bluuebunny/crossref_metadata_2025_split huggingface dataset:
A study of knowledge, attitude and practice in diabetic retinopathy among patients attending a primary health care centre
Authors: Geethadevi Malavika , Thampi Bindu , Antony Joosadima , Raghavan Remya , Sasidharan Rekha R. , Mohan Ajith 
Published: August 2018

Background: Diabetic retinopathy is a major cause of preventable blindness. Sufficient knowledge about the disease can prevent sight threatening complications. Aim of this study is to evaluate the knowledge and its influence on attitude and practice in diabetic retinopathy among patients attending a primary health centre.Methods: A knowledge attitude practice questionnaire was prepared and pretested in a sample group of representative population. The response was analyzed as to whether the questions were understood or not. Social workers were trained in administering questionnaire. Diabetic patients were given questionnaires at primary health centre and filled in the presence of social workers.Results: Out of 324 patients 60.8% had no knowledge of diabetic retinopathy compared to 39.19% who had knowledge (p <0.001). Knowledge was more in age <40 years (82.60%) and least in 51-60 years (29.34%) (p<0.001) and more among females (38.59%) than males (61.4%). Knowledge was significantly higher among upper socioeconomic group (77.8%). About 83.46% in knowledge group had right attitude which was significantly higher than non knowledge group (32.48%) (p<0.001). 42.51% in knowledge group had practice of visiting ophthalmologist for eye check-up which was significantly higher than non knowledge group (13.19%) (p<0.001).Conclusions: The attitude and practice of diabetic retinopathy was statistically significant in knowledge group compared to those who had no knowledge of diabetic retinopathy. Improving knowledge about diabetic retinopathy through awareness campaigns can increase attitude and practice. Early detection can help in preventing sight threatening complications of diabetic retinopathy.
Suprasellar epidermoid cyst: a rare cause of painless progressive bilateral vision loss-case report with clinico-radiological correlation
Authors: Chauhan Gaurav , Singh Vivek , Phadke R. V. , Yadav Sapna 
Published: August 2018

Intracranial epidermoid cysts are relatively rare lesions. They result from inclusion of ectodermal elements during time of neural tube closure. This lesion could rarely be acquired due to post-surgical or post traumatic implantation of the ectodermal components. They typically present in middle age group patients with evidence of loco-regional mass effect on adjacent structures. We present a clinico-radiological case report of the 27-year-old female patient who presented with painless progressive bilateral vision loss for last 4 months.
Risk factors for loco-regional recurrence after breast conserving surgery: impact of young age and surgical margin status in breast cancer patients
Authors: Vasigh Mahtab , Rahmani Soodeh , Omranipour Ramesh , Haghighat Shahpar , Olfatbakhsh Ensiie , Kenari Adel Yazdankha 
Published: August 2018

Background: Breast cancer is a common malignant tumor and treatment predominantly consists of surgery. Modern society has increased the demands of women to have higher requirements for breast appearance and quality of life. Therefore, exploring effective measures to control or reduce the rate of loco-regional recurrence (LRR) after breast conserving surgery (BCS) is the main focus of this study.Methods: This cohort included 743 consecutive patients with invasive breast cancer, treated with BCS in 2 centers in Tehran, Iran between 2005 and 2010. The primary endpoint was the rate of loco-regional recurrence in a 5-year follow- up period. Authors also investigated the factors that could predict LRR after BCS.Results: The prevalence of LRR after BCS was 7.6% in a median follow-up of 56.9 months. The Median time to local recurrence was 20.45 months. A correlation between follow-up outcome and age; histologic sub-type; surgical margin; number of positive nodes; complete pathologic response to neo-adjuvant chemotherapy; chemotherapy and hormone therapy was recognized. Surgical margin status, hormone therapy, histologic sub-type, age and Ki67 were shown to be significant risk factors for LRR in univariate analysis whereas surgical margin status emerged as an independent risk factor in multivariate analysis.Conclusions: Increased LRR was observed among those with higher ki67, aged under35, not receiving hormone therapy and with a surgical margin less than 2mm. These factors appeared to be risk factors for LRR after BCS, while, histologic grade, axillary nodal status, tumor size and biologic sub-type did not predict LRR after BCS.
Indications and outcome of patients undergoing cutaneous ureterostomy as a mode of urinary diversion after radical cystectomy: an experience from a tertiary care center
Authors: Agarwal Shikhar , Sarpal Rajeev , Dang Shivam , Kalra Yogesh , Biswas Manoj 
Published: August 2018

