bluuebunny/crossref_metadata_2025_split huggingface dataset:
A hospital based clinical study of 100 patients of solitary thyroid nodule
Authors: Chakraborty Mayank , Dnyanmote Anuradha , Balasubramanian Sree Ganesh , Bendre Mahendra 
Published: January 2018

Background: Thyroid nodules present as a challenge in their diagnosis, evaluation and management. Often these lumps are large in size and develop at the edge of thyroid gland so that they are felt or seen as a lump in front of the neck. The prevalence of these nodules in a given population depends on number of factors like age, sex, diet, iodine deficiency and even therapeutic and environmental radiation exposure. Prevalence increases with age with spontaneous nodules occurring at a rate of 0-0.8% per year, beginning early in life and extending till the eighth decade. In this study, the basic aim is to depict the various clinical presentations of solitary thyroid nodule and thereby find out the best diagnostic modality so as to plan out the most effective treatment strategy for such lesions.Methods: A hospital based prospective study was done with 100 patients to assess the various clinical presentations of solitary thyroid nodule and thereby find out the best diagnostic modality so as to plan out the most effective treatment strategy for such lesions.Results: Thyroid nodules are common in females of age group 31-40 years. Commonest presenting complaint is swelling in the front of lower neck. Most of the patients presented between 6 months to 3 years of onset of swelling.Conclusions: In present study, the sensitivity and specificity of FNAC was 85.71% and 100% respectively. All malignant lesions on FNAC were confirmed by histopathology indicating its excellence. Therefore, FNAC helps in planning the correct management and avoids second surgery.
Age distribution pattern of female breast cancer patients in Bangladesh- developing early and presenting late
Authors: Nessa Ashrafun , Hussain Tanvir , Alam Syed M. , Faruk Imtiaz , Jahan Ishrat 
Published: January 2018

Background: Carcinoma of the breast is the most common malignancy in females. At present carcinoma breast is the leading cancer in Bangladesh and is competing cancer cervix in incidence. Epidemiological studies at regional and global levels suggest the occurrence of carcinoma breast at a younger, premenopausal age in Indian and Asian women as compared with western women. Knowledge of this factor emphasizes the need to modify the timing of modalities of detection of early carcinoma and its management. According to literature, majority of carcinoma breast cases in the western countries present in Stages I and II of the disease whereas in Bangladesh majority cases present in Stage III of the disease. The objective of this study is to observe age of occurrence of breast cancer and stage of cancer in SSMC and MH.Methods: A cross sectional observational study was conducted in 34 patients of histopathologically confirmed breast cancer.Results: Mean age of subjects was 46.24±7.4 years. Age distribution showed peaks at 41-50 years with 18 patients. This study shows that 82.35% of the total patients were having advanced carcinoma breast (Stage III, IV) and 77% of these patients were below 50 years of age.Conclusions: Breast cancer is increasingly occurring in younger age groups in Bangladesh when compared with western countries and a more aggressive nature of the disease strikes in their reproductive period suggesting the need for change in modalities of early cancer detection and adjusting preventive and therapeutic efforts. This small study may provocate thought for larger scale population study to evaluate the scenario in Bangladesh.
A study of breast feeding practices among mothers of infants in an urban slum, South Indian city, Nellore
Authors: Kishore E. , Junapudi Syam Sundar 
Published: January 2018

Background: The benefits of breastfeeding are well established and for the most part it is rather beneficial for children to drink their mother's milk One of the most commonly cited benefits of breastfeeding is that it helps connect mothers and their children; the baby feels its mother's body warmth and heartbeat (reminiscent of the womb it has left) and can become familiar with its mother's smell. Studies have shown that babies who are breastfed are more likely to reach adulthood. Breast milk is the ideal food for the infant under any circumstance. Objective of present study was to assess the breast feeding and infant feeding practices among mothers of infants aged 0- 12 months.Methods: A Community based cross-sectional study among mothers of infants aged 0-12 months at field practice area of Narayana Medical College, Nellore. This Study was undertaken during March to May 2016. A sample size of 112 respondents were included in this study.Results: 112 mothers of infants aged 0-12 months were included in this study. The source of knowledge regarding breast feeding among these mothers was health personnel 60 (53.57%), Family members was the second most common source 35 (31.25%) fallowed by others 17 (15.18%).Conclusions: Family support and mother’s literacy play important role in promoting breast feeding among mothers. Health education given to mothers helps them to establish breast feeding and take care of their infants.
Study of lipid profile in cases of non-diabetic stroke
Authors: Kar Ayaskanta , Dash Chinmayananda , Murmu Malati , Mahesh K. P. Karun 
Published: January 2018

