bluuebunny/crossref_metadata_2025_split huggingface dataset:
The menace of caesarean scar pregnancy: a management challenge in modern obstetrics
Authors: Choudhary Anjali , Tanwar Meenakshi , Nimonkar Shweta , Singh Shailly 
Published: September 2020

Background: With the increasing caesarean section rates a new challenging evil of caesarean scar pregnancy (CSPs) has emerged. As a variant of ectopic pregnancy caesarean scar pregnancy is the rarest of all. Diagnosis and management of CSP can be challenging especially when there are no early symptoms and even lessor index of suspicion. Objective of this endeavour was to present one institute experience of management of caesarean scar pregnancies.Methods: This are a retrospective analysis of women admitted with CSP. Detailed history, investigation, management protocols and complications were noted.Results: Of the total cases maximum women (60%) had history of previous two caesarean section. 90 % of cases were managed successfully with intra-sac or systemic methotrexate, and surgical evacuation with Foley’s catheter tamponade, only two women needed hysterectomy for uncontrolled bleeding.Conclusions: Caesarean scar pregnancy is a diagnostic and management challenge in modern obstetrics. Early ultrasound diagnosis helps in planning a successful medical treatment and serves to preserve uterus and fertility. Treatment with transabdominal intra-sac methotrexate and Foley’s catheter for tamponade is safe and effective method of treating CSPs.
Immediate postpartum intrauterine contraceptive device insertions in caesarean and vaginal deliveries: a comparative study
Authors: . Ritu , . Mini 
Published: September 2020

Background: Post-partum family planning is prevention of unintended and closely spaced pregnancies during first 12 months following childbirth. Postpartum IUCD is the best method of all as it is the safest, most effective, has no effect on breast feeding, reliable and with minimum complications.Methods: The cross-sectional study was conducted in AIMSR Bathinda on 400 postpartum patients. It was a prospective, observational study of women who received PPIUCD in our region.Results: Out of total 400, 58% had normal vaginal delivery and 42% had cesarean section. PPIUCD was done in all cases after applying exclusion criteria and the females were called for follow up. 53% cases who had cesarean and 47% of normal vaginal delivery turned up for follow up. Acceptance is more in multipara (20.7%) than in primi patients (13.7%). Almost 90% patients had good continuation rate. There were few problems faced by patients like irregular bleeding for first few months, pain lower abdomen, leucorrhea etc. which were removed by good counseling and some treatment like NSAIDs for bleeding.Conclusions: The acceptance of PPIUCD was high in present study in both types of females delivered by normal vaginal delivery or post LSCS but with good counseling efforts. It was safe and effective and had high retention rate when done at good timing by trained service provider that is within 10 minutes of placental delivery. So the need of time is creating awareness of public towards it and removing fear from minds, breaking taboos and myths.
Clomiphene versus letrozole: a better agent for ovulation induction
Authors: Maji Aritra , Ramani Manisha V. , Kiran Kajal 
Published: September 2020

Background: Anovulatory dysfunction is a commonly encountered problem which is responsible for about 40% of female infertility. One of the leading causes of female infertility is polycystic ovarian syndrome (PCOS). Clomiphene citrate has been the drug of choice in treating women with anovulatory infertility. However, in recent years, letrozole, an aromatase inhibitor, has emerged as alternative ovulation induction agent. Aim of this study was to compare efficacy of clomiphene citrate and letrozole as first line therapy for ovulation induction in polycystic ovarian syndrome.Methods: This study was a hospital based prospective comparative study done in MVJ MC and RH involving 100 females suffering from infertility due to anovulation. They were divided into 2 groups of 50 each. One group was given clomiphene citrate 50 mg while another group was given letrozole 2.5 mg from day 3 to day 7 of menstrual cycle. Ultrasonographic follicular monitoring was done and injection beta HCG 5000 IU was given once follicle reached optimum size (≥18 mm) and endometrial thickness was adequate (≥7 mm). Patients were advised for timed intercourse after 24-36 hours of HCG administration. Ovulation was detected by sonographic findings of follicular rupture done after 48 hours. Primary outcomes measured were number of growing follicles (≥18 mm), endometrial thickness, ovulation rate and pregnancy rate.Results: In our study there was significant difference in the outcomes of ovulation induction between letrozole group and clomiphene group. Women who received letrozole showed improved endometrial growth (8.44 mm versus 7.86 mm), ovulation rate (72% versus 56%) and pregnancy rate (22.2% versus 14.3%) than those who received clomiphene. However, variation in follicular growth was negligible between the two groups (1.28 versus 1.36).Conclusions: Letrozole is a superior alternative to clomiphene citrate for ovulation induction in cases of PCOS with anovulatory menstrual cycle, and can be considered as first-line therapy for ovulation induction in such women.
A study of lipid profile and glycemic status in patients with chronic kidney disease of unknown etiology in Sri Lanka
Authors: Basnayake Duminda B. , Sandamali W. G. H. , Nayanamali Ayesha , Wazil Abdul W. M. , Siriwardena R. M. P. A. , Thennakoon T. M. C. I. , Dharmasiri Thilak , Nanayakkara Nishantha 
Published: September 2020