Background: Radical cystectomy is associated with high morbidity, especially in elderly patients. Most of the associated complications are related to the urinary diversion. Cutaneous ureterostomy (CU) is usually an uncommon form of urinary diversion and is avoided because of the frequent complication of stomal stenosis.Methods: In this study the authors retrospectively analyzed 84 patients who underwent radical cystectomy. 17 Patients who underwent single stoma CU were included in the study who required lifelong monthly stent changes. Varied indication and outcome of these patients were analyzed.Results: Patients in which CU was used as a mode of urinary diversion had less blood loss, less operative time and discharged without ICU stay.Conclusions: It seems that single stoma CU is a viable option in elderly, high risk patients and in post radiotherapy patients who require radical cystectomy. Although the patient requires lifelong stent changes, postoperative complications are reduced.
Early versus late dressing removal in clean and contaminated midline laparotomy wounds: a non-randomized pilot study
Authors: C. Vijayakumar , R. Prabhu , V. Muthukrishnan , R. Kalaiarasi , T. Swetha 
Published: August 2018

Background: This study was carried out to evaluate the efficacy of early versus late dressing removal in clean and contaminated midline laparotomy wounds.Methods: Fifty patients aged ≥18 years who were admitted and operated for surgical procedures (both emergency and elective) were included in the study. All laparotomy wounds had fulfilled the CDC criteria. Twenty-five patients each were included in early dressing removal group and the late removal group. In early removal group, the laparotomy wound dressing was removed within 48 hours and in late removal group, was removed after 48 hours of surgery. The incidences of superficial and deep surgical site infection (SSI) in both groups were analysed. Other secondary parameters like incidence of wound dehiscence and secondary suturing were also analysed.Results: Twenty-five patients each, in early removal group and in late removal group were included for final analysis. The incidence of superficial SSI (%) was significantly less in early removal group (65.50 versus 89.50; p= <0.001). The duration (days) required for complete wound healing (8.52 versus 10.65; p=0.734) was significantly less in the early removal group. The length of postoperative hospital stay (days) was significantly less in early removal group (10.30 versus 14.90; p= <0.001).Conclusions: Early removal of dressing significantly reduces the incidence of superficial SSI in midline clean and contaminated laparotomy wounds. It also significantly reduces the duration required for complete wound healing and facilitates early discharge of the patient compared to late dressing removal.
A clinical study of etiology and management of acute intestinal obstruction
Authors: C.R Shivakumar , Shoeb Mohammad Fazelul Rahman , Reddy Anil P. , Patil Sharangouda 
Published: August 2018

Background: Acute intestinal obstruction is one of common abdominal emergency and is associated with significant morbidity and mortality. Early diagnosis of obstruction, skilful operative management, proper technique during surgery and intensive postoperative treatment carries better results. The aim of this study was to identify the etiology, clinical presentation, management and outcomes of patients with acute intestinal obstruction presenting in GIMS, Gulbarga.Methods: This is a prospective study carried out in the department of general surgery A unit at Gulbarga Institute of Medical Sciences, Gulbarga, from May 2014 to January 2018. 50 patients with acute intestinal obstruction coming to the OPD and emergency department were included in study and data was analysed.Results: A total of 50 patients, presented with acute intestinal obstruction during the period of the study. Mean patient age was 46.5 years with peak incidence in 50-59 years. Small intestinal obstruction was seen more commonly than large intestinal obstruction. Most common etiology of intestinal obstruction was due to adhesion and bands (40%).Conclusions: Present study concluded that Intestinal obstruction is seen more commonly in middle age group. Males were affected twice as common as females. Abdominal pain was the most common symptom, while tenderness was the most common sign. Post-operative adhesion caused most cases of small bowel obstruction while large bowel obstruction was caused most commonly by malignancy. Earlier the presentation better will be the outcome.
The comparison of mesh and sutured repair for adult umbilical hernia: a prospective study
Authors: Agarwal Shwetank 
Published: August 2018

