bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neurological soft signs in autism spectrum disorder
Authors: Malviya Juhi Anil , Gawande Sushil , Faye Abhijeet , Kirpekar Vivek , Bhave Sudhir , Tadke Rahul 
Published: April 2022

Autism spectrum disorder (ASD) is a phenotypically heterogeneous group of neurodevelopemental syndromes characterized by impairments in social communication and restricted & repetitive behavior. Neurological soft signs (NSS) are minor neurological abnormalities that aren’t a part of any fixed/transient neurological disorders. The most common NSS in ASD are motor incoordination, difficulty sequencing motor tasks & sensory disintegration.22 participants of ASD satisfying the inclusion and exclusion criteria were assessed for NSS, using a semi structured performa & Heidelberg manual for neurological soft signs. The data was tabulated and analysed statistically.The mean age of the participants was 11.63 years with 82% males & 18% females. 100% participants had dysdiadochokinesia (82% -adiadochokinesia), errors in the finger-nose test(71% unable to perform), right-left confusion (39% -making gross errors), difficulty in tandem walking(70% -significant balance problems), difficulty in fist-edge-palm (54% unable to complete task) & ozeretski test (78%- unable to perform). 94% had difficulty in pronation-supination (56%-failed to complete exercise).89% of the participants had difficulty in finger –thumb opposition (63%- unable do it).NSS are present in a significant amount of patients of ASD & such patients should be assessed for the full spectrum of NSS.
Evaluation of serum Vitamin D level in Vitamin D supplemented 9 to 12 months old children in a tertiary care hospital
Authors: Saha Sudip , Mondal Tanmay , Saha Pradip 
Published: April 2022

Vitamin D deficiency has emerged as a significant public health problem throughout the world. Even in the Indian context, it has been reported to be present in majority of children in spite of wide availability of sunlight. Our objective was to evaluateSerum Vitamin D Level in Vitamin D Supplemented 9 to 12 Months Old Children in a Tertiary Care Hospital. A cross sectional study was conducted in the patients aged 9 months to 12 months attending Out Patient Department and Ward of Tertiary care mother and child hospital, Department. of Paediatrics between April, 2019 to March, 2020.Blood sample was collected and analysed by the Electrochemiluminescence Immunoassay (ECLIA) with the help of HITACHI Elecsys Cobas E411 to estimate 25-OH-D level after getting proper consent. The study done among 100 Vitamin D Supplemented 9 to 12 Months Old Children in a Tertiary Care Hospital resulted standard error 0.0952 and standard deviation 0. 9522. The children who had regularly taken vitamin D3 at 400IU/day since birth showed minimum vitamin D3 level at 22.34ng/ml and maximum vitamin D3 level found is 98.18ng/ml with a mean value of 40.67ng/ml that is sufficient. In our study we have found that if children are given vitamin D3 regularly since birth at 400IU/day the attain desired serum vitamin D3 level irrespective of the brand/preparation.
Renal functions in term neonates with weight loss of more than 10% in early neonatal period - A cross sectional study
Authors: Edbor Anjali , Dua Himanshu 
Published: April 2022