Background: Dyslipidemia and impaired glucose tolerance are common complications of chronic kidney disease (CKD) and are responsible for increased cardiovascular risk. Studies on lipid profile and glycemic status in CKD of unknown origin (CKDu) are scarce. The objective of this study was to evaluate the lipid profile and glycemic status of the patients with CKDu and to aid in preventing morbidity and mortality.Methods: The descriptive, cross sectional study was conducted in a rural CKDu endemic area, Girandurukotte. Data was collected from February 2018 to June 2019. For the diagnosis of CKDu, history and clinical features with supportive biochemical, renal biopsy and radiological evidence were taken as criteria. Blood samples were taken for serum creatinine, lipid profile and HbA1C. Already diagnosed patients with diabetes mellitus and dyslipidemia were excluded.Results: A total of 168 patients within the age range of 32-66 years (mean 50.3±7.7) were participated. There were 106 males (63%) 46.4% were farmers. Majority of the patients (65.5%) had normal body mass index (BMI) (mean 22.9 kg/m2, normal range 18.5-23.5%) followed by overweight (23.5-30 kg/m2) in 55 (32.7%) patients. The prevalence of dyslipidemia in CKDu was found to be 55.9%. Majority of the abnormality was seen in the HDL group with 68 (40.5%) patients having low HDL cholesterol (mean 44.7 mg/dl, SD=12.3). There was a significant rise in the serum triglyceride concentration (>150 mg/dl) in 53 (31.5%) (mean 152.4 mg/dl, SD=73.5) and total cholesterol (>200 mg/dl) in 30 (18%) patients (mean 182 mg/dl, SD=36.9). LDL cholesterol abnormality (>130 mg/dl) was seen in only 9 patients (mean 88.7 7658mg/dl, SD=25.4). From the total, 144 (85.7%) patients had abnormal HbA1C levels; 27 (16.1%) patients had HbA1C levels between 5.7% and 6.4% (pre-diabetes), and 117 (69.6%) patients had HbA1C level more than 6.5% (diabetes mellitus). There was no statistically significant association between HbA1C levels and BMI (p=0.29) or HbA1C and lipid abnormalities (p=0.32)Conclusions: The high prevalence of dyslipidemia, pre-diabetes and diabetes mellitus in patients with CKDu may accelerate the progression of chronic kidney disease and increase the risk of cardiovascular disease. Early detection, initiation of appropriate medication and early referral to the expertise will ameliorate morbidity and mortality.
Changing indications for intravitreal anti-vascular endothelial growth factor injections at the university college hospital, Ibadan, Sub-Saharan Africa
Authors: Adewole Adeyemi Timothy , Oluleye Tunji Sunday , Babalola Yewande Olubunmi , Majekodunmi Oluwole , Ijaduola Modupe 
Published: September 2020