Background: Umbilical hernia is the commonest of all the abdominal hernias. The current study was planned to evaluate the outcome of Mayo's tension free mesh repair to sutured repair in umbilical hernias.Methods: The prospective study was piloted on 110 patients who underwent umbilical hernia repair over a period of 1-year period in the department of General Surgery. The patients were divided into two groups – Group A comprises 68 patients and group 2 consists of 42 patients in which suturing, and mesh repair was done respectively. The patients were then grouped in Suture group or Mesh group as per the procedure done and 1 year follow up was done. The complications and the duration of hospital stay in both groups was recorded.Results: The mean age of the subjects was 52.8±12.1 years. The ratio of male to female was 7:4. Seven patients (10.3%) developed recurrence following sutured repair compared to none following mesh repair (P<0.05). Five patients (5.3%) developed wound infection following suture repair compared to none in the mesh group (P<0.05). Two patients had hematoma while 1 had seroma in suture group, both haematomas occurred in patients who underwent the Mayo repair.Conclusions: According to present results mesh repair is the preferred technique of manoeuvre in umbilical hernias. Mesh repair for umbilical hernias is in effect and concomitant with negligible morbidity.
Liver abscess, management strategies, and outcome
Authors: Jayakar Sudhir R. , Nichkaode Prabhat B. 
Published: August 2018

Background: Liver abscess, a disease troubling mankind from ancient times, has earliest documentation in the Sanskrit document. Where right upper abdominal pain, have potentially lethal consequences, if prompt diagnosis and treatment are not accomplished. However, two major types are known, amoebic and pyogenic, in medical literature. Pyogenic liver abscess constitutes major bulk of hepatic abscess in western countries. The diagnosis is confirmed by ultrasonography, reddish brown (anchovy-paste like material) aspirate from abscess. The diagnosis, treatment and prognosis, of liver abscess have evolved remarkably over past few years. Imaging has improved diagnostic competence and has altered therapeutic strategy. The study aims at early clinical and diagnosis on imaging of liver abscess, to set up some guide lines in view of conservative or either intervention.Methods: The present study was hospital based longitudinal study, carried out in tertiary care teaching hospital from November 2013 to November 2015. A total of 55 patients were enrolled in the study. All patients with suspicion of having liver abscess were confirmed on Imaging and included as present study population. Authors studied mainly presentation, role of conservative treatment, Aspiration, pigtail catheter, Outcome, and post procedural complications.Results: All patients presented with Pain right or left upper abdominal pain in abdomen, any chest complaints , majority of present study group patients had fever with or without rigors, deranged liver function. Imaging is the most diagnostic method, and also helped in therapy and follow up.Conclusions: Males are affected more than females, Imaging is the best modality for diagnosis, therapy and follow up. Aspiration or pigtail drainage is the standard method of drainage. Pigtail drainage is the better method of treatment than aspiration.
Retro-rectal mass: a clinical dilemma; report of three cases with brief review of literature
Authors: Kant Kamal , Singh Kapisoor , Rathod Yashpal Singh , Purohit Richa 
Published: August 2018

Retro rectal or presacral tumors are uncommon lesions. It can be difficult to diagnose as presenting signs and symptoms are usually nonspecific. Retro rectal lesions can be congenital or acquired, benign or malignant. Children can also have retro rectal masses like anterior meningocele, teratomas or cystic teratomas. FNAC or biopsy usually is not required as imaging can provide a reasonably good diagnosis. Cross-sectional imaging is essential in evaluating these lesions to determine the optimal surgical approach and the extent of resection. Surgery is the mainstay of treatment as it establishes the diagnosis and prevents the adverse consequences associated with malignant degeneration and secondary bacterial infection. The outcomes for patients with benign presacral tumors are favourable.
Management of rectal foreign body with endoscopic snare: a case report
Authors: Kishore A. Sai , Jeyasekharan S. Sabu , C. Nithila , Reddy N. Pradeep 
Published: August 2018

