bluuebunny/crossref_metadata_2025_split huggingface dataset:
Artificial intelligence and dichotomy on benefits and challenges: what do healthcare providers say?
Authors: Singh Bharat , Kashyap Surekha , Grover Ankita 
Published: August 2019

Background: In a developing country like India, with a vibrant information technology (IT) sector, employing Artificial Intelligence (AI) should be carefully weighed before its introduction in healthcare with relation to perception of healthcare providers (HCP's/Doctors). Methods: This qualitative study was conducted in medical college and affiliated hospital in India. Initially a pilot study was conducted for reliability and internal consistency of questionnaire. Thereafter, pre-tested questionnaire was distributed to 153 healthcare providers and their responses were analyzed on SPSS version 20.0 (IBM) to identify the demographic and job-related differences in their perception regarding the benefits and challenges of using AI in healthcare.Results: Most of respondent were agreed upon the benefits of using AI in healthcare and most cited benefits were speedy decision making, better resource utilization and improvement in staff satisfaction. Similarly most cited challenges were lack of training on AI enabled machines, lack of skilled technical support, high cost of AI and data privacy issue. Further, Age and Job experience were significantly associated with benefits like timely and speedy decision making, improvement in the patient and staff satisfaction respectively. Furthermore, Age, Department, Job experience, Job profile were significantly associated with challenges like high cost of AI, lack of skilled technical support, lack of training in AI enabled machines and lack of trust in AI among patients.Conclusions: Significant challenges of using AI in healthcare with demographic and job related variable based on the results of this research paper need to be resolved first in order to overcome the initial resistance in employing AI in healthcare.
Cystatin C based eGFR - for early detection of diabetic kidney disease
Authors: Shelke Sudarshan N. , Tele Jyoti S. 
Published: August 2019

Background: Diabetic kidney disease is the leading cause of premature death in young diabetic patients. Detection of diabetic kidney disease as early as possible in the disease process currently offers the best chance of delaying or possibly preventing progression to end-stage renal disease. The present study was aimed to evaluate utility of serum cystatin C based eGFR for early diagnosis of diabetic kidney disease.Methods: Diagnosed patients of type 2 diabetes mellitus having frank proteinuria were excluded. Patients without proteinuria were tested for microalbuminuria. 50 patients having microalbuminuria were tested for 24 hour urine creatinine, serum creatinine and serum cystatin C. Both cystatin C based eGFR and eGFR by Cockcroft and Gault equation were compared with standard GFR by 24 hour urine Creatinine clearance respectively.Results: There was statistically significant positive correlation between cystatin C based eGFR and standard GFR by 24 hr Creatinine clearance (r=0.87). For eGFR by Cockcroft-Gault equation, it was 0.36 (r=0.36).Conclusions: The results of this study suggest that serum cystatin C based eGFR measurement is a useful, practical tool for the evaluation of renal involvement in the course of diabetes. As serum creatinine values are affected by many factors like age, sex, muscle mass and diet, serum cystatin C based eGFR estimation offers a hope that diabetic kidney disease can be well prevented with appropriate interventions.
Association of mood disorder and modifiable life-style risk factors in medical students: a cross-sectional study
Authors: Titoria Reena , Mohandas Anu , Gupta Garima 
Published: August 2019