Background: Compare the current indications for intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy, to make recommendations for planning of services. To review the current indications for intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy, in order to make recommendations for planning of services.Methods: The medical records of 172 patients who had intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections from January 2016 to December 2019 were retrieved. Socio-demographic and clinical data were extracted, analysed, and compared with data from the previously published audit report covering 2010 to 2012.Results: Three hundred and thirty injections were given to 182 eyes in this cohort of patients. The mean age was 61.1±16.3 years (range <1-90 years), with a male to female ratio of 1.1:1. Retinal vein occlusion, 64 (35%) remained the most common indication for anti-VEGF injections in the eyes treated. This was followed by choroidal neovascular membrane/wet age-related macular degeneration which accounted for 42 (23%) as reported previously. However, cases of proliferative diabetic retinopathy/ diabetic maculopathy needing anti-VEGF were noticed to have almost doubled from about 8 (10%) in the previous study to 15 (27%) in the present study. In addition, idiopathic polypoidal choroidal vasculopathy, 18 (10%) ranked above proliferative sickle cell retinopathy in the present study. Retinopathy of prematurity (ROP), neovascular glaucoma, retinal artery macro-aneurysm and myopic choroidal neovascular membrane were the new emerging indications.Conclusion: There is an expanding indication for anti-VEGF in the management of retinal vascular diseases in the health facility and adequate measures should be put in place for early diagnosis and management. Patients should be counselled on the availability of this treatment option.
Comparison of two ophthalmic solutions of olopatadine hydrochloride (0.1%) and epinastine hydrochloride (0.05%) on clinical signs of vernal keratoconjunctivitis and side effects of the two drugs
Authors: Ansari Tahir Husain , Rizvi Yusuf 
Published: September 2020

Background: Vernal keratoconjunctivitis (VKC) is a recurrent, bilateral, external, ocular inflammation primarily affecting young adults living in warm dry climates. The objectives of the research was to compare the two ophthalmic solutions of olopatadine hydrochloride (0.1%) and epinastine hydrochloride (0.05%) on clinical signs of vernal keratoconjuntivitis and to determine side effects of both the drugs.Methods: The study was carried out in 40 patients who attended the out-patient department (OPD) Ophthalmology, Darbhanga Medical College and Hospital, Laheriasarai from July 2007 to December 2008. Forty patients with symptoms of VKC (ocular itching, ropy discharge, papillary hypertrophy, gelatinous thickening and horner-trantas spots were selected and included in our study.Results: Mean score of palpebral hyperemia at 0, 14, 28 and 42 days in olopatadine treated eye were 2.1, 1.4, 0.8 and 0.4 respectively having p value <0.01, and <0.01 and <0.05 respectively, while mean score at same stages in placebo eye were 2.1, 2, 1.9, and 1.5 having value >0.05. Epinastine treated group mean score of palpebral hyperemia were <0.01 and <0.01 respectively in epinastine treated eye whereas in placebo treated eye, mean score were 2.1, 2.0, 1.8 and 1.6 respectively having p value >0.05 in all stages. Statistically insignificant reduction at day 14 while very significant reduction at day 28 and 42 was observed in epinastine treated eye as compared to placebo.Conclusions: The present study had shown that both olopatadine and epinastine were effective in treating clinical signs of VKC as compared to placebo.
Effect of ethanolic extract of Centella asiatica on maximal electroshock seizure in albino mice
Authors: Kannoor Ahmed A. , T. Ramani P. 
Published: September 2020

Background: Animal models had always served as integral part in introducing newer drugs for epilepsy. India has long tradition of using herbal medicines. Centella asiatica is an ingredient of various ayurvedic preparations to treat brain related disorders like insanity, memory loss and epilepsy. This research is done to find out the usefulness of Centella asiatica in epilepsy. Methods: Ethanolic extract of the plant is prepared using Soxhlet apparatus. Experimental seizure is induced in albino mice by maximal electroshock method. Resulting seizure goes through different phases. Duration of the phase of hind limb extension was the measured data. Clinically used anti epileptic drugs can abolish hind limb extension. Effect is compared to that of standard drug phenytoin. Four different doses of the plant extract; 100mg, 200mg, 500mg and 1000mg per kilogram bodyweight was given orally. Statistical analysis of data was done by one way ANOVA and Dunnett test.Results: Ethanolic extract of Centella asiatica exhibited statistically significant protection from maximal electroshock seizures. All given doses of the extract had p<0.05 when compared to control.Conclusions: Centella asiatica is potential source of anti-epileptic drug. Detailed phytochemical studies and animal experiments are recommended.
Factors influencing incomplete immunization among under five years old children at CHUK hospital, Nyarugenge district, Rwanda
Authors: Nwankwo Chinenye Mercy , Orua Elizabeth 
Published: September 2020

