bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ultrasonography awareness among pregnant women attending medical college hospital in Kolhapur District of Maharashtra, India
Authors: Yadav Jeevankumar U. , Yadav Deepmala J. 
Published: May 2017

Background: Globally there has been increased medicalization of pregnancy due to advances in technology. Ultrasonography examination during pregnancy has become an integral part of antenatal care throughout the world with advanced health care services.Methods: The cross-sectional study was conducted in pregnant women attending the ANC clinic of Obstetric department of D. Y. Patil Medical College Hospital, Kolhapur, Maharashtra, India for routine check up to know the awareness about ultrasonography among them. The study included 290 pregnant women. All were explained the purpose of study and assured confidentiality. Data has been collected from willing participants using pre-tested questionnaire in June-August 2015.Results: The study shows literacy was 87.6%, pregnancy above 20 years age 98.97% and most of them unskilled (83.4%), majority of middle social class (89%). Many (72.41%) pregnant women considered USG use to detect fetal anomalies while 27.93% considered for sex detection. Majority (93.1%) done USG in this pregnancy, of that more (43.45 %) in second trimester and mainly advised by doctors (91.03%). Nearly half of them (50.69%) considered its expensive procedure, 69.31% spent 200/- to 500/- rupees per USG, in spite 94.83% of them would recommend other pregnant women to undergo USG in pregnancy. 50.69%% of them opined it should be done twice in pregnancy. Almost 94.83% considered USG as safe and beneficial.Conclusions: Awareness regarding the uses of Ultrasonography during pregnancy and attitude towards it was found to be average. There is need to create more awareness in community about PCPNT act and its provisions. Also there is need of counselling about the safety, utility and frequency of USG during pregnancy to avoid misuse.
The effect of waist hip ratio on the various stress types in I year Indian medical students
Authors: A. K. Sunitha Priya , Panchu Pallavi , Babu Rose , Bahuleyan Biju 
Published: May 2017

Background: A medical student faces tremendous academic and non-academic stress owing to the vast curriculum and inadequate time. The impact of stress results in detrimental mental and physical health which is assessed here using stress questionnaires and anthropometric parameters. Stress need not be only academic. Hence it becomes vital to identify and target the specific and common non-academic stressors to enable the students to have a stress-free learning environment. The objective of this study was to find the inter relationship between waist hip ratio (WHR) and various stressors the student is exposed to.Methods: 97 I year medical students participated in this cross-sectional study and were administered the medical student stress questionnaire (MSSQ), a validated tool and the anthropometric measurements (waist and hip circumference, waist hip ratio, body mass index) were taken. The data was analyzed using SPSS version 22.Results: The study showed a negative correlation of WHR with all the stress parameters of which inter personal relationship stress (IRS) and teaching learning related stress (TLRS) were significant.Conclusions: Increasing the duration of I year MBBS course and helping learners acclimatize to the new study environment may help in reducing stress. Stress relaxation techniques, psychological counselling and strengthening the mentor- mentee programs along with exercise regimen may aid in the stress reduction process and facilitate physical health.
Intrathecal baclofen in management of a patient with very severe tetanus
Authors: Jaju Madhusudan R. , Goverdhan M. , Reddy N. Pavan Kumar , Muttavarapu Sirisha Rao , Sekhar V. Chandra , Bandla Siddharth , Rammohan Srikanth , Srivastav Shashank Kumar 
Published: May 2017

Tetanus is uncommon in developed countries. The majority of tetanus cases occur in third world countries and 50% of these cases occur in neonates. There are more than 800,000 deaths due to tetanus each year in the world. We present a case of 40-year-old male patient diagnosed to have very severe tetanus - Grade IV as per Ablett classification of severity, managed in our hospital with aggressive treatment for 27-days and use of intrathecal baclofen he showed drastic improvement in this status. He was discharged in neurological intact conditions with hemodynamic stability.
Scalp shagreen patch: an unusual cutaneous manifestation of tuberous sclerosis complex: a case report
Authors: Abualiat Abdullah , Elobeid Wifag , Edris Hala 
Published: May 2017