Background: Bipolar disorder is one of the common chronic serious mental illness affecting 7 billion people in the world associated with significant morbidity which goes unrecognized. After extensive literature search, it was found that there is paucity of studies from the Indian setting that have addressed the issue of bipolar disorder.Methods: The present study was carried out to screen for bipolar disorder among medical undergraduate students and its correlates. Due to non-availability of many studies from India, the proportion of 50% was taken as prevalence to calculate the sample size. With 95% confidence interval and 8% absolute error, a sample size of 126 was calculated using Epi Info. Study tools used were a semi structured questionnaire on socio-demographic profile of participants, Global Physical Activity Questionnaire (GPAQ) and Mood Disorder Questionnaire (MDQ). MDQ is a self-reporting screening instrument for bipolar disorder having a Cronbach’s alpha coefficient of 0.83. Data was analyzed using chi-square test with p value <0.05 considered statistically significant.Results: The study included 87.3% males and 12.7% females with mean age 21.26±1.23 years. Out of 126 participants, 17 (13.5%) were screened positive for bipolar disorder. Factors found to have statistically significant association with bipolar disorder were number of siblings, type of family, migration status of family, living in hostel, body mass index and physical activity of the participant. Conclusions: The results suggest that medical students constitute a vulnerable group and there are certain risk factors other than academic stressors which predispose a medical student to mental illness.
An evaluation of hyperbaric ropivacaine with magnesium as an adjuvant in lower abdominal surgeries among the north Indian subjects: a double-blind randomized trial
Authors: Saxena Sulekha , Kumar Kuljit , Gupta Rajni , Agrawal Avinash 
Published: August 2019

Background: An evaluation of intrathecal hyperbaric ropivacaine without adjuvant and with adjuvant magnesium for lower abdominal surgeries.Methods: This was a prospective, randomized, double-blind study conducted among the patients aged 18 to 60 years planned for lower abdomen surgeries under spinal anaesthesia and ASA grade I or II. Patients were randomly allocated to two groups (30 in each): ropivacaine Group (R group): spinal anesthesia with 3ml of 0.6% hyperbaric ropivacaine (18mg )+ 0.5ml NS. hyperbaric ropivacaine + Magnesium Group (R+M group ): spinal anesthesia with 3ml of 0.6% hyperbaric ropivacaine (18mg) + 0.5ml magnesium sulphate (50 mg). All the patients scheduled for operation were given oral tablets ranitidine 150 mg and Alprazolam 0.25mg in the night before surgery.Results: There was no significant difference in the basic characteristics between the groups. The mean HR, MAP and SpO2 in both the groups decreased over the periods as compared to baseline. However, the trend of HR over the periods remains similar in both R and R+M groups. The bromage levels were significantly (p=0.0001) higher among the patients of Group R compared with R+M. The 2 segment sensory regression (min), Sensory regression S2 (hr), motor recovery (hrs) and long term mobilization after spinal anesthesia were significantly (p=0.0001) lower among the patients of Group R compared with R+M. The complications were lower in Group R+M than R.Conclusions: Magnesium may be more suitable drug in surgeries in which muscle relaxation has greater value in lower abdominal surgeries.
Health problems in geriatric population of age group ≥70 years in rural Kerala, India: a cross sectional study
Authors: M. Sarin S. , K. Jayasree A. 
Published: August 2019

Background: The proportion of elderly population is increasing considerably world over. The health and socio-economic issues of this section is to be considered separately and in depth insights about them is needed for formulating elderly friendly health policy. This study intends toidentify the important health concerns of elderly population above the age group of 70 years in a rural area in North Kerala, India.Methods: It is a community based cross-sectional descriptive study involving all individuals above the age group of 70 years in a randomly selected panchayath ward from rural North Kerala. The data regarding demography, socioeconomic aspects, medical history, access to health care and treatment of chronic illnesses were collected through interview of study participants by a trained health care volunteer using a pre-validated questionnaire.Results: A total of 93 individuals above the age group of 70 years were included in the study out of which 63% were females and 37% males. In the study population 55.9% of the elderly were widowed and 87.1 % were staying along with their children. Almost 75% of the elderly received social welfare pension from government agencies and 14.3% received service pensions. 67.74% of the study population were hypertensive and 35.56% were diabetic. Other health issues included arthritis, coronary artery disease, chronic kidney disease, genito urinary symptoms and cerebrovascular accident.Conclusion: The study provide valuable insights into the health and social issues of elderly in Kerala and points to the importance of formulating an elderly friendly health policy in the state.
Epidemiological and clinical profile of various plant poisons in a tertiary care center in South Tamilnadu, India
Authors: Kumari Meena , Latha Pattu Swarna , . Kalyanasundaram 
Published: August 2019