Background: To study serum lipid profile in non-diabetic patients with stroke and to determine whether there is any significant correlation between them and to compare the serum lipid profile between ischaemic and haemorrhagic group. Design: Case control study.Methods: The current study was done in the Department of Medicine VIMSAR, Burla, Odisha. Total 100 patients of completed stroke (Ischaemic63 and haemorrhagic37) and 30 controls were included in the study. All cases were adult (more than 14 years of age). Patients with suspected embolic stroke, diabetes (Type 1 and 2) and patients on lipid lowering drugs were excluded from the study. Routine investigations and fasting serum lipid profile was done.Results: 45 patients had elevated serum total cholesterol levels out of which 75.56% had Ischaemic stroke and 24.49% had haemorrhagic stroke. 24 cases had elevated serum Triglyceride levels of which 66.67% had Ischaemic stroke and 29.17% had haemorrhagic stroke. 76.47% of cases having elevated serum LDL cholesterol suffered from Ischaemic stroke where as 20.59% had haemorrhagic stroke.Conclusions: A statistically positive correlation was found between serum total cholesterol, Triglyceride, LDL levels and the risk of stroke.
Systemic evaluation of febrile thrombocytopenia
Authors: Katiyar Vivek , Khare Rajesh 
Published: January 2018

Background: Febrile patient with thrombocytopenia is commonly encountered by physicians especially during monsoon and perimonsoon period. Infections with protozoa, bacteria and viruses can cause thrombocytopenia with or without disseminated intravascular coagulation. Commonly dengue, malaria, scrub typhus and other rickettsial infections, meningococci, leptospira and certain viral infections present as fever with thrombocytopenia. Occasionally these patients can go on to develop a stormy course with multiorgan dysfunction requiring intensive care unit admission associated with high morbidity and mortality. Though thrombocytopenia is encountered in various diseases, it is for sure that potentially fatal bleeding due to thrombocytopenia is rare. The study was intended to know the underlying etiology of febrile thrombocytopenia in our community, the various presentations and relationship between platelet level and severity of disease and prognosis.Methods: This study was carried out in 218 adult patients (age above 18 years) presenting with fever having thrombocytopenia (platelet count <1,50,000/mm3) in Dept. of medicine in IIMS and R Lucknow UP.Results: Dengue was the commonest cause of fever with thrombocytopenia (58.71%) followed by P. falciparum malaria 8.71% and P. vivax malaria 6.88%. Bleeding manifestations were seen in 24.31% of patients. 58.49% of patients had patechie/purpura as the commonest bleeding manifestation followed by hematuria in 16.98 %.Conclusions: Fever with thrombocytopenia consists of occult presentations of common diseases rather than rare disease. Infection is the commonest cause of fever with thrombocytopenia. Among infections, dengue was the commonest cause. Treatment of underlying condition will lead to rapid improvement in platelet count with complete clinical recovery.
Study on relationship of total bilirubin with acute coronary syndrome (ACS) and associated risk factors
Authors: R. Purushotham , Gudage Nitin , Ambali Anand 
Published: January 2018

Background: Cardiovascular risk factors for ACS are on the rise in people of Indian origin and ACS is now the leading cause of death. More recent evidence suggests that bilirubin is a potent physiological antioxidant that may provide important protection against atherosclerosis and inflammation. Substantial evidence has documented that the development of CAD involves lipid oxidation and formation of oxygen radicals as atherosclerosis and inflammation are associated with formation of oxygen and peroxyl radicals. Keep of these points in mind, the present study was undertaken to find relation between Serum Bilirubin and Acute Coronary Syndrome.Methods: The present descriptive cross-sectional study conducted at A.J Institute of Medical Sciences and Research Centre, Mangaluru from October 2016 to April 2017. A detailed history, general physical examination, systemic examination and investigations was performed on all patients who fulfill the inclusion criterion and age >18yrs, both sexes who are admitted in CCU.Results: Hypertension had statistically significant correlation with ACS. All risk factors were more associated with STEMI compared to unstable angina or NSTEMI. On Correlation of LDL and Total leucocyte count with bilirubin both were statistically significant when compared to bilirubin levels.Conclusions: The study showed an inverse correlation of bilirubin with ACS, which in shows fact that bilirubin acts as an antioxidant and has cardioprotective action and patients with ACS have lower levels of bilirubin. This can use as a factor for screening individuals who have high risk for ACS and preventive strategies applied in them before the onset of overt ACS.
Study of neurological manifestations in patients of falciparum malaria
Authors: Murmu Malati , Kar Ayaskanta , KP Karun Mahesh , Naik Manoranjan , Kumar Meher Rajesh 
Published: January 2018

