bluuebunny/crossref_metadata_2025_split huggingface dataset:
COMPARATIVE ANALYSIS OF VARIOUS RISK ASSESSMENT SCORES FOR LOW RISK ACUTE CORONARY SYNDROME IN AN INDIAN SCENARIO – AN ED BASED OBSERVATIONAL STUDY.
Authors: Shaikh Zahid , Shinde V. S. , Tripathi Sumalya , Jadhav Dhiraj , Lamba Ishan , Gangurde Alok , K. Sweta 
Published: March 2020

Chest pain is one of the most common presentation to emergency department (ED). The misdiagnosis or over-diagnosis of patients with acute chest pain can be associated with serious clinical events or is time-consuming and this places a heavy burden on overcrowded and resource constraint ED. To help overcome this issue various scores are formed to rule out acute coronary syndrome (ACS) in these patients. Those who do not meet the criteria of high risk ACS like raised cardiac biomarkers, ECG changes, etc are labeled as low risk ACS. These patients form the majority of patients. A multitude of risk score have been formulated to predict the outcome and risk stratify patients with chest pain. Our objective was to evaluate the utility of these score in Indian setting in low risk ACS patients.
We studied the various risk prediction score of 100 patients presenting to the ED of tertiary care teaching institute in an urban industrial area with low risk ACS. The scores that were calculated included HEART, TIMI, ADAPT, GRACE, NACPR and EDACS.
Of all the scores only the HEART score correlated well with identifying those who required further testing. Taking a score of less than 3 as a marker of low risk ACS we get a sensitivity of 95.83% (95CI - 89.67% to 98.85%) and specificity of 100%. The PPV is 100% and accuracy of 96%. All other scores were either not specific enough or had limited utility.
Keywords: Low risk ACS, ACS, HEART, TIMI, ADAPT, GRACE, NACPR, EDACS
CASE OF DU PERFORATION WITH SECONDARY OMENTAL NECROSIS- A RARE CASE REPORT
Authors: K Dr. Radha Krishna , Khan Dr. Bushra , Samee Dr. Atif Abdul , Ibrahim Dr. Syed Mujtaba 
Published: March 2020

Introduction: The Omentum is rich in blood supply. Omental Infarction can be classified as primary or secondary depending on the pathogenesis.
Aims and Objectives: To report a case of DU perforation with secondary Omental Infarction.
Case Details: A 21 year old male patient came with complaints of generalized dull aching abdominal pain, associated with persistent vomiting and high grade fever since 3 days. On examination, he was drowsy, BP was not recordable and peripheral pulses were not palpable. Abdominal examination revealed guarding and rigidity. X-ray erect abdomen showed gas under the right dome of the diaphragm (pneumoperitoneum).
The patient was taken up for an exploratory laparotomy. Intraoperatively, findings included: 1) A 0.5*0.5cm in size perforation over the anterior first part of the duodenum, 2) approximately 3L of haemorrhagic peritoneal fluid 3) necrosed omentum and 4) petechial patches over the parietal wall of peritoneum. Primary repair of the DU perforation with omental plug (modified graham’s repair) with omentectomy of the necrosed part of omentum was done.
The HPE report of excised specimen of omentum was suggestive of intense congestion and necro-inflammatory reaction of the omentum with necrosis and netrophilic infiltrate.
Conclusion: A rare case of DU perforation with secondary omental necrosis is being reported.
Keywords: DU Perforation; Omental Necrosis; Omental Infarction; Modified Graham’s patch
Abbreviations: OI- Omental Infarction, DU- Duodenum.
CLINICAL SIGNIFICANCE OF THE LEVELS OF THE GINGIVAL CREVICULAR FLUID VOLUME AND LEPTIN DURING ORTHODONTIC TOOTH MOVEMENT
Authors: Upasana Dr. Kumari , Choudhary Dr. Shivendra 
Published: March 2020

