Τρίτη, 18 Οκτωβρίου 2016

Does Eustachian tube patency affect the outcome of graft uptake rate and average audiological gain in Intact canal wall and Canal wall down Mastoidectomies – A study of 50 patients

2016-10-18T11-48-19Z
Source: International Journal of Medical Science and Public Health
Mehtab Alam, Satish Chandra Sharma, Syed Abrar Hasan.
Background: Cholesteatomatous otitis media is a surgical disease managed either by Intact Canal Wall (ICW) or Canal Wall Down (CWD) mastoidectomy, depending upon the extent of cholesteatoma. The status of the eustachian tube relates to the pathogenesis of cholesteatoma and affects the surgical outcome in terms of recurrence of the disease, postoperative audiological gain, and graft uptake rates. Objective: To compare ICW against CWD mastoidectomies with tympanoplasty, in terms of hearing gain and graft uptake rates, based on the status of eustachian tube ( patent/ blocked ). Materials and Methods: The study comprised of 50 patients , who underwent either ICW or CWD mastoidectomy with tympanoplasty in the department of Otorhinolaryngology, J N Medical College, A.M.U Aligarh from September 2010 to August 2013, with a mean follow-up of 18 months. The Eustachian tube was patent in 30 (60%) cases and blocked in 20 (40%) cases. Chi-square and unpaired t-tests were used to analyze the results. The p-value of 0.05, t=1.73) and graft uptake rate (p=0.711), between patients with patent eustachian tube and those with blocked. Conclusion: The patency of eustachian tube plays a role in the outcome of mastoidectomies in regard to audiological gain.


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Evidence Based Approaches For Preventing Urinary Incontinence In Birth and Postpartum Period

2016-10-18T05-39-34Z
Source: TAF Preventive Medicine Bulletin
Dilek Bilgiç, Şükran Başgöl, Nezihe Kızılkaya Beji.
Evidence-based approaches are known to be effective in prevention and management of urinary incontinence. Evaluation of modifiable risk factors associated with urinary incontinence (UI) and taken preventive measures especially in the birth and the postpartum period play major role in reducing the prevalence of UI. Indeed, women's informing, evaluation and monitoring about urinary incontinence in the long term in accordance with evidence-based guidelines by multidisciplinary is extremely important in this process. In this review, changeable risk factors associated with urinary incontinence in birth and postpartum period will be analyzed in accordance with evidence-based and will be discussed with meta-analysis of randomized controlled trials and systematic reviews.


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Environmental factors and toxicologic substances' effect on olfactory function

2016-10-18T05-39-34Z
Source: TAF Preventive Medicine Bulletin
Sibel Kıran, Ufuk Emre, Burcu Küçük Biçer, Fikret Çınar.
Evaluation of the negative health effects of smell disfunction gains importance as much as smelling the odor in daily lives. Responses to volatile chemicals and other chemicals are often variable across individuals. This relation is still underobservation. Although variability can derive from differences in individual olfactory sensitivity, the response to a chemical stimulus is also influenced by the complex environment surrounding the exposure. This exposure can include the perceivers cognitive state. Occupational environment is one of the important places that has role on smell disfunction. At the present time, the terms "fragrance-free" or "unscented" gets interest. This paper is a review of smell sense, importance of olfactory functions and dysfunctions, and possible effects of environmental and occupational toxic exposure. We grouped the toxic materials that have negative impact on smell function as inorganic and organic compounds, powders, metals and other industrial agents. Deterioration of smell sense can affect vital functions. Smell disfunction evaluation must be considered with its relation to taste sense. It is of great significance to evaluate smell functions as a routine part of history taking and physical examination in order to detect dysfunctions as an early diagnosis. Smell function is evaluated with a series of chemical tests in clinics. Here you can find some early onset smell disfunctions with some environmental and occupational agents which potentially could affect smell functions.