Tuberous sclerosis complex (TSC) is an inherited neurocutaneous disorder with multisystem involvement and highly variable expression of the disease. Common cutaneous manifestations include angiofibromas, periungual fibroma, ash-leaf-shaped macules and shagreen patch which is slightly elevated soft skin-coloured plaque usually found in lumbosacral region. We report a case of TSC in a 21- year- old Saudi man with a 13 years history of asymptomatic skin lesions and generalized tonic-clonic seizures. Dermatological examination revealed facial angiofibromas, ash leaf macules, pedunculated fibromas on trunk, and shagreen patch on the back. Scalp swelling was found and confirmed to be shagreen patch by the histopathology findings. In conclusion, scalp shagreen patch is an unusual presentation of TSC. It should be considered in clinical examination of suspected cases of TSC with relevant histopathology to confirm the lesion.
Prevalence of overweight and obesity amongst adolescents and identification of risk factors
Authors: Choudhary Kirti , Mathur Priyanshu , Garg Manisha , Gupta P. P. 
Published: May 2017

Background: Childhood overweight and obesity are global nutritional concerns that are on the rise. These are among the most prevalent nutritional problems in the developed and developing countries and are associated with increased consumption of processed and fast foods, dependence on television and computers for leisure and less physically active lifestyle.Methods: The study has been conducted in the Department of Pediatric of Mahatma Gandhi Medical College of Mahatma Gandhi University of Medical Sciences and Technology, Jaipur. The study was a cross sectional analytical study conducted in schools of Jaipur. This study was done from August 2011 to November 2011 and 180 patients of aged between 10 to 18 years of age were enrolled.Results: In this study, we found the prevalence of overweight to be 32.65 percent in males and 34.15 percent in females. It was seen that 33.67 percent males and 32.93 percent females belonged to the obese category. It was seen that majority of overweight (65 percent) and obese (73.33 percent) adolescents lead a physically inactive lifestyle. None of the overweight and obese adolescents were involved in physical activity for more than an hour. The observation was significant (p=0.000). Most of the overweight and obese adolescents had appropriate diet. However, 11 of the overweight and 27 among adolescents consumed calories more than the requirement. This observation was found to be significant (p=0.000). Out of 149 adolescents consuming fast food, 59 were overweight and 51 were obese. This observation was found to be significant (P=0.015).Conclusions: The prevalence of overweight was 32 percent in boys and 34 percent in girls and the prevalence obesity was 33 percent in boys and 32 percent in the girls. There was no significant difference in overweight and obesity between boys and girls. Hours of physical activity, diet, consumption of fast food had a significant association with B.M.I. It was, therefore, concluded that reduced physical activity for less than 1 hour for less than 3 days a week, increased caloric intake and increased consumption of fast food have a significant association with BMI.
Nutritional status and prevalence of anemia in rural adolescents
Authors: Ramalingam Ezhilarasu , Thirumalaikumarasamy Sivaraman , Nadesan Balakrishnan , Mooorthi Mani Madhavan Sachithanantha 
Published: May 2017

Background: In developing countries like India, the adolescents constituting one fourth of population are not given the due importance in terms of resource allocation on health care or research. Thus, painting a lopsided picture of adolescent’s health and nutritional status is not truly reflective of ground realities. The objective of this study was to assess the nutritional status of the adolescent community residing in rural block and the prevalence of anemia among these adolescents.Methods: The study was a community based cross sectional survey among adolescents of 10 to 19 years of both sexes, from October 2004 to March 2006. Nutritional status, hemoglobin and prevalence of anemia were observed.Results: Under nutrition was found to be a significant problem in both sexes of rural adolescents. Anemia was more common in female than in male in both school going and non-school going.Conclusions: The significant number of anemic is in the middle adolescent age group, could be explained by the fact that menarche is attained around 12 years and the first few cycles are irregular with increased blood loss. So, any policy towards low birth weight and neonatal mortality needs the policy makers to make a note of this alarming trend of anemia among adolescent girls.
Iron deficiency anaemia in young children (6 to 23 months) in relation to complementary feeding practices in rural Telangana, India
Authors: Sailaja K. , Reddy K. Venkataramana , Reddy K. Abhishek , Keerthi S. 
Published: May 2017

