bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of sexual activity during the third trimester of pregnancy on labor outcome in nulliparous women
Authors: Simo Janice H. , Foumane Pascal , Meka Ngo Um E. , Dohbit Julius S. , Essiben Felix , Mboudou Emile T. 
Published: March 2020

Background: In the environment, there’s not enough studies on the effects of sexual activity during pregnancy on labor outcome, especially for nulliparous women. The aim was to assess the effects of sexual activity during the third term of pregnancy on the outcome of labor in nulliparous women.Methods: A prospective cohort study on labor was carried out for 11 months at the labor ward of the Yaoundé gynaeco-obstetric and pediatric Hospital. In this study compared women were exposed to at least one unprotected sexual intercourse with vaginal ejaculation per week during the third trimester of pregnancy (exposed group), to those who had less than one unprotected sexual intercourse per week (non-exposed group).Results: Of the 1123 primiparous women who gave birth within the study period, 426 consented to enroll in the study. Amongst these women, 186 women in the exposed group compared to 240 women in the non-exposed group. Intercourse during pregnancy predisposed on arrival into the labor ward to a Bishop’s score ≥7 (RR = 1.94; CI = 1.63-2.3) and within the course of labor to a spontaneous per vaginal delivery (RR = 1.18; CI = 1.06-1.31) and an active phase duration <6 hours (RR = 1.52; CI = 1.36-1.7). Furthermore, sexual intercourse during pregnancy protected against labor induction (RR = 0.21; CI = 0.12-0.36), dystocia (RR = 0.36; CI = 0.27-0.49), cesarean section (RR = 0.29; CI = 0.15-0.55), episiotomy (RR = 0.56; CI = 0.36-0.87) and an Apgar score <7 at the first minute of birth (RR = 0.31; CI = 0.14-0.7).Conclusions: Sexual activity during pregnancy improves the prognosis of labor in primiparous women. In the absence of contraindications, consented unprotected heterosexual vaginal intercourse should be promoted in nulliparous women.
Role of bundled intervention in reducing surgical site infection rate in gynecologic surgeries
Authors: Singh Nisha , Rai Shweta , Agrawal Shuchi , Banerjee Gopa , Singh Renu 
Published: March 2020

Background: Surgical site infection (SSI) is most common nosocomial infection (15%) among surgical patient’s and contributes significantly to morbidity and mortality. CDC (2015) provides “bundled intervention for prevention of SSI. The present study was planned to evaluate the feasibility and usefulness of these bundled intervention in reducing SSI in our setup. Objectives of this study to study the effect of bundled interventions on SSI in gynaecologic surgery.Methods: A total 50 cases undergoing gynecological surgery in elective OT included in pilot group and bundled intervention followed these pilot group cases compared with 50 control group operated in same OT in which bundled intervention not followed outcome measures recorded were Incidence of SSI, type of SSI, need for antibiotic usage, need for secondary suturing, duration of hospital stay.Results: Out of 50 subjects in pilot group, five developed signs and symptoms of SSI giving an SSI rate of 10%. Out of those five, two had superficial SSI and three had deep SSI, none of the patient had organ space SSI.SSI rate in 50 cases operated in the same operating room during the same time period without use of bundled interventions (control group) was 12%.Conclusions: Bundled approach is easy and feasible in all setups. It adds only three extra minutes to the total duration of the surgery with risk reduction of SSI.
Tubercular pyometra in a young unmarried female - dilemma and pitfalls in diagnosis: a rare case report with review of literature
Authors: Aggarwal Rasika , Malik Renuka , Singh Swati 
Published: March 2020