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Under-utilised opportunity: key contribution of public health nurses and school health services for outreach in Delhi, India

2016-10-18T04-37-46Z
Source: International Journal of Community Medicine and Public Health
Neerja Sood.
Background: The post of Public Health Nurses (PHNs) was created and filled for the first time in Delhi Administration, in 1978-79 under School Health Scheme (SHS) to provide services to school children but overtime they were utilised in public health activities without changing their job profile. This paper presents a history of development of SHS in Delhi and the various roles that PHNs played through it and present a case study of SHS in Delhi. Methods: A systems approach was used to study SHS as a part of Directorate of Health Delhi. Purposively selected school health clinics in East and North East Districts managed by Government and NGOs were studied. Review of reports, observation and interview checklist were used. Results: PHNs in SHS provided comprehensive services to school children. Since end of 1988 they were diverted to various public health activities. SHS covered nearly 40-50 percent government schools with no further expansion. Staff was transferred / posted to new hospitals and districts during end of 1990s. In 2002-03 Non-Government Organisations (NGOs) were involved to cover schools but by end of 2010 many NGOs withdrew from scheme. Conclusions: Based on findings, this paper argues that, while PHNs played vital public health roles in the 1970s and 80s, policy changes in governance and service structures have diminished their role since late 1990s. Other options tried by government in 2000s, such as opening SHS to NGOs, have largely failed. The under-utilised potential of PHNs needs to be recognised and better deployed.


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Bardet biedl syndrome: a rare occurrence

2016-10-18T03-40-29Z
Source: International Journal of Contemporary Pediatrics
Kavita Tiwari, Suresh Meena, Suresh Goyal.
The bardet-biedl syndrome (BBS) is a rare autosomal recessive genetic disorder that affects many body systems. It is characterized principally by obesity, retinitis pigmentosa, polydactyly, hypogonadism, kidney abnormalities and learning difficulties. We hereby present a 14 year old male patient exhibiting characteristic features of bardet biedl syndrome (BBS) along with a brief review of the literature.


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A rare case of neonatal bacterial sinusitis

2016-10-18T03-40-29Z
Source: International Journal of Contemporary Pediatrics
Natashya H. Sima, Poonam K. Saidha, Ophelia DSouza, Sandhya S. Patil.
Acute bacterial maxillary sinusitis is uncommon occurrence in the pediatric age group. Complications from this condition are rarer in the neonatal period with less than 10 cases reported worldwide. The diagnosis and treatment of maxillary sinusitis and its complications poses challenges as there are no clear guidelines on conservative management versus early surgery. We present a rare case of acute maxillary sinusitis with orbital complications in a 13 day old neonate.


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Evans syndrome with severe thrombocytopenia: a rare presentation

2016-10-18T03-40-29Z
Source: International Journal of Contemporary Pediatrics
Rugmini Kamalamma, Siddaraju ML, Swathi Badam, Niranjan Mahankali.
Evans syndrome is a rare disease characterized by the sequential or simultaneous presence of autoimmune haemolytic anemia and immune thrombocytopenia with a chronic relapsing and remitting course. Most of them present with severe anemia and moderate thrombocytopenia while neutropenia is associated in some cases. Associated laboratory parameters include unconjugated hyperbilirubinemia, decreased total serum IgG and IgM levels, presence of non-cross reacting auto antibodies against erythrocytes, platelets and in some cases against neutrophils. Management of evans syndrome includes glucocorticosteroids as the first line therapy and IVIG as second line treatment. Resistant cases are treated with cyclosporine, mycophenolate mofetil, vincristine, danazol, rituximab (monoclonal anti-CD20 antibody), alemtuzumab (humanized monoclonal anti-CD52 antibody). Autogenic or allogenic hematopoietic stem cell transplantation (HSCT) is the only curative option available. Here we are presenting an adolescent boy with Evans syndrome who presented with severe thrombocytopenia and moderate degree of haemolytic anemia and responded well to first line oral corticosteroid therapy.


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Late onset severe anemia due to rhesus isoimmunization

2016-10-18T03-40-29Z
Source: International Journal of Contemporary Pediatrics
Hareesh Vardhan Jadala, Pooja V., Raghavendra K., Prithvish C. M., Srinivas B..
Rh isoimmunization usually presents with severe neonatal jaundice associated with anemia needing exchange transfusion and phototherapy. Sometimes babies who have mild or no symptoms at birth may present later with severe hemolytic anemia. In this case report we have described a newborn infant who had mild jaundice initially and presented with severe anemia in the fourth week of life. This case signifies the importance of regular follow up and close monitoring of Rh isoimmunized infants for the first two months for delayed onset anemia.


