and positive predictive value of was 95.2% whereas the negative predictive value was 34.2%. The overall accuracy of ultrasound with histopathology report was 93%, with a sensitivity of 96.4%, specificity of 75%, and a positive predictive value of 95% and a negative predictive value of 80%. Negative appendicectomy rate was 8.82% in females and 3.63% in males.Conclusions: The Alvarado scoring system combined with ultrasound can therefore be used as a cheap and inexpensive way of confirming acute appendicitis thus reducing negative appendicectomy rate.
Prognostic factors of outcome in adults with non-traumatic altered mental status presenting to emergency department
Authors: Hilal Ahmad Sheikh , Mushtaq Wani A. , Sajad Tak
Published: April 2019

Background: Altered mental status (AMS) is a common presentation in the emergency department (ED) and poses a significant challenge to the emergency physician (EP). The prognosis seems to depend upon many diverse factors, like etiology of AMS patient, clinical variables and various laboratory tests.Methods: The aim of the study was to determine outcome in patients presenting with new onset AMS to emergency department in our population. And further to look for various prognostic factors for death. Adult patients aged >14 years, not having dementia and with no history of trauma, presenting to ED with altered mental status were included in the study.Results: Out of 200 patients, 108 were male and 92 females. Patients having AMS because of poisoning, seizure, intracranial infection all had decreased mortality. Whereas patients having AMS because of stroke, infection, cardiovascular causes had significantly increased mortality. Season, sex, pH, SaO2, TLC, GCS, mean Bp. were associated with increased mortality in patients of AMS presenting to emergency department. The logistic regression model was statistically significant (chi square=39.3, p=0.000). The model predicted 26% of the variance in predicting death and correctly classified 74.6% of patients.Conclusions: The importance of being able to prognosticate AMS patients at outset in emergency is immense.Male sex, low mean BP, low GCS, low pH, low arterial SaO2, and high TLC were predictive of higher death rate in this cohort of patients presenting to emergency department.
A study on injection practice and its awareness among adults residing in the rural field practice area of a teaching hospital in South India
Authors: Ganesan Dinesh Kumar , Rathinavelu Hema Kairavi , Chitharaj Rajan Rushender
Published: April 2019

Background: Injections are some of the most commonly done medical practice worldwide and it is estimated that approximately 16.7 billion injections are administered worldwide. A national study from India published in 2012 found that frequency of injection was 2.9 per person per year.Methods: Community based cross-sectional study was done to asses the practice and awareness of injection use among 119 adults in a rural field practice area of a teaching hospital in South India. A pre-validated, unstructured questionnaire was used to collect the data. It consisted questions about demographic data such as age, sex, education, marital status etc. and questions about injection usage such as type, frequency, route of administration was recorded.Results: Mean age of the study participant was 36.6. More than half 67 (56.3%) used injections in the past 3 months. On assessing the reasons for injection use, most of the participants complained of muscle pain 37 (31.1%). Among those who had injections in the past 3 months 52 (43.7%) received Intramuscular (I.M). 30 percent (35) of the injections were administered by interns followed by medical officer/physician 22 (34.5%) when asked about their general feeling after an injection, majority 78 (65.5%) of them said they felt better after receiving the injection. When asked about diseases transmitted through contaminated needles, 24 (20.2%) said don’t know.Conclusions: Nearly 60 percent of the individuals preferred injections to oral medicine awareness on the risk of injection and diseases transmitted through needles was low.
Perception of Sugar Content in Food Labels among Supermarket Consumers in Chennai City – A Cross Sectional Study
Authors: Diwakar Aklesh S. , Poorni Saravanan , Nishanthine Cruz , Srinivasan Manali Ramakrishnan
Published: April 2019