It is assumed that leptin has a role in protecting gingival tissues, leptin stimulates the immune system and enhances bone formation by acting directly on osteoblasts. As periodontal disease progresses, the protective role of leptin on the gingiva is lost owing to a decrease in the leptin level. During orthodontic tooth movement, the early response of periodontal tissues to mechanical stress is an acute infammatory reaction. Study of leptin therefore is a useful guide to determine its relationship with tooth movement in both tension and pressure sites and the role of this cytokine in controlling the local infammation around the tooth. Detection of the leptin level in GCF at sites under orthodontic movement had been tested and it was found that the concentration of leptin in GCF is decreased by orthodontic tooth movement.
The present study was planned in Department of Periodontology, Manipal College of Dental Sciences Manipal. Total 20 cases were evaluated in the present study. The 10 cases were enrolled in Group A as study cases and 10 cases were enrolled in control cases. The selected 10 patients were bonded with fixed appliance 0.022" PEA bracket slot, MBT prescription. The maxillary right canines (control tooth, CT) were not bonded with the bracket. The initial wire will be 0.016" NiTi wire. The distalisation force were applied on the left canine (test tooth, TT) using 0.010 SS lace backs.
Significantly decreased levels of leptin concentration might result from the presence of inflammation adjacent to the teeth undergoing movement. It has been shown previously that orthodontic tooth movement may therefore show local traits of a damage/ repair process with inflammation-like reactions: high vascular activity, many leukocytes and macrophages, and involvement of the immune system.
Keywords: Leptin levels, periodontal disease activity, orthodontic tooth movement, ininflammatory markers
ANATOMY OF TULP’S VALVE
Authors: K Khan , Mohammad Fateh , MT Alam , Nawaz Mohd , Mohsin Azmi , MS Ansari 
Published: March 2020

Introduction: Tulp’s valve is also known as ileocaecal valve which is situated at ileocaecal junction. Tulp’s valve is a diverse anatomical valve where the ileum makes an access into the caecum. Earlier researchers have observed that there is occurrence of high densities of neurons in the Tulp’s valve, though meticulous anatomical depiction about constitution of the myenteric plexus in and around the Tulp’s valve has thus far to be obtained in humans. In array to add contribution to this vicinity of explore, the present work was performed to appreciate the anatomical composition of myenteric plexus in and around the Tulp’s valve in human foetuses.
Materials and Methods: The research was performed on ileocaecal sections obtained from human foetuses (n=17) of various gestational ages after obtaining ethical authorization from the ethical clearance committee of Hind Institute of Medical Sciences, Sitapur. Cresyl Violet staining and NADPH- diaphorase enzyme histochemistry was performed over the obtained ileocaecal sections. Study Group-1(G-1) included foetuses of 9 to 14 week of gestational age group while Group-2(G-2) comprised of foetuses of 15 to 33 week of gestational age group. The Neuronal cell profiles (area, perimeter, ferret diameter) and Neuronal cell density were assessed in and around the Tulp’s valve in human foetuses.
Results: In Cresyl violet stained sections, the difference in the neuronal cell profile area between G-1 (50.10±2.26 µm2 )and G-2 (61.25±4.07 µm2 ) was found to be statistically significant (p=0.0028).The perimeter of myenteric neuronal cells in G-1 (26.32±0.51 µm ) was significantly (p=0.0028) lower than G-2 (29.17±0.85 µm). The differences in Feret diameter of neuronal cells between G-1 (9.49±0.27 µm) and G-2 (10.53±0.21 µm) was statistically significant (p=0.0028). The neuronal cell density in Myenteric Ganglia (MG) in G-1 and G-2 was 60.01±9.77 and 52.27±6.54 respectively, which was statistically insignificant (p=0.1367) difference. The difference in the nitrergic neuronal cell area between G-1 (66.35±8.43 µm2) and G-2 (74.93±0.53 µm2) was statistically significant (p=0.0038). The mean perimeter of nitrergic neuronal cells in G-1 (32.01±2.57µm) was insignificantly (p=0.2001) lower than G-2 (33.83±0.73 µm). The mean Feret diameter of G-1 (11.97±1.26) was also insignificantly (p=0.2624) lower than G-2 (12.91±0.75). The nitrergic neuronal cell density in Myenteric Ganglia in G-1 was 22.41±4.13 and in G-2 it was 18.61±2.09, which was statistically insignificant (p=0.0983). acquaintance of the innervations of the Tulp’s valve in human foetuses may help in restoration of it for improved movement of ileum inside into the caecum, as well as to check retrospective run of caecal inside into the ileum.
Keywords: Tulp’s Valve, Cresyl Violet, NADPH- diaphorase, Nitrergic Neurons
ROLE OF VITAMIN C IN TYPE 2 DIABETES MELLITUS CASES, A STUDY IN VEDANTA INSTITUTE OF MEDICAL SCIENCES
Authors: Teltumbadr Dr. Umesh 
Published: March 2020