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Response to 13 cis retinoic acid in metatstatic neuroblastoma

2016-10-18T03-40-29Z
Source: International Journal of Contemporary Pediatrics
R. Arun Kumar, S. Lakshmi Narasimhan, J. Muthukumaran.
Neuroblastoma is the most common extra cranial solid tumour of childhood, with 5 year survival rate of 40%-50% in high risk group. Surgery, chemotherapy, radiotherapy, high dose chemotherapy with stem cell transplant and retinoid therapy are treatment options for neuroblastoma. Here we present a 5 year female child presenting with abdominal pain for 1 month and abdominal distension for 3 weeks, and underwent biopsy after necessary investigations, and diagnosed to have high risk neuroblastoma and treated with multiple lines of chemotherapy and attained complete response after retinoid therapy. The case is presented because of complete response achieved with retinoid therapy with tolerable side effects.


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Varied and atypical presentation of Wilson disease in a family: report of 3 cases in siblings

2016-10-18T03-40-29Z
Source: International Journal of Contemporary Pediatrics
Shilpi Ranjan, Kumar Saurabh.
Study reports a series of three cases of atypical presentation of Wilson disease from a family. First sibling presented with isolated neurological manifestation without hepatic involvement and responded well with low dose penicillamine and zinc. Second sibling had history of recurrent long bone fractures along with hepatitis who also responded well with zinc therapy. Third sibling who was presymptomatic turns up into symptomatic state even after appropriate zinc prophylaxis.


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Coffin siris syndrome: a rare clinical entity

2016-10-18T03-40-29Z
Source: International Journal of Contemporary Pediatrics
Rupali Jain, Sandip Gediya, Amzad Khan, Suresh Goyal, Lakhan Poswal.
Coffin-siris syndrome (CSS) is a rare, clinically heterogeneous disorder considered in the setting of prenatal onset of mild to moderate growth deficiency, facial dysmorphism, cognitive/developmental delay, and speech impairment, moderate to severe hypotonia, seizures and 5th finger/nail hypoplasia. The child had distinctive features of CSS like developmental delay, seizures, and coarse facial features, body hypertrichosis, scalp hypotrichosis and SNHL.


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Supratentorial atypical teratoid/rhabdoid tumor: a case report

2016-10-18T03-40-29Z
Source: International Journal of Contemporary Pediatrics
Jyoti K. Kudrimoti, Neeta A. Wahane, Shailja C. Puranik.
Atypical teratoid rhabdoid tumor (ATRT) is a rare and highly aggressive malignant tumor of infancy and childhood with fatal outcome. Common site is kidney, but it can also occur in the liver, thymus and the CNS. The supratentorial compartment is less frequently the primary site for this neoplasm, but cases arising from the cerebral hemisphere have also been reported. Study came across a case of 18 months female child who presented with convulsions and MRI showed right frontal space occupying lesion, which after IHC confirmed as ATRT.


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Homozygous methylenetetrahydrofolate reductase -a1298c mutation in a case of precursor B acute lymphoblastic leukemia

2016-10-18T03-40-29Z
Source: International Journal of Contemporary Pediatrics
Gaurav Tripathi, Manas Kalra, Amita Mahajan.
Thrombotic events are well recognized during treatment for acute lymphoblastic leukaemia. We report a case of recurrent thrombosis off asparaginase wherein thrombophilia evaluation yielded specific etiology. A 14 year old boy with precursor B cell acute lymphoblastic leukemia (ALL) (high risk) presented with generalized tonic clonic seizures on day +22 of induction. Asparaginase associated thrombotic event was suspected. MRI brain with MRV done showed right frontal lobe infarct and superior sagittal sinus thrombosis with reduced blood flow in left transverse sinus. He was managed conservatively. However, after the first dose of systemic methotrexate therapy he presented with right sided hemiparesis. In view of his recurrent episode thrombosis in the absence of asparaginase, thrombophilia workup was done which showed homozygousity for methylenetetrahydrofolate reductase (MTHFR)-a1298c mutation. MTHFR mutation is a rare cause of thrombophilia which was found in a case of precursor B cell ALL as a cause of recurrent venous thrombosis precipitated by methotrexate therapy.


