bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of A Single Dose of Epidural Morphine for Postpartum Perineal Pain: A Randomized Controlled Trial
Authors: Mao Mao , Wang Zhaohui , Li Caijuan , Wang Nan , Feng Shanwu , Xu Shiqin , Shen Xiaofeng , Wang Xian 
Published: June 2017

OBJECTIVE
The purpose of this study was to identify the effectiveness of a single dose of epidural morphine for postpartum perineal pain, and the incidence of side effects.

MATERIALS AND METHODS
After institutional review board approval and patient consent, a total of 200 parturients with perineal trauma undergoing epidural analgesia were randomized into three groups: C, M1, and M2, wherein sole saline 10ml, morphine 1mg dissolved in saline 10ml, or morphine 2mg dissolved in saline 10ml was epidurally given immediately after umbilical cord clamp, respectively. Within 24 hours after vaginal delivery, perineal pain at rest and movement evaluated with present pain intensity (PPI) as well as the time to the first request for additional analgesia were recorded. Besides, epidural morphine related side effects including nausea, vomiting, pruritus, and urinary retention were observed as well.

RESULTS
The proportion of women with moderate and severe pain at rest was significantly lower in groups M1 and M2 compared to group C (4.5 & 0% vs. 20.6%, respectively). Meanwhile, the proportion of women with moderate and severe pain at movement was al-so significantly lower in groups M1 and M2 compared to group C (10.4 & 12.3% vs. 55.9%, respectively). Further, the proportion of women who require for additional analgesics in the first 24 hours after vaginal delivery in groups M1 and M2 was lower compared with group C (9.0 & 7.7% vs. 52.9%, respectively). The average time to first request for additional analgesia after delivery was prominently longer in groups M1 and M2 compared to group C (12.79±5.49 & 15.61±4.90 h vs. 7.17±3.84 h, respectively). No significant difference was found between groups M1 and M2 with regard to morphine efficacy. However, epidural morphine 2mg remarkably increased the incidence of nausea, vomiting, and pruritus compared to sole saline (P<0.05), and the incidence of nausea and pruritus compared to morphine 1mg (P<0.05).

CONCLUSIONS
Epidural morphine 1mg could decrease the proportion of moderate-severe PPI pain, prolong the time to first request for additional analgesia, and have fewer side effects.
The effects of alcohol expectancy and intake on slot machine gambling behavior
Authors: Sagoe Dominic , Mentzoni Rune Aune , Leino Tony , Molde Helge , Haga Sondre , Gjernes Mikjel Fredericson , Hanss Daniel , Pallesen Ståle 
Published: June 2017

Background and aims
Although alcohol intake and gambling often co-occur in related venues, there is conflicting evidence regarding the effects of alcohol expectancy and intake on gambling behavior. We therefore conducted an experimental investigation of the effects of alcohol expectancy and intake on slot machine gambling behavior.

Methods
Participants were 184 (females = 94) individuals [age range: 18–40 (mean = 21.9) years] randomized to four independent conditions differing in information/expectancy about beverage (told they received either alcohol or placebo) and beverage intake [actually ingesting low (target blood alcohol concentration [BAC] < 0.40 mg/L) vs. moderate (target BAC > 0.40 mg/L; ≈0.80 mg/L) amounts of alcohol]. All participants completed self-report questionnaires assessing demographic variables, subjective intoxication, alcohol effects (stimulant and sedative), and gambling factors (behavior and problems, evaluation, and beliefs). Participants also gambled on a simulated slot machine.

Results
A significant main effect of beverage intake on subjective intoxication and alcohol effects was detected as expected. No significant main or interaction effects were detected for number of gambling sessions, bet size and variation, remaining credits at termination, reaction time, and game evaluation.