Foreign bodies in the rectum, although not much common present a challenging task to the surgeons for retrieval. Depending on the type and position they can cause anorectal trauma and perforative peritonitis. Diagnosis is usually by history, per rectal examination and radiography. Here authors present a 27-year-old male who came with history of insertion of candle into rectum to prevent bleeding from haemorrhoids. Perforative peritonitis was ruled out and manually tried to remove it and all attempts failed. He was posted for colonoscopy and it revealed 23cm long candle in the rectum with bleeding anal tag. The tip of candle extended into sigmoid colon. Polypectomy snare applied around the candle and foreign body was gently removed. Check colonoscopy revealed no significant injury. He was referred to psychiatry department and he was discharged the next day.
Red cell distribution width as a prognostic marker in mechanically ventilated children admitted in pediatric critical care unit of tertiary care centre, India
Authors: Gadappa Swati M. , Behera Manas Kumar 
Published: August 2018

Background: Paediatric population is a vulnerable group necessitating standard care for medically and surgically ill children. Red cell distribution width (RDW) is a simple and low-cost measure that denotes the variability in red blood cell size. Any process that releases reticulocytes in the circulation will result in an increase in RDW. RDW may also be useful as a biomarker of disease severity and clinical outcomes in critically ill patients. Methods: Retrospective cohort study of all patients between 1month-12yrs of age, mechanically ventilated in Paediatric intensive care unit. Those patients with RDW on admission and complete data for PIM3 (Paediatric Index of Mortality 3) were included. Analyses included correlation, logistic regression analysis, and receiver operating characteristic (ROC) curves.Results: Retrospective analysis of data on 93 consecutive critically ill children admitted in PICU was done between Jan 2015- June 2016. We noted statistically significant correlation between mortality and anemia (10.24 g/dL, SD 2.26; 8.78 g/dL, SD 2.60.p = 0.009), LOS on MV (p = 0.008), RDW (p = 0.002), shock (p = 0.004) and ventilator associated Pneumonia (p = 0.024). Mortality increased as length of stay on mechanical ventilation increased (4.13 days, SD 2.125 versus 6.94 days, SD 7.603 p = 0.008). The cut-off of 18.10 was chosen as Mean RDW. Based on AUROC, RDW is independently associated with high risk of mortality.Conclusions: RDW measured within 24 hours of PICU admission was independently associated with length of stay on mechanical ventilation and mortality in a general PICU population. We recommend the need for multicentric, prospective longitudinal studies to determine the optimum utility of RDW to enhance decision making in PICU.
Study of quantitative bacterial cultures of non-bronchoscopic samples in ventilator associated pneumonia
Authors: Azarudeen Mohamed , Sharma B. S. , Jain Pankaj Kumar , Goyal Alok Kumar , Malhotra Bharti 
Published: August 2018

Background: Diagnosis of VAP based on non bronchoscopic samples-ETA, NB-BAL culture. The aim is to study quantitative culture of the non-bronchoscopic sampling techniques such as Blind Broncho-alveolar lavage (NB-BAL) and endotracheal aspirates (ETA)in Ventilator Associated Pneumonia. It is a hospital based, observational study conducted in SPMCHI, Jaipur from September 2015 to September 2016.Methods: Seventy patients who were under mechanical ventilation for more than 48 hours and clinically suspected for VAP were included in the study and divided into early and late onset VAP. The NB-BAL and ETA were obtained from these patients and quantitative cultures were performed.Results: Out of the 70 samples analysed, 60 patients were found positive in BAL and 61 positive in ETA. The agreement between NB-BAL and ETA is 86.8%. GNBs remain the main burden of both early and late onset VAP. Most common organisms isolated were Enterobacter and Acinetobacter in early onset and Pseudomonas and Acinetobacter in late onset VAP. All the GNB isolates were sensitive to Polymyxin and Colistin and were resistant to majority of routinely used antibiotics.Conclusions: The quantitative culture of non-bronchoscopic samples is a useful alternative to bronchoscopy, in the diagnosis of VAP in resource deprived centers. MDR gram negative bacilli are the main causative agents of VAP.
Clinico-hematological manifestations of malaria in children in Western Uttar Pradesh, India
Authors: Hassan Najia , Chalotra Sonam , Aneja Satinder 
Published: August 2018