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An infant with trichohepato-enteric syndrome: case report

2016-10-18T03-40-29Z
Source: International Journal of Contemporary Pediatrics
Mayssan Yousef Salman, Sirin Mneimneh, Mariam Rajab.
Trichohepato-enteric syndrome (THE-S) is a disease characterized by severe infantile diarrhea, failure to thrive, facial dysmorphism, woolly hair, and immune or hepatic dysfunction. We report the case of a boy who presented in early infancy with chronic watery diarrhea, dependent on total parenteral nutrition, along with other features of THE-S.


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Spontaneous tension pneumomediastinum in young child complicating bronchopneumonia successfully managed with high frequency ventilator

2016-10-18T03-40-29Z
Source: International Journal of Contemporary Pediatrics
Muhammad Asif Ghori, Ibrahim Al Helali, Ibrahim Albenhassan, Ahmad Al Qarni.
Spontaneous pneumomediastinum means air in mediastinum is usually associated with a sudden formation of pressure gradient between the alveolus and surrounding tissue, resulting from either an over inflation of the alveoli or a reduction of interstitial pressure. Spontaneous mediastinum is predisposed to asthma, respiratory tract infections, or situations reproducing the valsalva maneuver, uncommon in young children but potentially life threatening.


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Secondary malnutrition: clinico-etiological spectrum

2016-10-18T03-40-29Z
Source: International Journal of Contemporary Pediatrics
Surabhi Chandra, D. K. Singh.
Background: Secondary malnutrition, a less recognized entity results from an underlying disease that compromises growth directly or indirectly. The present study was undertaken to determine the clinico-etiological spectrum of secondary malnutrition in a tertiary care hospital of India. It also aimed at identifying asymptomatic masqueraders of malnutrition. Methods: In this prospective, observational study done in a tertiary care hospital over a year (April 2015 March 2016), all patients admitted were evaluated anthropometrically, as per the World Health Organization (WHO) guidelines, and categorized into having moderate or severe malnutrition. Any underlying secondary cause was worked up and asymptomatic masqueraders were identified on the basis of a pre-devised fixed diagnostic protocol. Results: One seventy seven patients (177/897 = 19.7 %) of a total of 897 malnourished patients had secondary malnutrition. Seventy eight (78/177 = 44.0%) patients had moderate and 99 (99/177 = 55.9%) had severe malnutrition. Asymptomatic masqueraders of secondary malnutrition were seen in 21 patients. Neurological disorders (54/177 = 30.5%) followed by tropical infections (40/177 = 22.5%), were the major underlying cause of secondary malnutrition. Conclusions: Identification of secondary malnutrition and treatment of the underlying disorder is a must to achieve optimal nutritional outcomes and decrease the burden of malnutrition.


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Addition of immunotherapy to chemotherapy in pediatric borderline leprosy: a clinical evaluation

2016-10-18T03-40-29Z
Source: International Journal of Contemporary Pediatrics
Raj Kamal, Natrajan M., Dayal R..
Background: Immunotherapy with BCG, BCG + M. leprae, ICRC, MIP has been observed to be effective in improving the treatment in adulthood leprosy. Clinical improvement with accelerated bacterial clearance and histological up grading using MIP vaccine as an immunotherapeutic with standard WHO-MDT has been reported in adult cases with high bacillary load. However, there is lack of information in borderline pediatric leprosy which is characterized by a state of shifting immunity and would therefore be ideally suited to such observations. This pilot study is originated from involvement of our Institute in a trial aimed for improving the therapy of pediatric borderline leprosy by using combined immunotherapy and chemotherapy. The study was aimed to assess the clinical improvement by adding immunotherapy (MIP vaccine) with chemotherapy (WHO -MDT) in pediatric borderline leprosy. Methods: A total of 98 new pediatric borderline leprosy cases were included, after formal written consent, detailed clinical examination. A non-randomized trial was conducted. In this study, patients attending the OPD were serially recruited in two treatment groups. In group-1 (Mw vaccine plus WHO- MDT) 50 pediatric cases and in Group-2 (MDT only), 48 pediatric borderline cases were recruited. The therapeutic regimens containing MIP vaccine was injected intra-dermally at the start of therapy and every six months in addition to chemotherapy (WHO- MDT) in group 1 pediatric patient and chemotherapy only (WHO- MDT) were given in group-2 pediatric cases and effect was observed on clinical parameters (size of lesions, erythema, infiltration, sensory improvement) and bacillary clearance. Results: Addition of immunotherapy resulted in faster clinical recovery from disease, faster bacillary clearance in pediatric borderline leprosy cases. Conclusions: This study shows the usefulness of adding immunotherapy (MIP vaccine) to chemotherapy (WHO- MDT) in pediatric borderline leprosy for faster clinical improvement.