Background: Iron deficiency, is the most common micronutrient deficiency seen in all age groups throughout the world. Young infants are more vulnerable because of growing size and increased demand. Iron deficiency anaemia due to improper complementary feeding practices in young children, will affect growth, cognitive and immune functions of the growing child.Methods: A cross sectional study was conducted from 01-05-2016 to 01-02-2017, at the Department of Paediatrics, S. V. S. Medical College and Hospital, Mahabubnagar, Telangana, India. The study included 130 children attended to our well baby clinics. A questionnaire was filled by mothers after taking consent. Data was Collected data was analysed using statistical package SPSS software version-19. Chi-square test was carried to test the relation. P-Value < 0.05 was considered as significant.Results: Prolonged breast feeding, late weaning, parent’s educational status and socioeconomic status are found to significant (p value <0.05) risk factors in contributing to the development of iron deficiency anaemia.Conclusions: As young infants are more prone for iron deficiency anaemia in the later part of first year, implementation of proper complementary feeding practices as advised by Infant and Young Child Feeding practices are essential.
The result of treadmill test in asymptomatic type 2 diabetes mellitus
Authors: Joshi Anil Shrinivasrao , Lahane Chandrakant Gunaji , Kashid Akshay Arvind 
Published: May 2017

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">To study the prevalence of silent myocardial ischaemia in asymptomatic patients with type 2 DM</span>.</p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">The present study was conducted in the Govt. Medical College and Hospital Aurangabad. During December 2012 to November 2014 with 50 patients. It was two year cross sectional study with the patients of asymptomatic type 2 diabetes mellitus without clinical and electrocardiographic evidence of coronary artery disease. </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">12 (24%) out of 50 subjects had positive TMT. It correlated with years of duration of diabetes (9 positive TMT cases with duration of diabetes more than 10 years). 5 (25%) out of 20 had serum cholesterol levels &gt;240, Number of positive TMT were higher in patients with LDL &gt;160 [5 (25%) out of 20]</span>.</p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Diabetic patients are at very high risk for cardiovascular morbidity and mortality. Early detection of IHD is very important so that pharmacological therapy, which may improve outcome, can be established. Tread mill exercise TMT being a non-invasive test with high safety, has an important role in early detection of IHD. It is recommended that TMT should be a part of routine management in asymptomatic patients with type II DM. </span></p>
Comparative evaluation of efficacy of various probiotics on Streptococcus species
Authors: Chandak Shweta , Moon Ankita A. , Karale Shruti S. , Bharadwaj Amit 
Published: May 2017

<p class="abstract"><strong>Background:</strong> Probiotics which when administered in adequate amounts confer a health benefit on the host. The role of probiotics is the replacement of pathogenic species with non-pathogenic species. Dairy food like cheese, curd and milk are considered as useful vehicles to carry probiotic bacteria. Aim of the study was to compare and evaluate the efficacy of various probiotics against different Streptococcus species.</p><p class="abstract"><strong>Methods:</strong> Three probiotic products viz probiotic milk, probiotic yogurt and probiotic capsules were used. <em>Streptococcus</em> species i.e. <em>S. mutans, S. sanguinis</em> and <em>S. sobrinus</em> were isolated from the saliva of children with moderate to high caries. 0.2 ml of each probiotic product was transferred to the blood agar plates coated with <em>Streptococcus</em> species. </p><p class="abstract"><strong>Results:</strong> The zone of inhibition was observed in all the test groups, for all the <em>Streptococcus</em> species against all the probiotics, highest for <em>S. mutans</em> against probiotic milk. The growth of <em>S. mutans, S. sanguinis</em> and <em>S. sobrinus</em> was inhibited by <em>L. casei shirota</em> present in probiotic milk (Yakult), <em>Lactobacilli acidophilus</em> present in probiotic yogurt (Actiplus nestle) followed by <em>Lactobacilli rhamnosus</em> present in pre and probiotic capsule (Inlife).</p><p><strong>Conclusions:</strong> The use of probiotic products that are readily available and cost effective like milk and yogurt can be inculcated in general population especially in children as a preventive tool for dental caries. </p>
Evaluation of Craniofacial Morphology in Subjects with Down’s Syndrome: A Cephalometric Study
Authors: Subbaiah Pradeep 
Published: May 2017