Normally neonates lose 5-7% of their birth weight in the first week of life. Inadequate breastfeeding resulting from different factors may result in dehydration and excessive weight loss. Hypernatremic dehydration leading to acute kidney injury (AKI) is a well-known complication of lactational insufficiency in exclusively breast-fed babies progresses from pre-renal to intrinsic renal injury, if persistent. Acute kidney injury (AKI) is a complex disorder which has a clinical manifestations ranging from mild dysfunction to complete anuric kidney failure.To evaluate renal function tests (RFT) in term neonates with more than 10% weight loss within 7 days of life.To determine the frequency of acute kidney injury in term neonates with more than 10% weight loss within 7 days of life.1:To determine type of acute kidney injury (Prerenal, Renal); 2: Assess the percentage of dehydration in terms of percentage of weight loss (more than 10%, more than 15%); 3: Assess type of dehydration (hypernatremic, isonatremic, hyponatremic); 4: To assess type of dehydration with acute kidney injury.A hospital based prospective study was conducted on term neonates in a tertiary care hospital for period of 12 months from July 2019 to June 2020. Daily weight of all the neonates was recorded using electronic weighing machine. 103 new-borns presenting with weight loss of more than 10 % of birth weight within 7 days of life were enrolled as per convenient sampling technique without any bias. Neonates with congenital anomalies of kidney, sepsis, birth asphyxia and diabetes insipidus were excluded. Neonates were assessed by performing renal function test as a marker of dehydration. One hundred and three neonates with weight loss of more than 10% were enrolled in the study. Among them, 88 (85.4%) had prerenal AKI and 15 (14.5%) had renal AKI; 68(66%) neonates had dehydration of 10-15% while, 35 (34%) had dehydration of more than 15%. Most of the neonates 75(73.4%) had hypernatremic dehydration while 25(25%) and 3(1.5%) had isonatremic and hyponatremic dehydration respectively. 69, 16 and 3 neonates with prerenal AKI had Hypernatremia, isonatremia and hyponatremia respectively while 5 and 9 neonates with renal AKI had Hypernatremia and isonatremia respectively. None of the neonate had renal AKI with hyponatremia.: Hypernatremia is severe enough to cause prerenal AKI progressing to renal AKI in exclusively breast-fed babies without any associated comorbidities. Training of mothers, care givers and doctors and weight monitoring of breast-fed babies to identify at risk neonates is important in early diagnosis.
Elevated high sensitivity c-reactive protein in patients with subclinical hypothyroidism: A case control study
Authors: Dasmohapatra Deepak Kumar , Panda Anuradha , Dash Aditya Narayan , Ekka Babita 
Published: April 2022

Inflammation in subclinical Hypothyroidism (SCH) imposes a significant cardiovascular risk. The aim of the present study was to assess the elevated levels of high sensitivity C-reactive protein (hs-CRP) in SCH patients. In this study, 50 cases of SCH and 50 cases of euthyroid were selected. The complete history of the subjects were taken and demographic , biochemical parameters like age, BMI, thyroid profiles, lipid profiles and hsCRP were estimated. The mean TSH levels were significantly (p&#60;0.05) elevated in SCH cases as that of the controls (8.56± 1.76 vs 2.28± 0.65 μU/ml). Further, hs-CRP level was significantly (p&#60;0.05) higher in SCH cases as that of the controls (2.93 ±0.87 vs 1.16 ±0.45 mg/l). Meanwhile, lipid profiles were also elevated in SCH cases as that of the controls. Coefficient correlation analysis showed significant association between TSH and hs-CRP. Thus, increased level of hs-CRP in SCH highlights the inflammatory status and thus associated with the development of cardiovascular diseases in SCH.
Factors affecting long term outcome in acute cervical spinal cord injury
Authors: Rajamohan B. , Rao P. Narasinga 
Published: April 2022

Spinal cord injuries are most commonly caused by motor vehicle accidents. The next frequent causes are falls and acts of violence, Sports-related spinal cord injuries. Drastic reduction in the mortality & morbidity was noticed with the better management of pressure sores, urinary tract infections and respiratory problems with the advent of modern rehabilitative methods. To study clinical factors affecting long term outcome in acute cervical spinal cord injury patients,A 2-year study Conducted between 2015-2017, 33 patients with acute cervical SCI were included in the study, admitted in the department of Neurosurgery, Osmania General Hospital.Maximum number of patients were in ASIA grade B 11/33 (33.33%), Neurological improvement-All patients improved in ASIA grade ‘D' and none in ASIA grade 'A'. Percentage improvement in cord edema group was 52% and contusion group was 0%. Percentage of improvement in less than forty years age group was 45%: and more than forty years age group was 46.1%. Percentage of improvement in early surgery group was 60% and in the late surgery group was 33.33%.Functional improvement in transfer, self-care and mobility was seen maximum in ASIA grade C. Amongst them, the 'transfers' function scored the maximum.
Parental beliefs and practices in childhood asthma – A hospital based cross-sectional study
Authors: Panda Abinash , Panda Sadhana 
Published: April 2022