Objectives: The aim of the present study was to assess the knowledge on sugar content in food labels among the super market users in Chennai city. Material and Methods: A study was designed as a descriptive cross-sectional study which was conducted among a sampled population of supermarket consumers in Chennai city. Chennai city was divided into 3 zones based on the parliamentary assembly constituencies and from each zone two supermarkets were randomly selected. Data was collected using a closed ended questionnaire. Data collected was tabulated and analyzed using SPSS software package version 16. Results: Majority (71%) were not aware of the rules guiding the display of contents in the food products which they purchased. 46.5% of the participants were more interested in the carbohydrate and protein content of the food products while only 13.2% were interested in the sugar content. About 65% were aware of the positive association between excessive sugar consumption of sugar and incidence of various diseases. Mere 51% of the study participants expressed their interest to know more information regarding the risk benefit of sugar consumption. Conclusion: Based on the findings of this study, it can be concluded that the majority of the supermarket consumers in Chennai city were not aware of the display of contents in their purchased products, including its sugar content. Though majority of them were aware of the association between sugar consumption and disease, they did not perceive sugar in the purchased food products as a potential risk factor.
Can a Multi-modal Communication Program Enhance Empathy and Doctor-Patient Social Interactions?; Results of a Pilot Training Study of Russian Medical Students
Authors: EA Zakharova , J Inklebarger , ES Bogomolova , A Roberts
Published: April 2019

Communication is a vital element of basic professional competency within medicine. However, some medical schools may not typically offer structured developmental skills training to medical students. A multi-modal doctor communications enhancement-training program was therefore organized at a medical university in Russia. A total of 83 students ages 18-19 participated. Pre-course communication ability levels were measured at 21.7% low, 69.8% medium, and 7% high level. Post course outcome measurements demonstrated 1.2% low, 51.8% medium, and 47% high communication levels.

Outcome: It was concluded in this pilot study that a formalized multi-modal communications development program in conjunction with performance feedback, could significantly enhance essential patient communication skills in Russian medical students.
Genes Expression in Type 1 Diabetes: An Update
Authors: Kumar Soni Dr. Kishore , Singh Dr. Sushil
Published: April 2019

Type 1 Diabetes (T1D) is autoimmune disease with a sturdy genetic component, which, through interactions with particular environmental factors, causes disease onset. T1D usually reveals in early to mid-childhood through the autoimmune destruction of pancreatic cells resulting in a lack of insulin production. Traditionally, prior to genome-wide association studies (GWAS), six loci in the genome were fully established to be associated with T1D. The originations of genetic factors involved in T1D through GWAS present the first step in a long process leading to cure. Genes uncovered using this approach is indeed necessary to disease biology and will define the key molecular pathways leading to cure of T1D. However, such genome wide scans can lack coverage in certain regions where it is difficult to , thus, it is possible that other loci with practical effect sizes remain to be uncovered through whole genome sequencing approaches. In this review, we address recent expansions in the genetics of T1D and provide an update on the latest predisposition loci added to the list of genes involved in the of T1D
Magnitude and associated factors of Perioperative hypothermia in patients who underwent Elective surgery at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.
Authors: Fekede Mulualem S. , Sahile Wosenyeleh A.
Published: April 2019

Background : Body temperature is a vital sign and 37°C is the mean core body temperature of a healthy human. Core body temperature is normally tightly regulated and maintained within narrow range. Perioperative hypothermia is one of the major problems during surgery and anesthesia that can affect operated patients. Methods: Institutional based cross-sectional study was conducted. Patient interview, chart review and temperature measurement were employed for data collection. Temperature was measured using tympanic membrane thermometer. SPSS version 20 software was used for analysis. binary logistic regression was used to look at associations anda p-value of <0.05 was considered statistically significant.

Result :The overall magnitude of preoperative, intra and post-operative hypothermia in this study was 16.2%, 53.2% and 31.3%, respectively. Age (AOR=7.15, 95% CI, 1.16, 43.99), coexisting illness (AOR, 3.32, 95% CI, 1.06; 10.36), preoperative hypothermia (AOR; 57; 95% CI; 7.1, 455.4), operation room temperature (AOR=1.91; 95 % CI, 1.04; 3.5) and crystalloid fluids administered (AOR; 2.3; 95% CI, 1.07, 4.9) were found to be factors associated with intraoperative hypothermia.