INTRODUCTION: Diabetes is one of the largest emerging global health problem with 415 million people between the ages of 20 and 70 worldwide estimated as having diabetes in 2015 and Type 2 DM (T2DM) accounts for at least 90% of all cases of diabetes. Vitamin C is naturally present in fruit and vegetables, is often added as a preservative to foods/beverages, and is also used as a dietary supplement. As vitamin C is water-soluble, it has a relatively short half-life in the body due to rapid renal clearance and a regular and adequate intake is required to prevent deficiency. In T2DM patients Vitamin C levels are usually low as blood glucose may compete with vitamin C for uptake into cells due to its structural similarity to the oxidised form, and increased oxidative stress may deplete antioxidant stores. MATERIAL AND METHODS: A total of 206 T2DM patients were included in the study and were divided randomly in to 2 groups of 103 each. Participant’s demographic and physical activity was noted. Anthropometric data including the body mass index (BMI) and waist and hip circumference were collected. Glycated haemoglobin (HbA1c) was determined in EDTA blood by standard methods. Fasting glucose was measured in blood collected in fluoride oxalate tubes. The vitamin C concentration of the processed samples was determined. Drug (Vitamin C and Placebo) was issued to patients for duration of thirty days at a time all patients were maintained on their usual dietary pattern while limiting their consumption of vitamin C-rich foods throughout the study. RESULTS: Mean age in Vitamin C group was 46.87 ± 6.77while in placebo group it was 42.11 ± 6.46. There were 56 male and 44 female in Vitamin C group. In Placebo group male and female were 60 and 40 respectively. No statistical significance was observed in both the group.At 12 weeks fasting blood sugar levels were decreased by -23.74± 2.74 in patients receiving Vitamin C while in placebo group reduction was -5.44± 3.77. Post meal blood sugar was reduced by -21.72± 2.45in vitamin C group while in placebo it was -8.11± 2.45.CONCLUSION:Supplementation of Vitamin C in T2DM patients can significantly reduce the blood glucose levels and HbA1C levels.
MORPHOLOGY AND MORPHOMETRY OF SCAPULAE IN TERTIARY CARE HOSPITAL IN K.M. MEDICAL COLLEGE AND HOSPITAL, MATHURA (UP).
Authors: Mittal Dr. Lavlesh , Madaan Dr. Sandeep 
Published: March 2020

Introduction: The shoulder joint is the most important joint in the body and limitation of this joint movements affects the quality of life. Severe shoulder injury and glenohumeral arthritis causes shoulder dysfunction with devasting results, and to restore normal functions orthopaedic surgeon can perform total shoulder arthroplasty, or reverse shoulder prosthesis, or hemiarthroplasty.Lateral angle of the scapula becomes truncated and broadened and bears the glenoid cavity which articulates with the humerus in the shoulder joint. Shoulder joint is formed when the glenoid cavity is connected with the head of the humerus. This study was carried out to study the morphology and morphometry of the glenoid cavity as dimensions of the glenoid cavity are important in designing and fitting of glenoid components for total shoulder arthroplasty.
Material and Methods: A total of 100 unpaired dry scapula were isolated from the department of Anatomy. Two groups were made according to the side of the scapula and were equally divided into 50 right and 50 left scapula each. Bones were segregated and inspected individually.To classifying shape of the glenoid fossa, presence or absence of a glenoid notch was used and were classified into 3 types, pear shaped or inverted comma shape in presence of a glenoid notch & oval in absence of notch. The pear shaped shows indistinct glenoid notch and the inverted comma shaped shows a distinct notch.
Results: On the basis of presence or absence of the glenoid notch. 56%, 28% & 16% glenoid cavities of right side were pear shaped, inverted comma shaped and oval shaped respectively. On the left side 60%, 30% & 10%were pear shaped, inverted comma shaped and oval shaped respectively. In total 58% glenoid cavities were pear shaped, 29% were inverted comma shaped and 13% were oval shaped.Average length and breadth of scapulae included in this study was 134.07±13.87 mm and 98.43 ±9.58 mm respectively.Mean glenoid cavity index of right side was 48.12 to 86.87 %, while in left side it was 44.21 – 84.78%.
Conclusion: The most common glenoid cavity was pear shaped followed by inverted comma shaped and the oval glenoid cavity. Mean glenoid cavity index of right side was 48.12 to 86.87 %, while in left side it was 44.21 – 84.78%.
EVALUATION OF TYPES OF GALL STONES AND FACTORS AFFECTING IT.
Authors: Khatri Ashok Premchand 
Published: March 2020