Childhood asthma represents a significant burden, not only in terms of morbidity and reduced quality of life but also in terms of healthcare costs, as reflected by the high rates of unscheduled emergency department visits, hospitalization, and school absenteeism. Parents play a key link in asthma management and adherence to treatment regimen in the early years of childhood before children can manage their asthma independently. However, some parents have misconceptions regarding asthma and its medication, which could in turn influence children’s control of asthma.To find out the effect of parental beliefs and practices with respect to their knowledge about etiology, folk beliefs, home remedies, alternative therapies, etiology and pharmacotherapy in childhood asthma influence the pharmacotherapy and outcome of asthma management.The hospital based cross sectional study was carried out on a convenience sample of 82 parents of children, 5-14 years of age and clinically diagnosed with asthma of any form in the Department of Pediatrics, F.M. Medical College & Hospital, a tertiary care teaching hospital in Balasore town in the eastern part of India. The parents’ beliefs and practices were captured with the help of a pre-designed and validated questionnaire. Descriptive analytical statictics was used to analyse the demographic data. Chi square test was used to find out the association of beliefs, use of home remedies, folk beliefs and alternative therapies and the use of prescribed asthma medications as per standard reference. GraphPad Prism free trial version 7.0 was used for statistical analysis. Statistical significance was taken at a level of p ≤ 0.05.Majority of the children were in the age group of 10-14 years with a male predominance. Most of the primary care givers less than 40 years age and literate, 30 (36.6%) having more than two children and a family history of asthma. The common beliefs were that asthma was chest allergy, of hereditary origin. Exposure to dust, indoor smoke believed to be a significant potential triggering factor for asthma attack The participants (68.2%) believed that inhaled steroids had more side effects lead to dependency also believed using inhaler only when serious. Domiciliary treatment was preferred. 𝛽-agonist were the commonest medications.Parental beliefs and practices have a predominant role in the management of asthma in children. In order to enhance the level of perceptions among caregivers, education should include knowledge about asthma and its management, as there might be misperceptions about the use of inhalers and the safety of inhaled corticosteroids.
Hyperprolactinemia in patients with high TSH levels with both clinical and subclinical hypothyroidism
Authors: Sahu Jyotindra Kumar , Ravikant M , Thakur Amar Singh 
Published: April 2022

Hyperprolactinemia is the most common endocrine disorder involving hypothalamic–pituitary axis. This results from multiple causes such as medications, hypothyroidism, and pituitary disorders. Hyperprolactinemia and hypothyroidism are closely interrelated conditions. The present study aimed to estimate serum prolactin levels and determine the prevalence of hyperprolactinemia in newly diagnosed subclinical and clinical hypothyroid patients and correlation between TSH and prolactin levels in subclinical and clinical hypothyroid patients.This study was conducted in the Department of Biochemistry, in collaboration with Department of Medicine, Department of Obstetrics and Gynecology, LATE BRKM Government Medical College, Jagdalpur, Chhattisgarh, India. Total of 138 patients presenting to Department of Medicine for various thyroid related problems were involved in this study. The newly diagnosed cases of primary hypothyroidism were included in this study. The demographic, physical and clinical history was taken from all the study subjects. In the present study, serum prolactin levels were significantly increased in subclinical (28.7 ± 6.4 ng/mL) and clinical hypothyroidism (15.02 ± 4.2ng/mL) compared to controls. Hyperprolactinemia was observed in 11 (22.9%) patients in subclinical hypothyroidism and 4 (8.3%) in clinical hypothyroid patients. In the subclinical hypothyroidism and clinical hypothyroidism, the serum TSH levels were (17.01 ± 8.2 μU/l, 7.3 ± 2.0 μU/l respectively) significantly increased than the controls. In the clinical hypothyroidism and subclinical hypothyroidism, the serum free T3 (fT3) levels were (5.6 ± 0.68 pmol/l, 2.54 ± 0.43 pmol/l respectively) significantly increased than the controls. In the clinical hypothyroidism and subclinical hypothyroidism, the serum total T3 (T3) levels were (1.27± 0.24 nmol/l, 0.59±0.12 nmol/l respectively) significantly increased than the controls. The study results may conclude that, prolactin regulation is altered, in patients with clinical and subclinical hypothyroidism. Thyroid functions tests ought to be conducted in patients with hyperprolactinemia prior to performing further tests.
Correlation of platelet indices with the spectrum of acute coronary syndrome and extent of coronary artery disease
Authors: Mohanty Nirmal Kumar , Satpathy Chhabi , Routray Satyanarayan , Dash Bijay 
Published: April 2022