This rare case is the first case being reported as tubercular pyometra in a young unmarried woman. Diagnosis of genital tuberculosis which is a form of EPTB (extra pulmonary TB) can be baffling, compelling a high index of suspicion owing to paucibacillary load in the biological specimens. A negative smear for acid-fast bacilli, lack of granuloma on histopathology and failure to culture mycobacterium tuberculosis do not exclude the diagnosis of EPTB. A 25-year-old unmarried, government employee from Bihar presented to our OPD with secondary amenorrhea for two months carrying with her an USG, CT and MRI done in Bihar suggesting enlarged uterus with fluid collection. CT-also reported few enlarged lymph nodes. Her preoperative investigations revealed an elevated ESR and x-ray chest was normal. Dilatation was done under ultrasonic guidance in OT and 150 cc of thick caseous material was drained A gentle curettage was done on lateral wall near cornea and both the caseous material and endometrial tissue was sent for gram staining, TB-PCR (polymerase chain reaction), NAAT (nucleic acid amplification techniques) and culture. In the post-operative period gram staining for AFB, NAAT, TB-PCR all came negative and it was difficult to convince patient to take ATT. However, on day 10, HPE report came as granuloma suggestive of TB and patient was put on ATT. Culture too was reported negative later. Paucibacillary female genital TB (FGTB) is difficult to diagnose because of varied presentation and limitations of diagnostic tests A raised ESR is presumptive but non-specific. Other tests are x-ray chest, HSG, endometrial tissue for TB PCR nucleic acid amplification techniques (NAAT, HPE and culture (conventional or Bactec). Patients with EPTB are, however, more likely to have negative sputum smear results and many EPTB cases do not have direct lung involvement. Currently, there are no standard guidelines or algorithm for the diagnosis of FGTB. Female genital TB has varying presentation and diagnosis is difficult because of the paucibacillary nature.
Study of correlation between adequacy of dialysis and glycemic control in patients of type 2 diabetes mellitus with chronic kidney disease stage 5
Authors: Mitra Samrat , Barui Sanghita 
Published: March 2020

Background: The adequacy of haemodialysis in patients of type 2 diabetes mellitus with chronic kidney disease stage 5 depends on several clinical as well as laboratory parameters. Previous studies from Western literature have identified several clinical and laboratory markers for predicting adequacy of dialysis. There is a dearth of literature regarding the same in Indian patient populace. Authors aimed to find correlation, if any, between glycemic control and adequacy of dialysis in this cohort of patients.Methods: A set of 200 patients of type 2 diabetes mellitus who have undergone hemodialysis at a tertiary care hospital were included in the study. Random blood sugar (RBS), Glycated hemoglobin (HbA1c) were measured at admission. After 4 hours of dialysis, the urea reduction ratio (URR) and Kt/V was measured for each patient. The correlation coefficient as well as linear equation of the association between these variables were calculated. Standard statistical method and software were used in the process.Results: The study revealed a linear negative correlation between the variables RBS, HbA1c and URR as well as Kt/V. This suggests the importance of pre dialysis glycemic control in patients undergoing hemodialysis.Conclusions: Authors formulate the hypothesis that glycated hemoglobin and random blood sugar at admission correlate well with the outcome and adequacy of dialysis in patients of stage 5 chronic kidney disease undergoing haemodialysis. Good glycemic control (HbA1c <6.5 % and RBS <120 mg/dL) have shown to be important predictive markers of adequate dialysis. The hypothesis needs to be tested with a larger study.
Characteristic of risk factor of thyroid cancer related metastatic bone disease at Sanglah General Hospital Denpasar between January 2013 to March 2019
Authors: Nugraha Gede Ketut Alit Satria , Wiratnaya I. Gede Eka , Andika Gde Dedy , Sunaria Made 
Published: March 2020

Background: Metastatic bone disease (MBD) causes a massive morbidity, pain, and disability for the sufferers. Thyroid carcinoma, which is the most common endocrine cancer worldwide, also contributes to the increased rate of MBD, as 60% of patients with thyroid carcinoma experience bone metastasis. An urgency to further analyze the risk factors of bone metastasis in thyroid cancer is necessary in order to prevent and treat this unwanted occurrence earlier and better.Methods: A descriptive retrospective study was conducted using patients’s medical record data obtained from Sanglah General Hospital between January 2013 until March 2019. The variables obtained were sex, age, diagnosis, management, and fracture site.Results: There were 15 patients involved in this study, presenting with pathological fracture due to MBD from thyroid cancer. Ten patients were female (66.7%) and 5 were male (33.3%). According to the age group, 2 patients (13.3%) were <40 years old, 5 patients (33.3%) were >60 years old, while the majority of 8 patients (53.4%) were 40-60 years old. From the pathological result, 9 patients had follicular neoplasm (60%) and 5 patients had papillary neoplasm (33%). The most common site of metastasis was humerus in 7 patients (47%), while the other sites were femur, pelvic, and tibia.Conclusions: According to this series, there are several risk factors related to MBD from thyroid carcinoma, including female gender, the age of 40-60 years old, and follicular type neoplasm. A further study with bigger amount of sample is needed to improve the result.
Persistent genital arousal disorder it’s etiology, treatment guideline and management strategy
Authors: Singh Preksha T. , Singhvi Shreyans D. 
Published: March 2020