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Nutritional and haematological status of human immunodeficiency virus infected children

2016-10-18T03-40-29Z
Source: International Journal of Contemporary Pediatrics
Chandra M. Pandey, Anubha Shrivastava.
Background: Under nutrition and anaemia are among the commonest presenting signs in human immunodeficiency virus (HIV) infected children. Cause could be multi factorial. HIV infection itself may produce this situation. Opportunistic infections, nutritional deficiencies and bone marrow suppression due to various factors could be the other reasons. To study the nutritional and haematological status in HIV infected children this study was undertaken. Methods: 140 children of both sexes, between the age 18 months to 15 years, who were diagnosed HIV positive as per guide lines of national AIDS control organization of India, were included in this study. Their anthropometric, general and systemic examinations were done. Haematological investigations including complete blood count (CBC), general blood picture (GBP), CD4 count was done in all cases. They were classified in clinical and immunological staging according to WHO classification criteria. Bone marrow aspiration was performed in 43 children. They were investigated for suspected opportunistic infections as well. Results: Out of 140 chidren, 91 were male and 49 were female. 47 children were orphan and 111 children were in low socioeconomic status. 101 children were significantly under nourished. No child was nutritionally normal. Clinical signs of vitamin A and D deficiency was seen in 21 and seven children respectively. 85% children were anaemic and most common morphology was normocytic normochromic blood picture. Lymphopenia was seen in 43.57%, granulocytopenia in 48.57% and thrombocytopenia in 30.71% children. There was no significant finding in bone marrow examination. Conclusions: This study concludes that in children, commonest route of infection was vertical transmission. Mean age of presentation was 7.67 years. Varying degree of mal nutrition and anaemia was noted in more than 85% HIV infected children. No child was nutritionally normal.


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Reticulocytosis: the unevaluated parameter in neonatal jaundice requiring phototherapy

2016-10-18T03-40-29Z
Source: International Journal of Contemporary Pediatrics
Rose Xavier, Manoj V. C., Sanjeev Kumar T. M., Vinod J. Cherian.
Background: Majority of the jaundiced neonates requiring phototherapy do not have an identifiable cause for the jaundice. Reticulocyte count more than 4% on day 3 of life is called reticulocytosis in neonates. So far no studies have evaluated the prevalence of reticulocytosis among jaundiced neonates requiring phototherapy. Objective of the study was to identify babies with only reticulocytosis as cause for jaundice and identify factors contributing to reticulocytosis. Methods: An observational study was carried out over a period of one year in the neonatal unit of a tertiary care hospital on 200 jaundiced neonates requiring phototherapy for determining the incidence of jaundice with unknown etiology. This data was analysed for prevalence of reticulocytosis and its contributing factors. Results: 67 of 200 babies with jaundice had reticulocytosis. An etiology for the reticulocytosis was found in 37 babies. 12 of the remaining 30 babies had dehydration (weight loss more than 10%) contributing to jaundice. 18 babies had no identifiable cause for the reticulocytosis. Mildly significant correlation was found with sibling history of neonatal jaundice (p = 0.052). No significant correlation was found with any other contributing factors. Conclusions: Reticulocyte count should be done for any baby with jaundice requiring phototherapy. Screening for irregular antibodies and genetic studies need to be promoted along with routine tests, to identify the cause for reticulocytosis after working out the costs involved.


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Effect of postnatal magnesium therapy on neonatal seizure in infants with moderate to severe hypoxic ischemic encephalopathy: a post- hoc subgroup analysis

2016-10-18T03-40-29Z
Source: International Journal of Contemporary Pediatrics
Raj Prakash.
Background: Magnesium has got both neuroprotective and anticonvulsant effect on developing human brain. A post hoc subgroup analysis was done to determine the effect of magnesium on neonatal seizures in infants with moderate-severe hypoxic ischemic encephalopathy (HIE) who received postnatal magnesium therapy for perinatal asphyxia. Methods: Term asphyxiated infants were randomly assigned to receive either magnesium sulphate infusion or placebo within 48 hours of life to maintain serum magnesium levels in neuroprotective range. Short term neurological outcome at discharge was evaluated. The post hoc analysis evaluated the effect of magnesium on neonatal seizures in infants with moderate-severe HIE. All statistical analysis was done through SPSS (version 19.0) for windows and p value


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Diphtheria pertussis tetanus vaccine induced convulsion: is hypocalcemia a triggering factor?