Background: Low-income countries still have challenges with vaccine-preventable diseases, despite improvement in immunization coverage in Rwanda, cases of drop out and incomplete immunization persists.Methods: The study adopted descriptive cross-sectional approach with the use of quantitative and qualitative techniques on a population of 186 guardians/mothers with their under five children. Convenience sampling techniques was used to draw study sample size of 127 that attends the clinic and approval to participate in the study. Data was obtained from validated study instruments and immunization records over a period of one month.Results: Study results showed that religion (p=0.01), gender (p=0.03), age (p=0.009) and educational status (p=0.04) influenced incomplete immunizations. About 78 (61.4%) respondents are unaware that vaccines prevents specific diseases, while 61 (48.0%) were too busy with other duty at the time of immunizations and 89 (70.1%) Participants do not see the need to complete the immunization. Furthermore, the age of the mother Knowledge of child immunization and hospital delivery were statistically significant with (p<0.05). Immunization cards and histories verified showed about 120 (94.4%) children were fully immunized, 46(24.5 %) were partially immunized and 67 (52.8%) children immunized before age one.Conclusions: A number of children were not fully immunized in their first year of life; others were inappropriately vaccinated. Emphasis made on completion of immunization schedule.
Baseline characteristics, level of disease severity and outcomes of patients with COVID-19 admitted to intensive care unit in COVID-19 dedicated Mugda Medical College and Hospital, Dhaka, Bangladesh
Authors: Hossain Irin , Khan Manzurul H. , Tuhin Shah G. , Aktaruzzaman M. M. , Rahman Shafiur , Mullick Ashekur R. , Shahin Md. , Yasmin Nahid , Choudhury Adnan Y. , Haque Monjurul 
Published: September 2020

Background: Novel coronavirus disease is associated with highly intensive care unit (ICU) mortality. With the dramatic increase of confirmed cases as well as death toll in Bangladesh, timely and effective management of severely and critically ill patients appears to be particularly important. This includes streamlining workflows for rapid diagnosis and isolation, clinical management, and infection prevention. The main objective of this study was identification of the demographic, clinical characteristics, severity and outcome of patients admitted into ICU. Methods: We aimed to describe the demographic and clinical characteristics, severity of disease, management patterns and outcomes of critically ill patients with coronavirus disease 2019 admitted to ICU in a Bangladeshi setting and for this purpose a retro-prospective study of conveniently selected 63 ICU admitted patients with COVID-19 was conducted from May 1 to June 30, 2020. Data were obtained from patient charts and the hospitals’ records using a structured questionnaire. Results: Most of the ICU patients were older male (30, 65.3%) and most of them were 70 or above years of age group (17, 37.0%). ICU patients more likely suffered from comorbidities like hypertension (938, 60.3%); diabetes (36, 57.1%); chronic kidney disease (21, 33.3%). In most cases treatment in ICU included the administration of antibiotics (100.0%) (Meropenem, 20, 31.7%). Forty-Eight patients died (discharge mortality, 76.2%), and fourteen patients were discharged alive from the ICU with a rate of 22.2%. One patient transferred (Palliative discharge, 1.6%) to other facilities for palliative care purpose.Conclusions: Our findings also highlight the importance of planning for mass critical care along with central oxygen supply system as the need for ICU care and ventilator support to treat patients with COVID-19 grows rapidly in Bangladesh.
Coexistence of fluoroquinolone resistance and ESBL production in urinary isolates
Authors: Khan Nazia , Panda Pragyan Swagatika , Rastogi Megha , Sharma Swati , Rana Neha , Faridi Maryam , Mehndiratta Man Mohan 
Published: September 2020