Platelets have a major role in acute coronary syndrome and their activation is a hallmark of this. Troponin I, Troponin T and Creatine Kinase enzymes are not enough sensitive at an early stage of acute coronary syndrome. Platelet indices can be detected earlier, inexpensive, widely available and easily recordable in most clinical laboratories, thus could be a better marker in these patients. The primary objective of this study is to determine the correlation between platelet indices and spectrums of acute coronary syndrome or the number of vessels involved. This is a prospective observation study conducted in a tertiary care teaching hospital of eastern India over a period of six months where 125 patients were non-randomly selected with a diagnosis of acute coronary syndrome who underwent coronary angiogram and reports correlated with platelet parameters. A total of 100 patients were finally evaluated. Only platelet large cell ratio and platelet-crit were significantly higher in ST elevated myocardial infarction group compared to the unstable angina group. Across all the spectrums of acute coronary syndrome or extent of coronary artery disease there was a strong positive correlation within platelet distribution width, mean platelet volume and platelet large cell ratio, which was also very significant. Similarly total platelet count had a strong positive and very significant correlation with platelet-crit in the above groups. Increase platelet large cell ratio and platelet-crit seems to be independent risk factors for development of ST elevated myocardial infarct than unstable angina. Thus they could serve as simple but important early biomarkers for predicting development of ST elevated myocardial infarction compared to unstable angina in acute coronary syndrome patients.
A comparative study between CO2 laser tonsillectomy and conventional tonsillectomy
Authors: R Ranjani , KR Radhakrishnan , T Sivasubramanian , DR Pandian , C Balasubramanian 
Published: April 2022

Tonsillectomy is one of the leading surgical operations of the ENT profession. Chronic tonsillitis has a massive effect on the quality of life and tonsillectomy used to treat the disease is a major procedure that can lead to multiple intraoperative and post-operative conditions, including bleeding, discomfort, etc., resulting in lack of school/work and impaired quality of life. To study the outcome of surgical procedures between CO2 laser Tonsillectomy and conventional tonsillectomy. In this study, 50 patients with chronic tonsillitis were included and randomized to underwent one tonsil removal by CO2 Laser method and the other side by Conventional dissection method. The outcome of the two procedures was measured using the duration of surgery, blood loss on each side. Post-operative bleeding, pain and tonsillar fossa healing were evaluated on the first, second and seventh day. The duration of surgery in the C02 laser method was 11.8±3.65 minutes, and the conventional method was 16.4±4.66 minutes. (P &#60;0.0001) The intraoperative blood loss in the CO2 laser method was 18.74±6.86ml and conventional method; it was 44.02±9.38ml. (P&#60;0.0001) Post-operative day 7 pain score was lower in the CO2 laser method than the conventional method. In the first, second, and seventh post-operative days, the percentage of slough formation in the tonsillar fossa was 80 percent, 74 percent, and 45 percent in the CO2 laser method, respectively, while in the conventional method was 40 percent, 47 percent, and 17 percent. CO2 Laser tonsillectomy is a simple procedure that results in substantially less intraoperative blood loss, post-operative discomfort, and a shorter surgery time.
A prospective study of displaced supracondylar fractures of the humerus in children treated with open reduction and internal fixation with k-wires
Authors: Singh Jhatoth Dhoom , Ratanam K. Raja 
Published: April 2022

Supracondylar fractures of the humerus were the most frequent occurrence, accounting for about 65.4% of all fractures around the elbow in infants. Displaced supracondylar humeral fractures need a high degree of respect and difficulty to be treated, as they require correct anatomical reduction and internal fixation to avoid complications. Thus, in this research, we documented the effects of open reduction and internal fixation with K-wires in the displaced (Gartland type III) supracondylar fracture humerus in infants.The prospective study of 25 cases of displaced (Gartland type III) supracondylar fractures treated with open reduction and internal fixation with K-wires were examined at our institution between September 2019 and July 2020 and followed for an average of 6 months. All Gartland Type III fractures were closed with an average age of 6.3 years in our study of 25 patients, 13 patients had slip fractures while playing, 18 patients had left-hand fractures, and 16 patients had posteromedial displacement. The fracturing of the distal end radius was associated with 2 patients. The majority of patients underwent surgery on the 2nd day and were home on the 3rd postoperative day. 16 had a loss of motion range of 0-5 °; 18 had a loss of motion angle of 0-5 °. 3 patients had inflammation of the superficial pin tract, 2 had traumatic median nerve paralysis, 2 had K-wire migration, 1 had a deformity of the cubitus varus and 1 had &#62;15 loss of motion.This research shows that anatomical reduction, stable fixation with minimal complications has enhanced open reduction and internal fixation with K-wires. Therefore, the present analysis reveals an open reduction, and K-wire internal fixing is most generally known as an option for the reconstruction of infant supracondylar humerus fractures.
Cutaneous and neurological profile of tuberous sclerosis complex in children: A case series and literature review
Authors: Chatterjee Anirban , Sinha Malay Kumar 
Published: April 2022