Persistent genital arousal disorder is a recently recognized disorder. Its first case was reported in 2001, since then many cases have been diagnosed and treated with various methods, yet no FDA approved treatment guidelines have been proposed. Although it is a cause of not only sexual, but also psychological impairment to the patients of the disorder, Persistent genital arousal disorder is not well recognized currently due to the social stigma attached to it This study is important for the physicians treating a case of PGAD, as it has all the published data about the disorder.The review of literature was done by using all the research articles and case reports of PGAD using keywords like ‘persistent’, ‘genital’, ‘arousal’, ‘disorder’ on platforms like google scholar and pubmed. Various research articles and case reports were reviewed and grouped into different levels of intervention; at the female genital system, at the spinal cord and the brain. This study has evaluated all the possible etiologies and suggested the possible treatments and management strategies for the disorder. This study has thrown striking limelight on all the potential causes leading to PGAD, its potential line of treatment, and the management strategy. This study is based on the case reports found till date, but there is still a paucity in data, the number of reported cases is less due to a possible social stigma associated with the disease. The present investigation demands extensive research in the topic as this is a cause of social concern leading to psychological, emotional and nervous breakdown.
Outcome of early laparoscopic cholecystectomy versus delayed laparoscopic cholecystectomy for patients with acute cholecystitis
Authors: Rather Zahid Mohd , Majid Nighat Ara , Islam Mohd Nazrull , Mohd Raja Waseem 
Published: March 2020

Background: This prospective randomized study was undertaken to to assess the outcomes of early versus delayed cholecystectomy for patient’s acute cholecystitis.Methods: 70 patients with acute cholecystitis were prospectively randomized to either an early laparoscopic cholecystectomy (n=35) or a delayed laparoscopic cholecystectomy group (n=35). The mean operative time, conversion rate, total hospital stay, intra-operative and post-operative complications, average hospital cost were evaluated between the two groups.Results: A total of 70 patients were enrolled, 35 patients in each group. There was no significant difference in the conversion rates (early, 8.57% vs delayed, 5.71%) and postoperative complications (early, 25% vs delayed, 20%). At the cost of an increased operating time (early, 81 minutes vs delayed, 78 minutes) and blood loss (early, 180.33ml vs delayed, 108.00 ml), early laparoscopic cholecytectomy significantly shortened the total hospital stay (early, 1.5 days vs. delayed, 7.95 days) and average hospital cost (early 9240 INR vs delayed, 12251 INR).Conclusions: The safety and efficacy of early and delayed laparoscopic cholecystectomy for acute cholecystitis were comparable in terms of morality, morbidity and conversion rate. However early laparoscopic cholecystectomy allows significantly shorter total hospital stay and reduction in days away from work at the cost of longer operating time and blood loss and offers definitive treatment at initial admission. Moreover it avoids repeated admissions for recurrent symptoms has both medical as well as socioeconomic benefits and should be the preferred approach for patients managed by surgeons with adequate experience in laparoscopic cholecystectomy.
A retrospective study on benign paraoxysmal positional vertigo in a tertiary health care facility of North India
Authors: Munjal Manish , Bhatti Harsimran , Kaur Japneet , Rishi Porshia , Munjal Shubam 
Published: March 2020