Conclusion and recommendation: The magnitude of perioperative hypothermia remains high. Measures should focus on improving room temperature and warming up fluids. Susceptible patients like the aged and those with coexisting disease should be given extra attention.
Current Concepts in the Treatment of adhesive capsulitis of the Shoulder
Authors: Andrés Rossi Luciano , Ranalletta Maximiliano
Published: April 2019

Adhesive capsulitis is characterized by chronic inflammation of the capsular subsynovial layer, which produces capsular fibrosis, contracture, and adherence of the capsule to itself and to the anatomic neck of the humerus. Physical therapy is the mainstay of treatment, regardless of stage. Based on the natural history of the disease, early corticosteroid injection has a role in shortening the overall duration of symptoms allowing patients to move faster in the stages of rehabilitation and thus return to their daily life activities more rapidly. Most patients will see complete resolution of symptoms with nonsurgical management.

In cases with refractory stiffness, manipulation under anesthesia or arthroscopic capsular release may be indicated. Because of various potential risks of complications with manipulations, arthroscopic capsular release is preferred. There is a lack of high level studies comparing different techniques for capsular release. Both circumferential and limited release have proven to be effective. Regarding postoperative rehabilitation, arthroscopic release should be followed by early, diligent, and directed therapy to prevent recurrent stiffness.
Role of Intra Articular Injections of Autologous Platelet Rich Plasma in Osteoarthritis of Knee Joint
Authors: Karra Dr Bansilal , Sreeja Dr.koppula , Raviteja Velicharla
Published: April 2019

Osteoarthritis is the most common form of arthritis and a leading cause of chronic disability, to a great extent in knee and/or hip joints. Osteoarthritis, commonly known as wear and tear in which a protective cartilage on the end of the bones wears down over time. osteoarthritis of the knees is one of five leading causes for disability among non-institutionalized adults. Osteoarthritis is the fourth leading cause of 'years lived with disability' (YLD), accounting for 3.0% of totals global YLD's. As per WHO by 2030. The most common symptoms of knee osteoarthritis are pain and physical limitations that have a significant effect on the individual's quality of life and her or his social and economic activities. Osteoarthritis diseases are a result of both mechanical and biological events that destabilize the normal biological coupling of degradation and synthesis of articular cartilage, chondrocytes, extracellular matrix, subchondral bone and subsequently synovial fluid. Current research efforts are focused on the identification of key biochemical pathways that can be targeted therapeutically through biological intervention for cartilage repair. Autologous platelet-rich plasma (PRP), which contains a pool of growth factors, appears to offer an easy solution for delivering multiple growth factors needed for tissue repair. PRP therapy provides delivery of a highly concentrated of growth factors to accelerate healing. The present study has been undertaken in Gandhi Medical College, Hospital, Hyderabad, Telangana, India to study the role of PRP in the osteoarthritis of knee joint. In this study PRP from the patient’s own blood i.e. autologous PRP has been immediately infiltrated into their knee joints with osteoarthritis and the results of injection of PRP have been observed and assess the functional outcome. It is a prospective longitudinal study on 100 patients with 161 primary osteoarthritic knee joints of Kellgren Lawrence radiological grade I-61 and II - 100. Patients were assessed with WOMAC (Western Ontario McMaster Universities Arthritis Index) scoring pre injection of PRP and post injection period of 1 month and 6 months. A reduction in WOMAC score is suggestive of improvement in the patient’s condition. In this study, the pain scores of the patients have decreased on the day of infiltration to one month and six months. Their mean scores have decreased from the day of infiltration to one month and six months. All the patients have started showing improvement at around two weeks and over all, the pain intensity has decreased in severity. It can be concluded that the efficacy of the PRP treatment from zero day to sixth month is statistically significant.
Pancreatic cancer as a complication of chronic pancreatitis – diagnostic approach
Authors: Getsov Plamen Georgiev
Published: April 2019

Patients with underlying chronic pancreatitis (CP) are at increased risk of pancreatic cancer (PC) development. The pathogenesis of the neoplastic transformation remains unclear. However, chronic inflammation, pancreatic stellate cells over-proliferation and genetic alterations play a major role in carcinogenesis progression. Early diagnosis and differentiation between benign and malignant disease is of a great importance. Better understanding the connection of the two entities could provide new therapeutic options.