2016-10-18T03-40-29Z
Source: International Journal of Contemporary Pediatrics
Usha Kiran C. B..
Background: Active pertussis toxin in diphtheria pertussis tetanus (DPT) vaccine has been proposed to cause severe reactions. A convulsion following DPT vaccine is a known adverse reaction but hypocalcemia as a triggering factor is not reported. The aim of the study was to find the association between serum calcium and DPT vaccine induced convulsions and to study the clinical profile. Methods: Retrospective observational and descriptive study was done at emergency ward of a tertiary care teaching hospital. 20 infants of DPT induced convulsions with previous normal neurodevelopment were included in the study. Main outcome measures were association between DPT vaccine induced convulsions and serum calcium levels. Results: Out of 20 infants included in the study, male to female ratio was 1.8:1, all of them were less than 6 months of age, 17 (85% ) were exclusively breast fed, hypocalcemia was seen in 17 cases (85%), 11 (55%) had fever. 16 (80%) had convulsions following third dose of DPT vaccine. Conclusions: There is a significant association between hypocalcemia and DPT vaccine induced convulsion. Hence there is need for Calcium and Vitamin D3 supplementation in pregnant and lactating mothers and early detection and adequate treatment of rickets in infants.


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A study of association between vitamin d deficiency in sepsis

2016-10-18T03-40-29Z
Source: International Journal of Contemporary Pediatrics
Nishaat Ahmed, Vikram Yadav, Rajendra Kumar Soni, Niranjan Nagaraj, Pramod Kumar Berwal, Gunshyam Singh Sengar.
Background: Vitamin D is a fat-soluble steroid hormone that contributes to the maintenance of normal calcium homeostasis and skeletal mineralization the aims of this study is to evaluate vitamin D levels in pediatric patients admitted in the intensive care unit with sepsis. Methods: Fifty children between 1 year to 12 years of age with systemic inflammatory response syndrome (SIRS) with suspected or proven sepsis, admitted in PICU were included for the study. Blood was drawn at the time of admission on the first day of hospital stay for measurement of 25-hydroxyvitamin D (25-OHD) levels. Results: Forty two (84%) patients out of 50 patients had vitamin D levels 30 ng/ml. This was statistically significant as the p value was


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Clinicoetiological profile of acute kidney injury in paediatric intensive care unit patients

2016-10-18T03-40-29Z
Source: International Journal of Contemporary Pediatrics
Vidya Krishnamurthy, Anil Shetty K., Jaidev M. D..
Background: Acute kidney injury (AKI) is common in patients in the paediatric intensive care unit and is associated with poor outcome. Present study was conducted to determine the occurrence, risk factors and etiology of AKI in the PICU. Methods: Data was collected retrospectively from case records of children admitted to PICU during one year.AKI was defined and classified according to modified pRIFLE (risk injury failure loss end stage renal disease) criteria. Results: 227 children were included in the study, 31(13.6%) developed AKI, of these 16 (51.6%) had risk, 11 (35.4%) had injury and 4 (12.9%) had failure. Overall mortality was 32.3%. 83.9% of AKI was in the age group of

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Changing trends in clinicopathological parameters in dengue with evaluation of predictors of poor outcome in children

2016-10-18T03-40-29Z
Source: International Journal of Contemporary Pediatrics
Smita Ramachandran, Akriti Gera, Murtaza Kamal, Rani Gera, Manas Pratim Roy.
Background: A study was planned to evaluate the changing trends in dengue according to the revised WHO guidelines in children and at identifying and evaluating the association between clinical features the child and the outcome. Methods: This was a retrospective observational study conducted in Safdarjung Hospital. Children with signs and symptoms of dengue fever along with serological or antigen NS1 positivity were included. Continuous variables were analysed using percentage, mean, standard deviation. Categorical variables were analysed using chi-square test. P value