Introduction: Gallstone (GS) is an important cause of morbidity all over the world. Gallstones are becoming increasingly common and are seen in all age groups. When there is an imbalance in the chemical constituents of bile that result in precipitation of one or more of the components gall stones are formed. In majority of the cases they do not cause symptoms, and about 10% to 20% will eventually become symptomatic within 5 years and 20 years of diagnosis. Gallstones contain mainly cholesterol, bilirubin, and calcium salts, with some amounts of protein and other materials. Pure cholesterol crystals are generally soft, and protein contributes to the strength of cholesterol stones. Pigment stones account for 30 % of gallstones and are divided into black pigment and calcium bilirubinate stones.
Material and Methods: Demographic characteristics of the patients participating in the study such as age, sex, occupation, lifestyle habits such as alcohol consumption , smoking, sports activity , medication if any used, any diseases, Body mass index (BMI), milk consumption, liver diseases and dietary habits was obtained. Patients were divided into two groups depending upon the type of gall stone either cholesterol or pigment stone.
Results: A total of 76 patients were included in the present study who underwent cholecystectomy surgery. Age group of more than 51 years showed maximum number of stones in both the groups. Maximum numbers of stones were seen in patients having family history of stones. Patients who were overweight and obsess were having higher incidence of gall stone as compared to normal weight and slim population. Formation of stones in female was more as compared to males.
Conclusion: Various factors can be considered for the formation of gall stones of which gender, increasing age, genetic factors, dilatory habits, and sedentary lifestyle can be considered as the contributing factors for formation of gall stones and most of them can be prevented by proper education.
Keywoerds: GS, BMI, liver disease, smoking, alcohol consumption.
STUDY BASED ON DIAGNOSIS AND EVALUATION OF PATIENTS AFFECTED BY ORAL SUBMUCOUS FIBROSIS (OSMF) FROM BIHAR REGIONS
Authors: Manish Kumar , Raman Nikita , Gautam Abhishek , Jain Samir , Jha Prakash Chandra , Kumar Amar 
Published: March 2020

OSMF (Oral Submucous Fibrosis) is a widely recognized precancerous condition which is also looked upon as a potentially malignant disorder of and is characterized by a reduction in mouth opening, having palpable circumoral fibrous bands either on one side or bilaterally along with the sensation of “burning mouth”. The condition is defined as “an insidious, chronic disease affecting any part of the oral cavity and sometimes the pharynx. Although occasionally preceded by and/or associated with vesicle formation, it is always associated with juxta-epithelial inflammatory reaction followed by fibroelastic change of the lamina propria, with epithelial atrophy leading to stiffness of the oral mucosa causing trismus and inability to eat”. The increased consumption of commercially prepared arecanut preparations (Gutkha, Pan masala) specially in the younger generation has led to such high incidence of this diseasein certain areas of India. Based on above reported findings the present study was planned for Study of Cases of Oral Submucous Fibrosis (OSMF) from Bihar Region.
All the patients were informed consents. The aim and the objective of the present study were conveyed to them. Approval of the institutional ethical committee was taken prior to conduct of this study. Total 30 cases of the patients suffering from oral submucous fibrosis were enrolled in the present study.
In conclusion, the result of present study provides information on the prevalence of oral mucosal lesion in our population. It is important that preventive efforts be carried out by the concerned authorities and public health professionals in establishing tobacco cessation clinics and tobacco education in such masses (especially the young generation) along with a long standing and a close knit motivation program that enables our future generations to come to avoid the menace of tobacco and its subsequent health effects.
Keywords: Oral Submucous Fibrosis, OSMF, Oral Cancer, Bihar region, etc.
EVALUATION OF PERFORMANCE OF TRAINEE AT 4 DAYS MOODLE BASED INTERNAL AUDITOR TRAINING AS PER ISO 15189:2012 AND NABL-112
Authors: Tailor Dr Piyush , Savaliya Dr. Niral , Patel Dr Chinka 
Published: March 2020

Background: For medical testing laboratories accreditation, laboratory has follow ISO: 15189:2012 and NABL-112. For this,quality manager of the laboratory must have to go under 4 days internal auditor training as per ISO 15189:2012 and NABL-112. Moodle is Learning Management System (LMS) which helps in systemic evaluation of trainee during internal auditor training.
Objectives: The study was done to measure performance of trainee after completion of internal auditor training by comparing for each sub-clause of ISO 15189:2012 as well as for various categories of trainee.
Materials and Methods: Online Moodle based - internal auditor training as per ISO 15189:2012 and NABL-112 was arranged in GMC, Surat, Gujarat for 4 days, with total 28 trainee. MCQ test was taken on-line with Moodle. Relationship of score with ISO 15189:2012 clauses and trainee category were analysed.
Results: Participant’s average score in general, management and technical clause were 67% ,73.4% and 77.9% respectively. Teaching staff, Residents and Technicians scored 76.3 %, 77% and 70% respectively.
Conclusion: Training emphasis and effectiveness in ISO 15189:2012 management clause was comparable with technical clauses. Moreover, the study found that, Training was effective across all categories of trainee.
Keywords: ISO 15189:2012, NABL, Moodle
OCULAR MANIFESTATIONS IN SYSTEMIC LUPUS ERYTHAMATUSUS PATIENTS: A HOSPITAL BASED OBSERVATIONAL STUDY.
Authors: Kant Dev , Kumari Jyoti 
Published: March 2020