Background: Plant poisoning is a common scenario in a toxicology unit . Some of the plants contain active components used as medicines. However, some of the plant constituents are poisonous with wide variety of clinical manifestations. Authors aimed to study the pattern of various types of plant poisons and clinical presentations and complications of various plant poisons admitted in our toxicological unit.Methods: A total of 87 patients admitted with history of plant poison ingestion, in toxicological unit of Tirunelveli medical college were studied . It was a retrospective observational study and was done over a period of one year.Results: Out of 87 cases studied, 92%were due to consumption with suicidal intention. Plant poisoning ranks second only to pesticide poisoning . among the plant poisons encountered 66.6% were due to Oleander poison, followed by Datura (8%) and Glory lily(5.7%). Common parts of plant consumed by patients include seeds and plant oils . Vomiting and abdominal pain were the commonest presentations. Encephalopathy, dyselectrolytemia and arrhythmias were the notable complications in our study.Conclusions: Early admission and prompt first aid and monitoring at tertiary care center are key to the reduced mortality. The study throws light on various manifestations, toxic parts and complications of plant poisons.
Sporadic ovarian sex cord-stromal tumor with annular tubules: a rare case report
Authors: Patel Krutika , Painter Devang , Bhagat Vashudha M. , Shah Pinkal 
Published: August 2019

Ovarian sex cord stromal tumor with annular tubules (SCTAT) is a distinctive, rare subtype of sex cord stromal tumor of the ovary, predominant component of which has morphological features intermediate between that of granulosa cell and sertoli cell. The majority of ovarian SCTAT are benign. So far, malignant behavior in SCTAT has been reported only in sporadic cases. We have presented a case of SCTAT in a 40 year old lady with no association of Peutz-Jegher (P-J) syndrome. The patient’s chief complaints were post-menopausal bleeding for 1 year on and off along with menorrhagia. MRI abdomen was suggestive of intensely enhancing solid tissue mass lesion in the right adnexa, features suggestive of ovarian mass. Panhysterectomy was done. Grossly uterus and left adnexa appeared to be normal. Right ovary showed mass measuring 17x11x9cm3 in size, on cut section, solid, homogenous lobulated, yellowish areas identified. Microscopic and Immunohistochemistry findings confirmed the diagnosis of sex cord stromal tumor with annular tubules of granulosa cell type. PAS stain supported the diagnosis.
Laser versus dermabrasion and split thickness skin graft for management of post burn leucoderma
Authors: Gad Shawki S. , Kishk Tarek F. , Taalab Ahmed A. , Gerza Ahmed I. El 
Published: August 2019

Background: The aim of the study is to compare between dermabrasion and split thickness skin grafting and fractional CO2 laser in management of post burn leucoderma. Deep burn can have serious aesthetic consequences as it often result in scar tissue and pigmentary changes in the skin. It is understood that skin pigmentation involves melanin. Leucoderma results from melanin loss at the basal layer of the epidermis. Fibrosis ultimately inhibits melanocyte migration and subsequent production of melanin in the injured area. Management of post burn leucoderma was either non-surgical or surgical treatment. Non-surgical therapies are make-up, tattooing and fractional CO2 laser. The surgical treatments include dermabrasion with thin split thickness skin grafting, non-cultured keratinocyte-melanocyte suspensions, mini grafting, cultured epithelium, blister epidermal grafting, chip skin grafting and epidermal cell suspension spray.Methods: A prospective study of 30 patients with post burn leucoderma between May 2018 and May 2019, at Ahmed Maher Teaching Hospital. Dermabrasion and split thickness skin grafting in 15 patients (group 1). Fractional CO2 laser in another 15 patients (group 2).Results: Group one: 13% of patients showed excellent colour match, 33% good colour match and 53% poor colour match. Group two: 27% of patients showed excellent colour match, 47% good colour match and 26% poor colour match (p value=0.311).Conclusions: Fractional CO2 laser is better than dermabrasion and STSG for management of post burn leucoderma.
Impact of the modified bleomycin, etoposide and cisplatinum chemotherapy regimen on the outcome of testicular germ cell tumor: a tertiary care institute experience
Authors: Madan Renu , Thakur Niketa , Rana Sakshi , Kumar Narendra , Yadav Budhi Singh , Khosla Divya , Kapoor Rakesh 
Published: August 2019