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PREVALENCE OF CHRONIC DAILY HEADACHE (CDH) IN PEOPLE OF AGE GROUP 18-80 YEARS IN MAX SUPERSPECIALTY HOSPITAL, SAKET, NEW DELHI ” INDIA – A PROSPECTIVE STUDY

2016-10-18T01-42-24Z
Source: International Journal of Current Research and Review
Maqsood Ahmad Dar, Baseerat Ali, Rajasheikar Redid, Rommel Roshan Tickoo, Owais Hamid Dar.
Introduction: Chronic daily headache defined as headache occurring on 15 or more days in a month for at least three months affects around 4% of the general population causes significant distress with substantial impact on the quality of life of an individual and huge economic cost to the society through occupational disability and healthcare consultations. Objectives of the Study: To study the prevalence of chronic daily headaches in people of age group 18-80 years in Max Super Specialty Hospital and to identify risk factors associated with CDH (stressful life events, obesity, and medicine overuse.) Material and Methods: It was a prospective study conducted in Max Super Specialty Hospital, Saket, and New Delhi between Aug 2014 to May 2015. Patients coming with complaints of headache in age group of 18-80 yrs and fulfilling the inclusion criteria and exclusion criteria were enrolled in the study. Sample size was calculated by using n-Master (2.0) software and 176 subjects were enrolled. History of the patient including the precipitating factors and drug history was taken. MIDAS and HIT score was used to know the severity of headache; medical conditions were noted by taking brief interviews. Data was analyzed by using chi square test, Pearsons correlation coefficient. Result: Of the 4500 subjects presented to our hospital with complaints of headache, 176 fulfilled the criteria of chronic daily headache (CDH) with a prevalence of about 4.5%.In our study we observed that 103 (58.5%) had migraine without aura, 30.6(20.5%) migraine with aura, 33(18.8%) tension type headache (TTH), 2 (1.1%) hemicranias continua and 2(1.1%) mixed-migraine and TTH.We observed that out of 176 patients in age group of 18-80 years ,maximum number of patients were in age group of 30-39 yrs- 67 patients(38.1%) and the least common age group was >70yrs where only 1 patient had chronic daily headache(CDH). It was observed that out of 176 patients 123 (69.9%) were females and 53 (30.1%) were males and type of headache was statistically significantly (p=0.00) associated with gender. Conclusion: We conclude that Migraine without aura was the most common type (58.5%) and least common type being mixed chronic migraine and tension type headache and Hemicrania continua 1.1%. We found chronic daily headache was more prevalent in females as compared to males, 123 (69.9%) were females and 53 (30.1%) were males. The most common age group affected was 30-39 years and was more common in married. We observed that most of the patients (61.9%) had BMI between 18.5 and 25.After analyzing risk factors it was observed that history of drug intake was present in 154 subjects, most common being Acetaminophen, Naproxen, Triptans, Ergotamine the rest were using preventive. In our study prevalence of medication overuse headache (MOH) among 176 patients of chronic daily headache is (108/176) 61.36% whereas prevalence of MOH in subjects coming to our hospital with headache is 2.4% (108/4500). Stress was the most common precipitating factor of chronic daily headache (CDH), stress was present in 146 patients (85.9%) others being lack of sleep, hunger, working on computer, noise, menstruation, sunlight, travel. Recommendations: Chronic daily headache is under estimated due to lack of awareness; screening of patients should be done on primary and secondary care centers to estimate the actual burden of disease. Stress, anxiety should be handled as early as possible to prevent transformation of episodic headache to chronic daily headache.


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TREATMENT OF SPECIAL CHILDREN: AN ORTHODONTIC PERSPECTIVE

2016-10-18T01-42-24Z
Source: International Journal of Current Research and Review
Shyama Dash, Uday N. Soni, Rahul S. Baldawa, N. G. Toshniwal, Shubhangi A. Mani.
Orthodontic care may seem out of reach for many children with special needs due to physical and developmental disabilities. Orthodontists who lack education and experience to work with such patients with disabilities end up denying treatment of these patients, as a result, patients and parents become frustrated.Orthodontic treatment is an elective procedure for essentially all patients, including those with medical problems. Correction of disfiguring dental and facial problems contributes in an important way to an individuals self-esteem. The positive benefits of orthodontic treatment influence social integration and interaction, and can lead to significant improvement in overall well-being.