Background: Enterobacteriaceae group of organisms are commonly implicated for causing urinary tract infection (UTI). Fluoroquinolones (FQ) are widely used as empirical therapy for UTI. Enterobacteriaceae exhibits high resistance rates to FQs. The plasmid mediated extended spectrum beta lactamase (ESBL) production confers resistance for FQs as well. The aim of the study is to determine the prevalence of fluoroquinolones resistance in urinary isolates and to study the coexistence of FQ resistance and ESBL production in urinary isolates.Methods: Retrospective data of the urine samples received in our microbiology laboratory between December 2018 to May 2019 were reviewed. The organisms were isolated and identified as per standard procedures and the antibiotic susceptibility testing was done following CLSI 2019 guidelines. Ceftazidime (30 µg) and ceftazidime-clavulinic acid (30 µg/10 µg) were used for detection of ESBL production. Levofloxacin (5 µg) and ciprofloxacin (5 µg) were used for detecting FQ resistance.Results: Out of a total of 1403 urine samples received in our laboratory, 240 (17.1%) sample showed growth of Enterobacteriaceae. The different species were E. coli (80.4%), Klebsiella spp (12.2%), Citrobacter spp (4.2%), Enterobacter spp (1.6%) and Proteus mirabilis (1.6%). Amongst these organisms 121(50.4%) were ESBL producers. Co-existence of FQ resistance among the ESBL producers was observed in 106(87.6%) isolates which is higher as compared to that among the ESBL non producers 71(59.7%).Conclusions: Around 50% of the UTI Enterobacteriaceae bacteria are ESBL producers. Fluroquinolone resistance amongst ESBL producing Enterobacteriaceae is very high (87.6%).
Seasonal trends in ear, nose, throat and head, neck patients undergoing shortwave diathermy at a tertiary care centre of Punjab: a five-year study
Authors: Munjal Manish , Teotia Avkash , Kaur Jatinder , Rishi Porshia , Sidhu Harjinder , Munjal Shubham , Verma Hitesh 
Published: September 2020

Background: Shortwave diathermy, a therapeutic modality in acute inflammatory conditions of the ear, nose and neck has its utility in the paediatric, adolescent, middle age and the elderly. The seasonal variations of the patients enrolled in physiotherapy clinics for temporo-fascio-cervical diathermy sessions during a 5 years period, were analysed. Methods: 490 patients with inflammatory pathologies localized to the head and neck region and referred to the physiotherapy unit of a tertiary care centre of Punjab were analysed. All were subjected to shortwave diathermy. The subjects were analysed for any seasonal trends.Results: In the paediatric age group, maximum patients were observed in the month of March over the period of 5 years followed by the month of January. In the adolescent population maximum patients were observed in the month of November over the period of 5 years followed by the month of December. In the Adult population maximum patients were observed in the month of April over the period of 5 years followed by January and August.Conclusion: Paediatric patients came for regular sittings in the end of March end, i.e. post examination vacation period. The elderly visited mostly during winters. Malignant otitis externa with underlying diabetes worsens in winters due to increase in intake of sugary energy drinks.
Knowledge and practices regarding management of minor ailments of pregnancy among antenatal mothers: a descriptive study from Rajasthan
Authors: Sharma Ankita , Rani Raj , Nebhinani Mamta , Singh Pratibha 
Published: September 2020

Background: Pregnancy is considered as one of the most beautiful events in every female life which brings a lot of physiological and hormonal changes to prepare women for motherhood. Even though these changes are not dangerous, still they are bothersome. Women use number of homemade remedies to alleviate these discomforts. Objective: The objective of this study was to assess knowledge and practices regarding management of minor ailments of pregnancy among antenatal mothers.Methods: This study was conducted at obstetrics OPD of All India Institute of Medical Sciences, Jodhpur, Rajasthan. 368, 3rd trimester pregnant mothers were recruited by convenient sampling technique. Self- structured knowledge questionnaire, checklist for practice were used for data collection using face to face interview method.Results: Most common health problems as reported by pregnant women were increased urine frequency and fatigue. Nearly 61% of mothers had fair knowledge levels. Majority of the antenatal mothers used one or another home remedy to alleviate their symptoms. 86.6% ate small and frequent meals followed by 74.3% avoided strong odors to prevent nausea and vomiting.Conclusion: Increased urine frequency is the most evident minor ailment faced during pregnancy. Overall antenatal mothers had fair knowledge regarding management of minor ailments and varied practices have been performed by antenatal mothers to relieve their problems. There is a need to conduct aggressive and comprehensive health promotion and awareness sessions for the expectant mothers so as to manage these ailments and prevent further complications.