Background: Bleomycin, cisplatin and etoposide (BEP) based combination chemotherapy is established as standard treatment for testicular germ cell tumors. As these tumors are highly curable, so management is crucial in terms of long-term toxicity particularly lung toxicity. With standard BEP there is increased toxicity which leads to poor compliance. So, we at a tertiary care center assessed modified BEP regimen in such patients and evaluated its effectiveness in terms of response and toxicity as compared to standard BEP.Methods: Forty-nine patients of testicular germ cell tumors were enrolled in this study from January 2012 to December 2016. The modified BEP regimen consisted of bleomycin 30 IU day 1, cisplatin 20 mg/m2 day 1-5 and etoposide 100 mg/m2 day 1 to 5, given every three weeks. The planned drug intensities were 33.3 mg/m2/week for cisplatin, 166.7 mg/m2 week for etoposide and 10 IU/body/week for bleomycin. The schedule for chemotherapy was as follows: four courses of modified BEP for stage I patients and six courses of modified BEP for stage I S, II and III patients.Results: Overall response rate in our study was seen to be 81.2% which was comparable with the available evidence. Five (10.4%) patients developed febrile neutropenia. Two (4.1%) patients showed clinically evident bleomycin induced pulmonary toxicity. Lower toxicity seen in these patients led to better overall compliance.Conclusions: Modified BEP protocol is a good alternative to standard BEP with comparable efficacy and reduced toxicity.
Prevalence and associated factors of domestic violence against married rural women of Gurugram, Haryana
Authors: . Shambhavi , Deswal Balbir Singh , Ray Shalini , Singh Manisha 
Published: August 2019

Background: The global health burden from domestic violence against women in reproductive age group is about 9.5 million disability adjusted life years (DALYs). Women suffering from violence have more chances of suffering from physical, emotional, and mental problems such as anxiety, depression and post-traumatic stress disorder. The objectives of the present study are to find the prevalence and awareness of domestic violence in an urban slum of Gurugram and to elicit associated risk factors and the reasons for tolerance of domestic violence.Methods: A community based, cross sectional study was conducted among married women (18-45 years) using a semi structured questionnaire in a rural area of Gurugram by systematic random sampling. Sample size collected was 900. Study population was enquired about the awareness regarding domestic violence, self-experience about domestic violence and about the form of violence experienced and the reasons for their tolerance. Data was entered and analyzed using Epi Info ver 7.Results: Total 980 subjects were enquired about their awareness and self-experience of domestic violence. Overall prevalence of domestic violence in the study population was 28%. Prevalence of domestic violence was statistically significantly associated with education, employment, duration of marriage (p value <0.05).The prevalence was highest of emotional violence (40.5%), followed by physical (33.4%), economic (21.4%) and sexual violence (4.7%).Conclusions: Public health professionals should emphasis on measures to raise public awareness so that women can talk freely about domestic violence and its consequences and help in mitigating this medico-social problem.
An approach towards metastatic neck nodes and most common site of primaries: a retrospective study
Authors: Prakash Rudra , Dutta Smrity Rupa Borah 
Published: August 2019