Background: Several types of neurological manifestations are associated with falciparum malaria. Cerebral malaria is one of the most dreaded complications. A significant number of survivors are left with disabling neurological sequelae, most of which are self-limiting. Neurological involvement is more frequent with falciparum malaria because of its unique characteristics leading to micro-vascular involvement.Methods: Present study was conducted at department of General Medicine, VIMSAR, Burla (Odisha). This observational study included in total 110 patients, who were confirmed cases of falciparum malaria. Clinical profile including detailed neurological examination with relevant investigations was done. Spectrum of neuropsychiatric manifestations were observed.Results: Out of 110 patients male and female ratio was 1:1 (M 55 and F 55). The mean age of presentation in male was 36.09 + 14.85 yrs. and in female was 31.85 + 14.00 yrs. The major presenting symptoms were fever, headache, vomiting, altered sensorium, altered behaviour and convulsions in their decreasing order of frequency. On neurological evaluation, diminished level of consciousness was found in 56.4% cases. 14% cases had GCS score ≤ 7 and 63% had GCS score ≥ 11. Convulsion was found in 31% cases, cranial neuropathy in 10.9%, cerebellar dysfunction in 12.7%, neck rigidity in 22.7%, speech abnormality in 3.6%, peripheral neuropathy in 8.2%, fundoscopic changes suggestive of retinal involvement in 44.5% cases. Atypical manifestation like; Intracerebral haemorrhage, subarachnoid haemorrhage, cortical venous sinus thrombosis were also found in few cases. 32.72% patients had Neuropsychiatric manifestations at discharge in the form of focal neurological deficits, psychosis, depression, speech disorder, memory loss, cerebellar abnormality & peripheral neuropathy.Conclusions: Neurological manifestations in falciparum malaria patients are common and encompass a wide spectrum of clinical presentation. In an endemic area, falciparum malaria should be kept as a differential diagnosis in patients presenting with atypical neurological manifestations.
The double burden of tuberculosis and diabetes prevalance of diabetes melitus in tuberculosis
Authors: Khare Rajesh Kumar , Katiyar Vivek 
Published: January 2018

Background: The burden of diabetes mellitus is increasing worldwide. The prevalence of TB has been rising in recent years globally. Aging, changes in life style, socioeconomic factors, and population growth have lead to an increased prevalence of DM, particularly, type 2 DM. Diabetes Mellitus (DM) almost triples the risk of developing tuberculosis (TB). India, the nation with the highest number of TB cases in the world, is also undergoing epidemic growth in DM rates. With the demographic transition underway globally, increase in life expectancy, improvements in provision of health services and a subsequent increase in the elderly population, the absolute numbers of cases of diabetes will increase exponentially. As a result, DM and TB are increasingly present together, and this calls for renewed interest in this topic. Various studies done in different parts of India and in other parts of globe where TB is endemic have shown a higher prevalence of DM among PT infected with tuberculosis. We in our study undertaken in Department of medicine in IIMS&R Lucknow UP found a high prevalence of DM amongst TB patients. Routine screening of TB patients for DM will help detect cases of diabetes and pre-diabetes early, so that primary prevention methods may be initiated early and effectively.Methods: This hospital-based cross-sectional study was undertaken in Department of medicine in IIMS and R Lucknow UP. All TB cases more than 18 years of age, including new and re-treatment cases, sputum positive, sputum negative and extra-pulmonary cases currently on treatment in the were included in the study.Results: Using the diagnostic criteria, as mentioned in the methodology, the prevalence of diabetes among TB patients in this study was found to be 24.5% of which 18.5% were known DM cases and 5.9% were newly diagnosed.Conclusions: The burden of diabetes mellitus is increasing worldwide. The association between diabetes and tuberculosis is the next challenge for global tuberculosis control. Improved understanding of the bidirectional relationship of the two diseases is necessary for proper planning and collaboration to reduce the dual burden of diabetes and TB. In people with TB, it may be appropriate to actively screen for DM. Prevention, screening, and treatment of both diseases together is more effective.
Characterization of adrenal masses with non-enhanced CT and 18F FDG-PET in patients with primary malignancies
Authors: S. Prasanth P. , Kandanga Indu , P. Ambooken Robert , P. Sankaran Priya 
Published: January 2018