Background: Globally, malaria is one of the important causes of mortality in pediatric age group. We describe here the clinico-hematological manifestations of malaria in children in Western Uttar Pradesh.Methods: A Retrospective study was done over 8 months in pediatric ward and pediatric intensive care unit of a tertiary care centre in Greater Noida. Children below 18 years admitted with acute febrile illness with peripheral smear and / or rapid malaria antigen test positive were included in the study. Detailed clinical, biochemical and hematological characteristics of children hospitalized with severe malaria were recorded and patients were managed according to National Vector Born Disease Control Programme Guidelines for malaria treatment.Results: Out of 115 children admitted with malaria, majority of cases were due to P. vivax (88.7%) compared to P. falciparum (5%) and Mixed infection (6%). Malaria was more common in males and in 1 to 5 years age group. Out of 115 patients, severe malaria was present in 27 (23.4%) patients, all infected with P. vivax. Among them, bleeding was present in 13.04 %, shock in 9.56%, acidosis in 9.56%, jaundice in 5.21%, seizures in 3.47%, severe anemia in 5.21%, renal impairment in 3.47%, impaired sensorium in 1.73% and pulmonary edema was present in 0.86% patients respectively. Case fatality Rate was 1.73%, all due to severe vivax malaria.Conclusions: The study highlights that P. vivax is a common cause of malaria in Western UP and can result in a severe disease with potential mortality.
Vitamin D status in exclusively breast-fed infants and their mothers
Authors: C. R. Vignesh Kumaran , S. Sundari , Ramesh Shanthi 
Published: August 2018

Background: India, despite being a tropical country has widespread vitamin D deficiency across all age groups. Present study was conducted to estimate the prevalence of subclinical hypovitaminosis D in exclusively breastfed infants and their mothers and also to study the correlation between the Vitamin D levels of these infants and their mothers.Methods: This cross-sectional study was conducted in 37 exclusively breastfed infants aged 6 months and below and their mothers. Under strict aseptic precautions 2 ml of blood was taken from each infant and mother and serum levels of 25(OH) D levels were measured by the direct ELISA method. Statistical analysis was done by using chi-square test, one-way ANOVA f-test and student independent t-test.Results: In present study, authors found that 78.3% of the mothers were Vitamin D deficient and 21.7% of the mothers were Vitamin D insufficient. Among the infants, authors found that 91.9% of the infants were Vitamin D deficient and 8.1% of the infants were Vitamin D insufficient. The association between dietary pattern and socio-economic class and mean maternal vitamin D levels was found to be statistically significant (p <0.05).Conclusions: There is a high prevalence of hypovitaminosis D amongst exclusively breastfed infants and their mothers. Hence, public awareness needs to be created regarding the benefits of sunlight exposure. Vitamin D fortification of food products and routine Vitamin D supplementation program for antenatal and lactating mothers and their young infants may be able to address this emerging public health problem in our country.
Menstrual hygiene: knowledge and practice among adolescent girls in orphanage
Authors: Kumari Savita , Sheoran Poonam , Siddiqui Adiba 
Published: August 2018

Background: In India menstruation is generally considered as unclean. Orphanage girls are vulnerable group in our society. The unfailing support and a constant check of orphan girls during menstruation are usually absent. The objective of the study was to assess the knowledge and practices regarding menstrual hygiene among adolescent girls residing in selected orphanages of Haryana.Methods: A descriptive survey was conducted on 150 adolescent girls residing in selected orphanages of Haryana. Purposive sampling technique was used to select the adolescent girls for study. The data was obtained by structured knowledge questionnaire and structured practice questionnaire.Results: SPSS version 20 was used for statistical analysis. The result of the study indicated that more than half of adolescent girls (62.7%) were in age group of 12-15 year. Half (50.7%) of adolescent girls had age of menarche at 12 year. Only 16% adolescent girls had good knowledge regarding menstrual hygiene. 95.3% were using sanitary pad during menstruation.Conclusions: The present study concluded that adolescent girls had poor knowledge of menstruation and menstrual hygiene.