Tuberous sclerosis complex (TSC) is a rare genetic disease, belongs to the group of neurocutaneous syndrome. The consequence of genetic mutation is inadequate inhibition of the mammalian target of rapamycin (mTOR) signal pathway that results in inactivation of regulated cells growth and formation of dysgenic tissues/ hamartomas in multiple systems. The updated version of diagnostic criteria for TSC and management has been laid down after second International Tuberous Sclerosis Complex Consensus Conference (2012). To describe the clinico-neuroradiological profile and aspects of antiepileptic treatment of “ definite” TSC casesWe report a case series of four TSC cases attended in a teaching hospital. The “ definite” TSC cases are diagnosed by updated diagnostic criteria (2012) and data obtained retrospectively from records. We discuss the present series in the light of the current literature.We report three female and one male TSC patients. The “definite” TSC diagnosed by two major criteria - one or more cutaneous lesions and neuropathological lesion by neuroimaging. No family history of TSCs have been reported in the series.Hypomelanotic macules were observed in all (n=4) patients. Two TSC patients (n=2) had facial angiofibroma and one TSC had (n=1) shagreen patch. In neuroimaging studies, subependymal nodules were reported in three TSC patients (n=3) and one TSC had cortical dysplasias.The most common neurological manifestation in the TCS series is epilepsy; three TSC patients (n=3) had epilepsy. One TSC patient (n=1) did not present with epilepsy. Infantile spasms, tonic-clonic seizure and focal seizure were the phenotype of seizures. Vigabatrin, valporate and phenobarbitone have been prescribed in TSC patients. Scholastic performance was normal in one TSC patient (n=1) and subnormal in another patient(n=1).TSC -associated cutaneous lesions, the major features for diagnosis, develop in age-dependant manner. The prospective evaluation with a neuroimaging is an integral part of TSC management. Infantile spasm, focal seizure are the first manifested seizures with subtle presentation. First-contact physician must be well knowledgeable about updated 2012 diagnostic criteria, so timely management could be advocated. Vigabatrin is the first choice for infantile spsams in TSC patients as well as for focal seizures. Cognitive outcome/ scholastic performance may varies in TSC patients.
Comparative study of wound healing following purse-string closure versus conventional linear closure for stoma reversal
Authors: Roy Vivek Kumar , Jaiswal Pradeep , Kumar Mukesh , Roy Sukalyan Saha , Sinha Saumya , Kumari Anjili , Gopal Krishna 
Published: April 2022

Stoma closure is associated with several complications, wound infection being the most common. This study is done to establish that purse string suture closure method for stoma closure is superior to the conventional linear mattress closure and is associated with better wound healing cosmesis. This Prospective randomized controlled study enrolled 80 patients who underwent stoma closure from April 2021 to March 2022 in department of General Surgery in IGIMS, Patna. Patients were divided in two groups inclusive of ileostomy and colostomy based on type of closure technique. Conventional linear closure method was applied to Group A and purse-string technique applied to Group B patients. All Patients were followed regularly upto three months after operation. Rate of infection, pain as assessed by VAS score and satisfaction as assessed by POSAS Score were done. Purse string Closure had better outcome in terms of wound infection rate and Cosmetic results over a 3 months follow up. Ten patients in Group A and 2 from Group B out of 40 patients had wound infection. Patients with purse-string suture had statistically significant greater satisfaction over 3 months. Medium operative time of Group A was 100 minutes and that of Group B was 98 minutes. There were no significant difference in regards duration of hospital stay was more in Linear Group than Purse String (Group B). Purse-string closure was associated with better cosmesis and lower infection rate in comparison to Linear conventional closure.