Background: Characterizing adrenal lesions in patients with a known primary malignancy has a vital role in treatment and prognostication. A study by Gufler et al proposed a scoring system based on density, contour, homogeneity and size and found a high accuracy in differentiating adrenal adenomas from metastasis in patients with a known malignancy. This study evaluates the sensitivity and specificity of this NECT scoring system and comparing it with that of 18F FDG PET.Methods: The study was conducted on patients with diagnosed malignancies with adrenal mass, referred for 18F-FDG PET-CT scanning as a part of work up or follows up between October 2014 and March 2016. Whole-body CT and PET images were obtained using standard protocol. NECT scoring and quantitative analysis of FDG uptake in the adrenal lesions (SUVavg analysis) is done separately.Results: Of the 50 patients studied, 33 patients had benign adrenal lesions and the rest had metastatic lesions. Most common site of primary was lung. NECT score yielded a sensitivity of 88.2%, specificity of 100% and positive predictive value of 100%. SUVavg analysis yielded a 100% sensitivity, specificity and positive predictive value. Comparison of the predictive power of the two tests showed a z score of 2.5 and p value of 0.0124.Conclusions: 18-FDG PET can be considered as a gold standard for differentiating between metastasis and benign lesions of adrenal glands in patients with known primary. NECT has a comparable specificity as that of FDG PET, however with lower sensitivity.
The advantage of PCR for MTB in comparison to ADA in diagnosing tubercular pleural effusion
Authors: Agarwal Abhishek , Hussain Ahbab , Prasad Rajendra , Verma Anand , Banka Amitabh , Raza Tasleem 
Published: January 2018

Background: Tuberculosis continues to be an important health problem globally. The bacteriological confirmation of diagnosis in extrapulmonary tuberculosis patients is more difficult because most of the cases of extrapulmonary tuberculosis are paucibacillary in nature. In this study we have compared the pleural fluid ADA levels with PCR for MTB in pleural fluid to confirm the diagnosis of tuberculosis in the pleural fluid.Methods: The study was done over two years and a total of 106 patients with a clinico-radiological diagnosis of pleural effusion were enrolled for the study. The pleural fluid was aspirated and examined for total cell count, differential cell count, protein, sugar, ADA and PCR for MTB.A CT Thorax was done in all the 106 patients of pleural effusion and underlying consolidation along with pleural effusion was found in 60 patients.Results: The pleural fluid was exudative in nature in all the patients. 90 patients (84.9%) had lymphocyte predominant pleural effusion while 16 patients (15.1%) had neutrophil predominant pleural effusion. The overall sensitivity of ADA in all the cases of pleural effusion was 85.2% while the overall sensitivity of PCR for MTB in all the cases of pleural effusion was 51.1%. However, in the 60 patients of pleural effusion with underlying lung consolidation, the overall sensitivity of ADA was 69.1% while the overall sensitivity of PCR for MTB was 92.8% for diagnosing tubercular pleural effusion.Conclusions: PCR for MTB is a useful test along with ADA for diagnosing tubercular pleural effusion. PCR for MTB is especially useful in the diagnosis of tubercular pleural effusion in patients with underlying lung consolidation.
Clinicopathological study of cervical lymphadenopathy at rural tertiary health care centre
Authors: M. Paikrao Yogesh , M. Deshpande Prashant , N. Chintale Kailas 
Published: January 2018