<p class="abstract"><strong>Background:</strong> Head and neck cancer is one of the most common cancers in India and worldwide. It accounts for 30 percent of the total cancer burden. Head and neck cancers are notorious for loco regional spread presenting late with metastastasis to cervical lymph nodes.</p><p class="abstract"><strong>Methods:</strong> Our study was carried out on patients presenting with metastatic neck nodes at Silchar Medical College and Hospital, Assam from 1<sup>st</sup> April 2013 to 30<sup>th</sup> March 2015. </p><p class="abstract"><strong>Results:</strong> In our study 167 patients presented with head and neck cancer with metastatic neck nodes. Metastatic nodes involving level II accounted for 51.4% of cases with primaries in oral cavity, base of tongue. Level III lymph nodes were involved in 48.6% of cases with primaries in the hypopharynx and larynx.</p><p><strong>Conclusions:</strong> In our study it was found that hypopharynx is the most common primary head and neck cancer with metastatic neck node. The most commonly involved lymph nodes are level II and level III. This helps in understanding the pattern of micrometastases in head and neck cancer patients with N0 neck which makes way for the role of selective neck dissection in these groups of patients.</p>
An analysis on evaluation of surgical outcomes in zetaplasty for circumferential collapse of velopharynx: a case series
Authors: Venugopal M. , Siddique S. Mohamed 
Published: August 2019

<p class="abstract"><strong>Background:</strong> Obstructive sleep apnoea syndrome is a disorder that involves periodic partial or total collapse of the pharyngeal airway during sleep which results in progressive asphyxia. It also leads to more insidious conditions including hypertension, diabetes mellitus, coronary artery disease, stroke, cognitive impairment and daytime somnolence. The aim is to analyse the surgical outcomes of series of 16 patients of OSA having circumferential collapse at velopharynx for which Zetaplasty was done by comparing pre-operative and post-operative symptoms, Epworth Sleepiness Scale, DISE and polysomnography.</p><p class="abstract"><strong>Methods:</strong> A prospective study in 16 patients was done in our institute during the period from July 2017 to June 2018 and was followed for a period of 6 months. It comprised of 14 male and 2 female. At the patients in our study had complaints of snoring, frequent awakening at night and excessive day time sleepiness. </p><p class="abstract"><strong>Results:</strong> All the 16 patients showed good improvement in symptoms after the surgery. There was around 50% drop in the post-op AHI. The post-op ESS score was also reduced. Lowest oxygen saturation improved significantly.</p><p><strong>Conclusions:</strong> Zetaplasty for circumferential airway collapse at velopharynx level is a very safe and effective option as determined by the results of our study which is substantiated by reduction in AHI, ESS score and reduction in snoring. </p>
Study of clinical profile, pathological and functional changes in contralateral ear in patients of chronic suppurative otitis media
Authors: Nigam Ritu , Bairwa Rajesh Kumar , Goel Ayesha 
Published: August 2019

<p><strong>Background:</strong> Since unilateral chronic suppurative otitis media (CSOM) does not look to be an isolated entity, but rather a series of constitutional events that affect both ears. The aim of the present study is to study the clinical profile, pathological and functional changes in contralateral ear in patients of CSOM.</p><p><strong>Methods:</strong> Three thundred CSOM patients were studied in the Department of Otorhinolaryngology and Head and Neck Surgery. Patients were examined with otoscope after complete history and sociodemographic taking. </p><p class="abstract"><strong>Results:</strong> CSOM was more prevalent among females (54%) of young age group (41.6%) and with lower socioeconomic status (46%). Right ear was mostly affected (52.66%). Majority had discharge with hearing impairment (49.3%), 32.3% had ear discharge and 13.6% had hearing impairment and majority had pars tensa perforation (82.66%). In mucosal type CSOM, in CLE majority had abnormal tympanic membrane TM, of them majority had thinning (17.33%) and out of 65 patients with pars tensa retraction, majority had Grade I (22.17%). In squamosal type of CSOM, in CLE, 75% had abnormal TM, out of that 34.61% had pars tensa retraction and of that 23.07% had Grade I.</p><p><strong>Conclusions:</strong> Abnormal contralateral ear was more prevalent. Mucous type of CSOM has a chance forming various grades of tympanic membrane retraction, tympano sclerosis, thin healed membrane in the contralateral ear whereas squamous type of CSOM has a greater chance of contralateral ear involvement like, retraction granulation.</p>