Conclusion
Alcohol expectancy and intake do not affect gambling persistence, dissipation of funds, reaction time, or gambling enjoyment.
A comprehensive study on the incidence and management of incisional hernia
Authors: Malviya Ajay , Patel Arvind , Bhardwaj Girish , Bulchandani Hitesh P. , Saini Vivek 
Published: June 2017

Background: Incisional hernia is a frequent complication of abdominal surgery. The reported incidence of incisional hernia following abdominal surgery ranges from 2-20%. It may be caused by flawed operative techniques, by postoperative complications such as wound infection, by increased abdominal wall tension or by a metabolic connective tissue disorder.Methods: The present study was conducted on patients of incisional hernias admitted in various surgical wards of the department of surgery, associated group of hospitals attached to Dr. Sampurnanand Medical College, Jodhpur over a period of 10 years extending from 2005 to 2015. Detailed history and clinical examination of all patients were obtained from the case sheets. Other risk factors like obesity, hypertension, diabetes mellitus and malignant disease were recorded. Routine investigations were also documented. Patients were closely monitored in pre, intra and post-operative periods. The data collected were systemically recorded and statistically analysed.Results: Maximum incidence (67.21%) of incisional hernia seen in 31-60years of age and mean age was 48.54years with twice common in female sex. Abdominal swelling was the commonest (90.57%) presenting symptom. 80% of patients present within 1 year. Of previous surgery, 50% of them were gynaecological. Midline vertical incision (70%) was most notorious to develop in incisional hernia. Wound infection (50%) was major risk factor. Mesh repair (laproscopic 3.68% & open 92%) was the procedure of choice.Conclusions: Incisional hernia is twice common in women than in men with gynaecological procedures mainly caesarean section contributing for half of the cases of incisional hernias. It more frequently develops in vertical midline incision and post-operative wound infection is the most important predisposing factor. Incisional hernia usually appears within 1 year of previous operation. Mesh repair of incisional hernia has of late become popular amongst surgeons.
Early gallbladder carcinoma with cholelithiasis: a rare case report
Authors: A. C. Senthil Kumar , S. Balamurali , S. Reshma 
Published: June 2017

Gall bladder carcinoma is an exceedingly rare and fatal cancer with a high mortality rate. Detecting gall bladder carcinoma in early stages can be difficult, despite improvements in ultrasound and computed tomography (CT) imaging. Most diagnoses of gallbladder carcinoma are made at advanced stages, with majority being found incidentally during surgery for cholelithiasis. The presented case demonstrates suspicion of Gallbladder carcinoma pre-operatively.
Multiple epidermal cysts of the scrotum: a rare case report
Authors: N. N. T. Yeshwant Kumar , S. Reshma , S. Deivanayagam 
Published: June 2017

Multiple epidermal cysts over the scrotum is a rare condition and requires surgical intervention if infected or cosmetically unacceptable. Grossly enlarged cysts require complete excision, followed by scrotoplasty. We are reporting a case of multiple epidermal cysts on the scrotum. Complete excision of the cysts followed by scrotoplasty was done in this case.
Challenges of care givers of children with cerebral palsy in a developing country
Authors: Eyong Komomo Ibor , E. Ekanem Emmanuel , A. Asindi Asindi 
Published: June 2017

Background: The role of caregiving takes on an entirely different significance when a child experiences functional limitations and possible long-term dependence. The main challenges for parents of children with disabilities are their ability to cope with their children's chronic health problems and effectively carry on with daily requirements of everyday living. The aim of this study is to evaluate the challenges parents encounter in caring for children with cerebral palsy in a developing country.Methods: Consenting parents of children with cerebral palsy presenting in the neurology clinic of the University of Calabar Teaching Hospital, Calabar, south-south Nigeria were recruited for the study. The bio data of the parents were obtained. The challenges encountered by parents of children with cerebral palsy were determined using a semi structured questionnaire.Results: Seventy parents of children with cerebral palsy were recruited into the study. Majority of the subjects (61.4%) are from the low socio economic while the least represented was the high socioeconomic class. Sixty-four (91.4%) of the parents worry about the handicap and comorbidities of cerebral palsy. Similarly, 91.4% of parents admitted that their social life has been adversely affected by caring for these children. Also, more than half of the parents find it difficult to cope with their jobs or businesses and have their resources depleted. Family disharmony was found in over 40% of the parents. The task of caring for children with cerebral palsy is a daunting one as its negative impact on family, social and family resources are enormous especially in resource poor countries with little or no social support system. Parents caring for children with disabilities therefore need assistance and respite care to alleviate these challenges, since rehabilitation services are limited in most African countries, it has been suggested that community-based and outreach services are provided in order to decrease the burden of care.Conclusions: Effort should therefore be geared toward prevention. The provision of a social support system and rehabilitation centres at subsidized rates will significantly ease the burden encountered by these parents.
Profile of medico-legal cases registered at a tertiary care children’s hospital
Authors: Mina Shyam Sundar , Basu Srikanta , Kumar Virendra , Mina Deepika 
Published: June 2017