<p class="abstract"><strong>Background:</strong> Benign paraoxysmal positional vertigo (BPPV) has been attributed to be one of the commonest causes of vertigo presenting to the clinician. However, this often remains undiagnosed and undertreated, epidemiology remaining an underexplored territory for this disorder.</p><p class="abstract"><strong>Methods:</strong> A study was carried out at outpatient clinic, Ear Nose Throat, Head and Neck services, Dayanand Medical College and Hospital, Punjab over a period of one year from 1<sup>st</sup> January to 31<sup>st</sup> December 2018. Based upon history, detailed otological examination, and Dix-Hallpike testing, 374 patients were evaluated for benign paroxysmal positional vertigo presenting with complaint of vertigo and dizziness in the vertigo clinic and were treated with Epley’s maneuver. </p><p class="abstract"><strong>Results:</strong> Out of 374 patients evaluated, 79 patients were diagnosed as BPPV and underwent office management in the form of Epley’s maneuver.</p><p class="abstract"><strong>Conclusions:</strong> This study helps in effective team approach among practitioners and clinicians in the hospital for referring vertigo cases to ENT OPD for effective management of vertigo.</p><p class="abstract"> </p>
Management of acute otitis externa in India: a questionnaire based survey of ENT specialists across the country
Authors: Singh Kritarth Naman , Patil Saiprasad , Barkate Hanmant 
Published: March 2020

<p class="abstract"><strong>Background:</strong> A questionnaire-based survey was conducted across ENT specialists in India to know current perception and practice of acute otitis externa (AOE) management.</p><p class="abstract"><strong>Methods:</strong> The survey was conducted between January-June 2019 using a 23-item questionnaire. Questions were pertaining to epidemiology, clinical as well as microbiological features, diagnostic and management approaches. An ENT specialist who has postgraduate diploma or masters in ENT with an active practice from at least 5 years was considered eligible. 100 ENT specialists were randomly approached across India to take this survey. </p><p class="abstract"><strong>Results:</strong> 68 doctors filled survey-questionnaires completely. 60 (88.23%) specialists were males, with mean age of 48.46±9.98 years. Majority agreed that AOE is polymicrobial (62,91.17%), with bacteria being either a primary pathogen or superimposed on fungal infections (otomycosis) (64,94.11%). Almost 90% respondents (61, 89.7%) agreed that empirical cover for both bacterial and fungal pathogens should be provided in AOE cases. 75% respondents (51/68) agreed that topical ear drop containing antimicrobial agents with steroid is the desirable option to manage AOE. Majority respondents (54, 79.41%) agreed that pain-relieving local anaesthetic eardrops should not be recommended in AOE as their usage can mask the symptoms. 63 respondents (92.64%) agreed that neomycin and clotrimazole have broad spectrum action and are safe in AOE. </p><p class="abstract"><strong>Conclusions:</strong> Majority ENT specialists opined that AOE cases have mixed bacterial and fungal etiology, and topical eardrop containing both antibacterial and antifungal agent with steroid is the desirable empirical option to manage AOE. Local anaesthetic eardrop should not be used as it may mask the symptoms and affect patient compliance. This publication has collated viewpoints of ENT specialists in India pertaining to AOE. It can aid practitioners in getting information about the current practice in the country related to AOE. </p>
Study of effect of chronic suppurative otitis media on auditory brainstem response latency
Authors: Muniyappa Hanumanth Prasad , Dudda Ravi , Kalegowda Balaji Nagavara , Basvaraj Vandana 
Published: March 2020

<p class="abstract"><strong>Background:</strong> Chronic suppurative otitis media (CSOM) emerging as common hearing problems in the recent years with high prevalence requiring immediate attention. Hence, our study includes assessment of adult patients with CSOM using electrophysiological test, auditory brainstem response (ABR) and analysing the latency of ABR peaks in order to find the effect of CSOM on ABR latency with respect to shift in latency.</p><p class="abstract"><strong>Methods:</strong> The study followed cross sectional study design where data collected from March to September 2019 were used. A total of 50 subjects with unilateral CSOM were analysed. Descriptive statistics and paired t-test was used for statistical analysis of the data. </p><p class="abstract"><strong>Results:</strong> The data was divided into 3 groups based on degree of hearing loss (mild, moderate and moderately severe). The Mean ABR peak latency was analysed and subjects showed a significant latency shift. Also, it was found that the magnitude of latency shift increased with increase in degree of hearing loss.</p><p class="abstract"><strong>Conclusions:</strong> Hence the study concludes that as the amount of conductive component increases the pure tone threshold deteriorates and ABR latency gets affected. Also, the morphology of ABR peaks on comparison to the normal hearing ear gets affected due to constant conductive pathology in the pathological ear.</p><p class="abstract"> </p>
Clinical, pathological and radiological correlation of thyroid swellings
Authors: Chauhan Hetal H. , Aiyer R. G. , Shah Purva C. 
Published: March 2020