Background: The term lymphadenopathy refers to nodes that are abnormal in size, consistency or number. Cervical lymphadenothy is one of the common and important presentations of the underlying pathology of the head and neck region which has large number of differential diagnosis like neoplasms, infections (specific and non-specific) and in immune deficiency disorders and also, the rare disorders like Inflammatory pseudotumour (Plasma cell granuloma) and Kikuchi-Fujimoto diseases. Etiological profile of cervical Lymphadenopathy varies from region to region, in developing countries like India, acute respiratory infection, suppurative skin infection and tuberculosis are the main causes for cervical lymphadenopathy while in developed countries secondary carcinoma are the most frequent causes for cervical lymphadenopathy.Methods: This hospital based cross sectional study was carried out in the Department of Otorhinolaryngology in Rural Tertiary Health Care Centre. The period of the study was from January 2014 to June 2016.Results: In our study of 176 patients the youngest patient was 13year of age and oldest patient was 68 years old. The majority of patients affected were in the age group of 21 to 30 years (30.68%) followed by 13 to 20 years (23.86%). The least affected age group was 60 to 70 years (5.8%). There were 80 men and 96 women. The male to female ratio in present study was 1:1.2 The frequently affected age group was 21 to 30 years in men (26.25%) as well as women (34.38%). In our study Neck swelling was present in all cases (100%). fever was the second most common symptom in 54 cases (30.68%) followed by cough in 45 cases (25.56%). In our study most frequently involved lymph node group was posterior cervical in 68 cases (38.39%), followed by upper deep cervical in 66 cases (37.50%).Conclusions: In the present study it was found that tuberculosis was the most frequent cause of cervical Lymphadenopathy in 48.29% of patients, followed by reactive Lymphadenopathy in 17.34%, metastatic lymphadenopathy in 15.34% chronic nonspecific Lymphadenopathy in 14.77% and primary lymphoreticular malignancy in 4.35%. In our study out of 176 cases of cervical lymphadenopathy 141 cases (80.11%) were non neoplastic and 35 cases (19.88 %) were neoplastic.
Correlation of serum-ascites albumin concentration gradient and endoscopic parameters of portal hypertension in chronic liver disease
Authors: I Suresh , Prasad Jagini Shiva 
Published: January 2018

Background: In many studies Serum ascitic albumin gradient (SAAG) was found to be an independent predictor of PHTN and EV especially in alcoholic cirrhosis. Objectives of this study was to study correlation of level of “Serum-Ascites Albumin Concentration Gradient” (SAAG) and complications of “Portal hypertension” (PHTN), manifested by “Esophageal Varices” (EV).Methods: Present study was hospital based cross sectional study. The sample (100) was of patients with ascites. SAAG was measured in all subjects. EV was assessed by endoscopy in all. Data was analyzed using proportions and appropriate statistical tests.Results: High SAAG value was seen in 79% of the patients. EV incidence was 84.5%. “child-pugh score” and size of the portal vein was found to be associated with EV. The incidence of EV among patients with high “SAAG value of 1.1 to 1.44 g/dl” was 50%. The size of the EV was found to be significantly associated with SAAG level.Conclusions: Patients having ascites with EV were also having high levels of SAAG. Thus, we conclude that value of SAAG more than or equal to 1.2±0.05 g/dl can be used as a predictor of EV presence among ascites patients.
Clinical profile of patients with acute ischemic stroke receiving intravenous thrombolysis (rtPA-alteplase)
Authors: Prasad Jagini Shiva , I. Suresh 
Published: January 2018

Background: Stroke patients are at highest risk death in the first few weeks after the event, and between 20-50% die within first month depending on type, severity, age, co-morbidities and effectiveness of treatment of complications. Objective of this study was to clinical profile of patients with acute ischemic stroke receiving intravenous thrombolysis (rtPA-alteplase).Methods: Prospective Observational study of 26 cases of acute ischemic stroke receiving IV thrombolysis using rtPA-alteplase at Kovai Medical Centre Hospital, Coimbatore over a period of 1 year 9 months.Results: 21 cases had NIHSS score of range 10 to 22. The mean NIHSS score at admission is 13.5. 15 subjects (57.7%) had achieved primary outcome in this study. MRS Score of 0 to 2 is considered as favorable outcome. In this study 20 subjects (76.92 %) had favorable outcome at the end of 3 months.Conclusions: Majority of the patients receiving rtPA-alteplase had favorable outcome.