Background: The aim of this study was to analyse the patterns, social factors and the clinical outcomes of medico legal cases in Delhi.Methods: In this study, 238 medico-legal cases were studied at tertiary care centre.Results: Out of 238 cases studied, 188(79%) were males and 58 (21%) were females and a majority of these cases were from the urban slum areas (53.78%). Majority of the medico-legal cases were due to routine medical examination for fitness of abandoned children’s (26.89%) followed by poisoning (23.10%), trauma (16%), road traffic accident (8%), assault (13.33%). Most of the MLC cases were reported in casualty within 1 hour through PCR police. In this majority of the MLC cases were discharged after treatment (78.99%) and 2 children (4.72%) expired.Conclusions: This study shows the prevalence of medico-legal cases in a tertiary care hospital. Majority of the cases were males and adolescents. There is an urgent need to focus more on this vulnerable age group. Moreover, there is a need of awareness on the part of treating pediatricians about these medico legal cases and to handle the victims empathetically and at the same time follow the legal procedures diligently as per the law of the land.
Prevalence of anaemia and visual impairment among primary school children of Ahmedabad City, Gujarat: a cross sectional study
Authors: Gunjana Geet , Upadhyay Nisha , Dixit Grishma , Thakor Nilesh 
Published: June 2017

Background: Nutritional anemia and visual impairment among school age children are recognized as public health problem worldwide. The objective of the study was to prevalence of anemia and visual impairment among school going adolescents of Ahmedabad city, Gujarat.Methods: This cross-sectional study was carried during period from January 2012 to March 2012. 4 schools were selected by purposive sampling. After taking the permission from principals of schools and informed written consent of the parents of the children, 421 children from these schools of Ahmedabad city were examined for anemia and visual impairment. The data was collected by predesigned, pretested performa and analyzed using Epi Info.Results: Out of total 421 children 205 (48.7%) were female. Mean age of the study children was 7.9 ± 1.06 years. The prevalence of anemia in children in present study was 61.9 % (261 children). The prevalence of anemia in female (134, 62.9%) was higher than males (130, 60.1%). Moderate to severe visual impairment and blindness was 7.2% in girls and 10.5% in boys respectively and the gender difference was not statistically significant. Though 38 (8.9%) children had moderate to severe visual impairment to blindness only 10 (2.3%) children were wearing spectacles.Conclusions: High prevalence of anemia and visual impairment among these children needs great attention and health education.
A clinical study to determine the relationship between serum vitamin D levels and severity of asthma
Authors: Kumar Pragalatha , Gowdra Aruna , Arathi Arathi , Sampath Ananya 
Published: June 2017