Objectives: This study was to evaluate the incidence and ocular manifestation in systemic lupus erythematosus (SLE) patients.
Methods: A total of 50 cases with age group 15 to 50 years were enrolled. A detail history, clinical examinations and relevant investigations were performed to all cases. Patients who were diagnosed with systemic lupus erythamatusus (SLE) by using American Rheumatologic criteria with or without ocular features were included in this study.
Results: Data was analysed by using simple statistical methods with the help of MS-office software. All data was tabulated and percentage was calculated.
Conclusions: Females were commonly suffered with systemic lupus erythamatusus (SLE) and it was commonly seen in age 15-25 years. Episcleritis was the most common symptoms in SLE. Second most common symptoms were conjunctivitis and scleritis. Right eye was more affected than left eye. Most of the cases had ANA positive. Hence, ocular manifestation is the most common in SLE patients. Early diagnosis and prompt treatment may give light of hope for SLE patients. And more research is needed in order to determine which therapy will provide the best prevention and management in SLE patients.
Key words: Systemic lupus erythamatusus (SLE), ocular manifestation, age group, ANA-positive.
“PREVALENCE OF ISOLATED HYPERTENSION AMONG ELDERLY PATIENTS ATTENDING PERIPHERAL HEALTH CENTRE OF TERTIARY CARE HOSPITAL OF INDIA.”
Authors: Sharma Munish Kumar , Gour Neeraj , Choudhary Sanjay , Goel N K , Sharma Deepak , Chaudhary Meenakshi 
Published: March 2020

Background: In this modern era, chronic non communicable diseases (NCDs) are a major global health challenge with numerous grave complications on the human body. Old age population tends to carry risk of almost all kind of diseases including non communicable diseases. Hypertension is one of biggest well known risk factor for many of non-communicable diseases usually found in the outdoor patients.
Method: This cross sectional study was undertaken to provide the data on the Prevalence & Pattern of hypertension amongst patients who were aged 60 years & above and who attended the Out Patients Department of the Rural Health & Training Centre of tertiary care hospital of Chandigarh city of India.
Results: Majority of patients belonging to age group 60-69 years were found to be diastolic hypertensive (24.46%). Majority of male patients were found to be diastolic hypertensive (28.43%) (P< 0.05). More of less same trend was found among female patients.
Conclusion: Hypertension was found to be highly prevalent among the outdoor elderly patients of Rural Health & Training Centre of Chandigarh, India. This study warrants the need of an early detection of hypertension, which can be accomplished by a periodic screening of the people.
Keywords: Hypertension; Elderly; India.
EFFECT OF SLOW BREATHING EXERCISE PRACTICE ON ANTHROPOMETRIC PARAMETERS IN HEALTHY VOLUNTEERS
Authors: Tripathi Sonali , Tripathi Apoorva 
Published: March 2020

Introduction: Regular practice of slow breathing technique shows improvement in the cardio respiratory functions. it is well known to decrease the effect of stress which, in turn, improves the physical and mental health of an individual.
Objectives: To assess the effect of slow breathing exercise practice on anthropometric parameters in healthy volunteers.
Materials and Methods: A total of 60 young, healthy volunteers of both genders participated in this study. The subjects were allocated to the study group (n = 30) and control group (n = 30) based on simple random technique. Slow breathing exercise training was given to the study group for 20 minutes daily in two sessions for 12 weeks. Heights, weight, body mass index (BMI), were recorded at the start of the study and after 12 weeks in both the groups. Comparison between the study group and control group was done by Student’s unpaired t-test. P < 0.05 was considered as statistically significant.
Results: The average age of the study group and control group participants was 19.7 ± 1.7 years and 19.4 ± 1.9 years, respectively. BMI was significantly decreased in the study group from 21.72 ± 4.12 to 19.56 ± 3.92 (P < 0.05). There was a trend toward decrease in the waist–hip ratio from 0.78 ± 0.62 to 0.74 ± 0.58 (P > 0.05) which was not statistically significant.
Conclusion: Slow breathing exercise training improve the anthropometric parameters in the study group. This indicates that regular, long-term slow breathing exercise training helps in weight reduction among the obese population.
Keywords: Obesity, Anthropometry, Slow Breathing Exercises, body mass index, stress.