<p class="abstract"><strong>Background:</strong> The cause and type of thyroid swellings vary across geographical areas, lifestyles, and socioeconomic status of people. The incidence of palpable thyroid swellings is 4-7% out of which only 1% are malignant. Out of all thyroidectomy cases, histologically confirmed thyroid malignancy constitutes only 20%. Hence, we attempt to evaluate thyroid swellings based on clinical examination, ultrasonography (USG), Fine needle aspiration cytology (FNAC), and histopathological evidence to aide in arriving at proper diagnosis and treatment at an early stage.</p><p class="abstract"><strong>Methods:</strong> This was a prospective observational study conducted at the SSG Hospital, Vadodara from December, 2016 to September 2017 and included 30 patients. Following preliminary examination, we performed thyroid function tests, FNAC, and USG pre-operatively. Histopathological examination of excised tissue was performed within 4-5 hours after thyroid surgery, and later, post-op complications were noted. Results were derived after appropriate statistical tests. </p><p class="abstract"><strong>Results:</strong> 65% patients belonged to 2nd and 3rd decade with male to female ratio of 1:5 and all patients presented with an anterior neck swelling. Clinical examination was found to be 50% sensitive and 100% specific. The sensitivity and specificity of FNAC was 50% and 96% respectively while that of USG was 67% and 100% respectively. Out of 16% malignant cases, all were of papillary type. Most common post-op complication was related to wound care (3-5%).</p><p class="abstract"><strong>Conclusions:</strong> Correlation between clinical findings, ultrasonography findings, cytology, serum investigations and histopathological examinations are to be carried out for appropriate management of thyroid swelling.</p><p class="Default"> </p>
Hoarseness of voice-prospective study: etiology, evaluation and treatment
Authors: Upadhya Ila B. , Patel Dhaval C. , Rao Kartika R. 
Published: March 2020

<p class="abstract"><strong>Background:</strong> Despite advances in medical technologies and improvement in diagnostic armamentarium in laryngology about 20% of cases remain undiagnosed until suspension laryngoscopy. The study was undertaken to identify etiological factors, type of lesions, age and sex distribution, sites of involvement, efficacy of different diagnostic and treatment modalities.</p><p class="abstract"><strong>Methods:</strong> A prospective study of 45 cases of benign vocal cords lesions was carried out. Patients with hoarseness of voice for &gt;3 weeks were investigated and treated with conservative management and surgery. </p><p class="abstract"><strong>Results:</strong> Hoarseness of voice presented within 6 months after onset of symptom. The common age of presentation was between 21 to 40 years, with male:female ratio of 1.25:1. Vocal abuse, laryngopharyngeal reflux disease (LPRD) and smoking, were the most common etiological factors. Housewives were most common group. Wide angled 70<sup>0</sup> telelaryngoscopy showed 80% accuracy rate. Suspension laryngoscopy showed 100% accuracy rate. Involvements of both the vocal cords were more common, vocal cord nodule being the commonest. 70% responded very well to conservative management.</p><p class="abstract"><strong>Conclusions:</strong> Dysphonia is the most common presenting symptom having vocal cord lesion, non-professional voice user young females are most common sufferers with delay of 6 months in presenting to a laryngologist. Vocal abuse and LPRD are most common aetiologies. Telelaryngoscopy can diagnose up to 80% of them which is cost effective Outpatient Department procedure. 70% of them respond well to medical therapy and voice training. Identification of causative factor and management of them is mandatory for treatment and prevention of recurrence.</p>