Background: Vitamin D deficiency has been rediscovered as a public health problem worldwide. Few studies have shown that vitamin D deficiency is associated with asthma severity. The objective of present work was to study the serum vitamin D levels and its relationship with asthma severity in children.Methods: A prospective cohort study of 100 children with asthma between the age group of 5 to 15 years and age and sex matched 40 healthy controls who had come to Indira Gandhi Institute of Child Health, Bengaluru was done. These children’s serum vitamin D levels were estimated and correlated with asthma severity.Results: A total of 100 children with asthma and 40 healthy age and sex matched controls were evaluated. The study group had lower vitamin D (34.95 ng/ml) levels as compared to the control group (57.94 ng/ml) which was statistically significant (p<0.05). 68.4% children had significantly low vitamin D levels and severe form of asthma (p value <0.001). There was also a marked rise in absolute eosinophil count in those who had low vitamin D levels (56.6%) (p-value <0.0001).Conclusions: Vitamin D deficiency is an important risk factor for asthma severity. It modifies the immune system and reduces the inflammation. In the present study, low serum vitamin D levels were significantly correlated with severe form of asthma. There was a significant rise in the absolute eosinophil count in those who exhibited deficiency of vitamin D.
Study of serum electrolytes with different clinical co-morbidities in complicated severe acute malnutrition children aged 6 months to 5 years
Authors: Meena Suresh K. , Suman Rameshwar L. , Jain Rupali , Meena Pradeep 
Published: June 2017

Background: Severe acute malnutrition (SAM) is one of the most common health problem. SAM children are more prone to severe infections that culminates into different co-morbid conditions and consequentially leads to electrolyte derangements. Hence this study aims to find out the incidence of dyselectrolytemia (Na+ and K+) in malnourished children with different clinical co-morbid conditions.Methods: It was a hospital based prospective, case-control study conducted on 100 children of complicated as study group and 50 children of uncomplicated SAM as control group, over a period of six months in year 2016. The children included as per WHO reference criteria of SAM in 6 months to 5-years age group. All the enrolled children were assessed with detailed clinical examination according to different co-morbidities, including anthropometry and routine investigations along with serum electrolytes (Na+ and K+) and chest x-ray.Results: In our study, out of 100 complicated SAM children, dyselectrolytemia was present in 94.0% children. The SAM children with most co-morbidities had subnormal sodium ranging from 128-135 mEq/L while potassium was normal ranging from 3.68-4.34 mEq/L at the time of admission. We observed that mean sodium level was 131.82±6.66 mEq/L while mean potassium level was 4.17±1.03 mEq/L in complicated SAM children. In control group children mean sodium level was 135.90±4.26 mEq/L while mean potassium level was 4.14±1.11 mEq/L.Conclusions: To conclude that dyselectrolytemia is high in complicated SAM and it is mainly sodium disturbances in the form of hyponatremia in different co-morbid conditions. Hence, we recommend that due care is to be given for management of dyselectrolytemia in complicated SAM children.
Influencers of childhood over nutrition: a cross sectional study among primary school children in Kolkata, West Bengal, India
Authors: Dasgupta Aparajita , Bhattacharyya Aritra , Paul Bobby , Bandyopadhyay Lina 
Published: June 2017

Background: Changing trends of dietary habits and lack of physical exercise force the world to face a modern era epidemic obesity which also affects our children counterpart. Childhood obesity is now a challenge of public health to combat with. Prevalence of childhood overnutrition (obesity and overweight) found to be rising in many developing countries including India in recent decades in many studies by different researchers, it is ranging from 2.9% to 14.3%, which makes our youth vulnerable to many life-threatening consequences.Methods: It was a school based cross sectional study done in primary schools of Barasat among 548 students of 3-11 years of age group. Parental perception towards child eating behaviour were assessed with the help of CEBQ questionnaire.Results: Among the total 548 students, as per BMI 38% were overweight and obese. Then hierarchical multiple logistic regression revealed that at Step one socio-demographic factors accounted for 16.9% of the variation in overnutrition status. Introducing the responses on selected life style factors in step two and CEBQ responses in final step explained an additional 9.9% and 5% of variation respectively. At all three-level model correctly predicted 62-70.3% of the dependent variables.Conclusions: The high proportion of over nourished children were found in our study, and this found to be related with parental perception about few lifestyle and child eating behaviour which calls for further research and interventional programme for this alarming topic in this age group.
Prevalence of metabolic comorbidities in obese children
Authors: Jacob Ambili Susan , G. Reetha 
Published: June 2017