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SEROPOSITIVITY OF HEPATITIS B VIRUS AND HEPATITIS C VIRUS AMONG BLOOD DONORS AT A TERTIARY CARE HOSPITAL IN KASHMIR: A TEN-YEAR STUDY

2016-10-18T01-42-24Z
Source: International Journal of Current Research and Review
Mohammad Zubair Qureshi, Humaira Bashir, Peer Maroof, Samoon Jeelani, Nazia Bhat, Fehmeeda Akhter.
Objectives: Hepatitis B virus (HBV) and Hepatitis C virus (HCV) are important transfusion-transmissible infections. This study was performed to assess the Seropositivity of HBV and HCV Seropositivity among blood donors at a Tertiary Care Hospital based blood bank at SKIMS, Kashmir. Materials and Methods: The blood donation records over 10 years from Jan- 2003 to Dec-2012 were reviewed, retrospectively, for the seropositivity and yearly trends of HBV and HCV. Results: A total of 97427 donations were received. The overall number of HBV seropositive donations was 469 and that for HCV was 194, with the seroprevalence rates of 0.48% for hepatitis B surface antigen (HBsAg) and 0.20% for HCV. The seropositivity rate was higher in the replacement donors compared to the voluntary donors and 0% in repeat voluntary donors. The annual rates showed decreasing trends for both HBsAg and HCV. Conclusion: The seropositivity of viral markers was lower in our study as compared with studies from other parts of the country. It was significantly lower in voluntary donors compared to replacement donors and repeat voluntary donors were found to be much safer.


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ASSESSMENT OF SALIVARY ENZYMES-ALANINE AMINOPEPTIDASE(ALAP) AND DIPEPTIDYL PEPTIDASE IV (DPP IV) IN PATIENTS WITH CHRONIC PERIODONTITIS

2016-10-18T01-42-24Z
Source: International Journal of Current Research and Review
S. Rajasekar, V. Ramasubramanian, Sethupathi.
Introduction: Alanine Aminopeptidase (ALAP) and dipeptidylpeptidase (DPP IV) are proteolytic enzymes released in the periodontal tissues from leukocytes, host cells and microorganisms. Both enzymes play an important role in collagen degradation and destruction of periodontal tissues. Therefore, detection of these enzymes might be useful in the diagnosis of periodontal disease. Aim: To assess the salivary levels of ALAP and DPP IV in periodontally healthy and those with chronic Periodontitis and to correlate the enzyme levels with the severity of disease. A prospective comparative case control study was done on 60 systemically healthy patients in the age group of 25-55 and was divided into four groups with 15 patients in each as Periodontally healthy, Mild, Moderate and Severe Periodontitis. Methodology: Parameters like Plaque index, Gingival bleeding index, Probing pocket depth and clinical attachment loss were recorded at baseline and unstimulated whole saliva was collected from each patient and quantified for levels of ALAP and DPP IV using spectroscopic quantification method. Statistical analysis used ANOVA, Students t test and Pearsons correlation coefficient analysis was used. Results: The salivary levels of ALAP and DPP IV were found to be higher in patients with Periodontitis than p healthy controls and were higher in severe (42.34±8.96) (8.41±1.44) and moderate group) (25.46±6.79) (5.17±1.31) than mild Periodontitis group) (15.83±4.54) (3.69±1.00) which was statistically significant. Discussion and Conclusion: ALAP and DPP IV were higher in saliva of patients with chronic Periodontitis and positive correlation existed between the levels of these enzymes with the severity of Periodontitis.


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UTILIZATION OF AGRICULTURAL WASTE FOR BIOETHANOL PRODUCTION- A REVIEW

2016-10-18T01-42-24Z
Source: International Journal of Current Research and Review
Nwosu-Obieogu K., Chiemenem L.I., Adekunle K.F..
The utilization of agricultural waste to produce bioethanol proves to be an alternative energy source for the limited non renewable energy and a dependable substitute for food crops. Though the process has several challenges and limitations such as biomass transport and handling, efficient pre-treatment methods, high cost based on current technologies which results in low yield and high cost of the hydrolysis process. This review highlights different classes of agricultural waste, their sources and the processes undergone to produce bioethanol economically.


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