<p><em><strong>D</strong>own’s syndrome is a disease entity in which the defect in mental development is associated in a unique way with a large number of physical defects. It is a condition resulting from an extra chromosome 21 and thus the condition is also known as Trisomy 21. It is considered one of the most frequent genetic causes of mental retardation.</em></p><p><em>The incidence of Down’s syndrome is estimated to be between 1.6 to 2.5 per 1000 live births and increases with increase in maternal age.<sup>4,59,10</sup> Mongoloids usually exhibit retarded motor and language skills, with an IQ range from extremely low to 45-55.</em></p><p><em>Cephalometry has now been firmly established as the most essential procedure for gaining knowledge of the complexities of dentofacial skeletal pattern. By utilizing cephalometric radiography, whereby description, morphologic outline, measurement and change in growth of the skull can be fairly accurately ascertained, it might be possible to observe some of the subtle</em></p><em>The present study is an attempt to determine cephalometrically whether the group of individuals with Down’s syndrome have a distinctive craniofacial phenotype. The growth of the craniofacial area in the presence of the extra chromosome is also examined.</em>
Solution to Avoid Power Crisis in Telangana State by Implanting Non Convectional Energy
Authors: Dilawar Mohammed , Hussain Mohammed Arif , Khan Mohammed Akram Ullah 
Published: May 2017

<div><p><em>Perennial Efforts to combat power crises in newly found Telangana state, compelled to use hybrid source of power which is being catered to facilitate the needs of modern trends, life style, multinational business requirements which enforced the need to explore the modern application of solar energy run household and administrative block. Air conditioning requirement, which consumes more than 30% of the state procured power from different sources, which can be save and utilize for agriculture sector and other constructive needs.</em></p><p><em> In Telangana State every commercial, administrative and elite residential block is equipped with air conditioning system where the temperature ranges between 32-43<sup>0</sup>C in summer season. Telangana State is attracting the world class business investors. This design can caters the world class needs therefore this paper explore the design and performance of solar power air-conditioning system, which is integrated with invertors, PV panels, solar charger and batteries. This design can be used in non-electrified rural arid areas to avoid the expenses of supplying electricity.</em></p><p><em> This research project begins with the cooling load calculations for the selected space ideally whose dimensions are assumed to be one tone of refrigeration (3.5kW). Considering the basic parameters of cooling the photovoltaic cells has been deduced and necessary connections are arranged. </em></p><p><em> To acquire the inlet and outlet temperatures of compressor, evaporator and condenser, data logging procedure is employed. The input power for this system as well as coefficient of performance for above said climatic conditions can be deduced. The COP varies from two to four for this system and these results are compared with the convectional system performance they both match with each other considerably.</em></p></div>
Changes in river flood hazard in Europe: a review
Authors: Kundzewicz Zbigniew W. , Pińskwar Iwona , Brakenridge G. Robert 
Published: May 2017

Abstract
Despite costly flood risk reduction efforts, material damage and death toll caused by river floods continue to be high in Europe. In the present review paper, after outlining a process-based perspective, we examine observed and projected changes in flood hazard. Spatial and temporal variability of large floods is analyzed, based on a time series of flood information, collected by the Dartmouth Flood Observatory in 1985–2016. Model-based projections of future flood hazard are critically reviewed. It is difficult to disentangle the climatic change component from strong natural variability and direct human impacts. The climate change impact on flood hazard is complex and depends on the river flood generation mechanism. It has not been possible to detect ubiquitous changes in flood characteristics in observation records in Europe, so far. However, we found an increasing tendency in the number of floods with large magnitude and severity, even if year-to-year variability is strong. There is a considerable spread of river flood hazard projections in Europe among studies, carried out under different assumptions. Therefore, caution must be exerted by practitioners in charge of climate change adaptation, flood risk reduction, risk insurance, and water resources management when accommodating information on flood hazard projections, under considerable uncertainty.
Two phosphAte taRGets in End-stage renal disease Trial (TARGET): A Randomized Controlled Trial
Authors: Wald Ron , Rabbat Christian G. , Girard Louis , Garg Amit X. , Tennankore Karthik , Tyrwhitt Jessica , Smyth Andrew , Rathe-Skafel Andrea , Gao Peggy , Mazzetti Andrea , Bosch Jackie , Yan Andrew T. , Parfrey Patrick , Manns Braden J. , Walsh Michael 
Published: May 2017

Background and objectives
Hyperphosphatemia is common among recipients of maintenance dialysis and is associated with a higher risk of mortality and cardiovascular events. A large randomized trial is needed to determine whether lowering phosphate concentrations with binders improves patient-important outcomes. To inform such an effort we conducted a pilot randomized controlled trial.