Background: Obesity has been defined as an excess of body weight due to chronic caloric imbalance with more calories consumed than expended each day. Objective of present study was to determine the prevalence of metabolic co morbidities in obese children in our local populationMethods: Hospital based cross-sectional study conducted in the endocrinology clinic of a tertiary care hospital for a period of 1 year. Obese children attending the clinic during the study period were included. Their clinical and metabolic parameters including hypertension, lipid profile, diabetes and thyroid status were evaluated.Results: A total of 65 children were included in the final analysis. Dyslipidemia was seen in 63% of the study subjects with high LDL cholesterol being the most frequent lipid abnormality.Conclusions: The prevalence of dyslipidemia among obese children in our population was similar to that in other parts of the country, though we got a higher prevalence of LDL cholesterol.
Comparison of various methods of temperature measurement in children admitted in the pediatric ward of a tertiary care center
Authors: Varadarajan Poovazhagi , Muthaiyan Jayakumar , Jayachandran Ganesh , Sankaran Anupama , Sankaran Suresh Kumar 
Published: June 2017

Background: Temperature measurement is an important procedure in the diagnosis and management of childhood illness. Rectal measurement of temperature is often done with resentment from the child, the parents as well as the physician. Intra aural (Tympanic), temporal artery and axillary measurements are commonly undertaken for temperature recording in children. The aim of the study was to compare the various methods of temperature measurement (intra aural, temporal artery and axillary measurements) in children. This was a hospital based descriptive study (pilot study) from a pediatric tertiary care center.Methods: This was a hospital based descriptive study (pilot study) from a pediatric tertiary care center. 250 children admitted with history of fever in the pediatric ward. All consecutive children with fever were recruited for the study. Children with ear pain, ear discharge and wax in the ear were excluded.Results: Inter-group comparison was performed using student paired t-test. There was no difference in the temperature measured by axillary and temporal artery touch when compared with intra aural. Temperature measured by infra-red temporal at 3 cm showed significant lower temperature. Temporal artery and axillary measurements had a correlation coefficient of 0.74 and 0.64 respectively when compared with intra aural measurement.Conclusions: Temporal artery and axillary measurements are not significantly different from intra aural measurement in children. For the ease of measurement, better correlation, better compliance of the child, temporal artery method can be a reliable preferred temperature measurement in children with fever.
Evaluation of prevalence, clinical spectrum and outcome of acute ITP in children in a tertiary care centre in Odisha, India
Authors: Champatiray Jyotiranjan , Behera Deepak Kumar , Krishnamoorthy Akhil , Bhat Shreesh 
Published: June 2017

Background: Idiopathic thrombocytopenic purpura (ITP), also known as immune thrombocytopenic purpura is one of the commonest bleeding disorders encountered in children between the ages of 2 to 10 years affecting both sexes. The objectives of the study were to collect the prospectively data including age, gender, bleeding type, platelet count and other laboratory tests, treatments, responses to treatment and outcomes in children with acute ITP from 1month to 14 years of age over a period of two years.Methods: The present study was conducted in the Department of Paediatrics Shrirama Chandra Bhanj, Medical College and Hospital and Sardar Vallabhbhai Patel Post Graduate Institute of Paediatrics, Cuttack during the period October 2011-Septmber 2013.Results: Total 36 cases of hospitalized acute ITP patients were studied out of 29200 cases. Prevalence of acute ITP was found to be 12.3 per 10,000 of all hospitalized children above 1 month. Male children outnumbered female children by Ratio 1.2. Past history of URTI was present in 78% of cases. Petechaie/purpura was the universal presenting features followed by Oral / Gum bleeding in 67% of cases. 8% of patient experienced clinical bleeding requiring blood transfusion and platelet transfusion. Mean duration of Hospital stay was 6.34 days. Maximum number of Patients (69%) had complete recovery and 14% each had persistent and chronic course.Conclusions: ITP is a common pediatrics disease presenting at any age with low morbidity and mortality. Most children with acute ITP recover in weeks to months. A long-term hospital based prospective study is suggested to know any significant risk factor in patient presenting with acute ITP.