Design, setting, participants, & measurements
We conducted a randomized controlled trial of prevalent hemodialysis recipients already receiving calcium carbonate as a phosphate binder at five Canadian centers between March 31, 2014 and October 2, 2014. Participants were randomly allocated to 26 weeks of an intensive phosphate goal of 2.33–4.66 mg/dl (0.75–1.50 mmol/L) or a liberalized target of 6.20–7.75 mg/dl (2.00–2.50 mmol/L) by titrating calcium carbonate using a dosing nomogram. The primary outcome was the difference in the change in serum phosphate from randomization to 26 weeks.

Results
Fifty-three participants were randomized to the intensive group and 51 to the liberalized group. The median (interquartile range) daily dose of elemental calcium at 26 weeks was 1800 (1275–3000) mg in the intensive group, and 0 (0–500) mg in the liberalized group. The mean (SD) serum phosphate at 26 weeks was 4.53 (1.12) mg/dl (1.46 [0.36] mmol/L) in the intensive group and 6.05 (1.40) mg/dl (1.95 [0.45] mmol/L) in the liberalized group. Phosphate concentration in the intensive group declined by 1.24 (95% confidence interval, 0.75 to 1.74) mg/dl (0.40 [95% confidence interval, 0.24 to 0.56] mmol/L) compared with the liberalized group. There were no statistically significant differences between the two groups in the risk of hypercalcemia, hypocalcemia, parathyroidectomy, or major vascular events.

Conclusions
It is feasible to achieve and maintain a difference in serum phosphate concentrations in hemodialysis recipients by titrating calcium carbonate. A large trial is needed to determine if targeting a lower serum phosphate concentration improves patient-important outcomes.
Risk of Severe Hypoglycemia in Type 1 Diabetes Over 30 Years of Follow-up in the DCCT/EDIC Study
Authors: Gubitosi-Klug Rose A. , Braffett Barbara H. , White Neil H. , Sherwin Robert S. , Service F. John , Lachin John M. , Tamborlane William V. ,   the Diabetes Control and Complications Trial (DCCT)/Epidemiology of Diabetes Interventions and Complications (EDIC) Research Group
Published: May 2017

OBJECTIVE
During the Diabetes Control and Complications Trial (DCCT), intensive diabetes therapy achieving a mean HbA1c of ∼7% was associated with a threefold increase in the rate of severe hypoglycemia (defined as requiring assistance) compared with conventional diabetes therapy with a mean HbA1c of 9% (61.2 vs. 18.7 per 100 patient-years). After ∼30 years of follow-up, we investigated the rates of severe hypoglycemia in the DCCT/Epidemiology of Diabetes Inverventions and Complications (EDIC) cohort.

RESEARCH DESIGN AND METHODS
Rates of severe hypoglycemia were reported quarterly during DCCT and annually during EDIC (i.e., patient recall of episodes in the preceding 3 months). Risk factors influencing the rate of severe hypoglycemia over time were investigated.

RESULTS
One-half of the DCCT/EDIC cohort reported episodes of severe hypoglycemia. During EDIC, rates of severe hypoglycemia fell in the former DCCT intensive treatment group but rose in the former conventional treatment group, resulting in similar rates (40.8 vs. 36.6 episodes per 100 patient-years, respectively) with a relative risk of 1.12 (95% CI 0.91–1.37). A preceding episode of severe hypoglycemia was the most powerful predictor of subsequent episodes. Entry into the DCCT study as an adolescent was associated with an increased risk of severe hypoglycemia, whereas insulin pump use was associated with a lower risk. Severe hypoglycemia rates increased with lower HbA1c similarly among participants in both treatment groups.

CONCLUSIONS
Rates of severe hypoglycemia have equilibrated over time between the two DCCT/EDIC treatment groups in association with advancing duration of diabetes and similar HbA1c levels. Severe hypoglycemia persists and remains a challenge for patients with type 1 diabetes across their life span.