Τρίτη, 22 Νοεμβρίου 2016

Maternal and fetal outcomes in HIV positive pregnant female

2016-11-22T23-05-36Z
Source: International Journal of Research in Medical Sciences
Mahim Mittal, Ashutosh Kumar Mall, Yash Gopal Sharma.
Background: Vertical Transmission is still not an uncommon mode of HIV transmission. HIV and its treatment can also affect maternal and fetal outcomes. We aimed to study incidence and factors of MTCT and maternal and fetal outcomes with the current standard of care. Methods: It was an observational study, at BRD medical college Gorakhpur. Pregnant, HIV positive females consenting for the study were enrolled. Follow up was up to 6 months post-delivery. Infant testing for transmission was done at 6 months. Results: A total 35 HIV positive pregnant female were studied. Follow up could be completed in only 29 patients. Four (13.79%) infants had HIV DNA detectable in whole blood at 6 months. Transmission was 16.6% in group taking ART for 3 months, 25% in mixed feeding group vs. 12% in exclusive breast feeding and 16.6% in NVD group vs. 9% in LSCS. Incidence of Preterm delivery was higher in group who took ART for longer duration. IUGR was present in 10/29 (27%) and growth failure in 12/29 (41%) infants. Conclusions: Longer ART duration and cesarean section delivery were more effective in preventing MTCT. Even exclusive breast feeding could result in MTCT. HIV exposure in utero may lead to IUGR. ART has no deleterious or positive effect on fetal growth but may be associated with preterm delivery. Better patient education will probably lead to earlier diagnosis and initiation of therapy to prevent transmission, and also to better fetal and infant outcomes.


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Clinical significance of presence of accessory foramen transversarium in typical cervical vertebrae

2016-11-22T23-05-36Z
Source: International Journal of Research in Medical Sciences
Esakkiammal N., Renu Chauhan.
Background: The cervical vertebrae are smallest of all the vertebrae present in the vertebral column. It is characterized by a foramen in each transverse process. The foramen transversarium (FT) of 6th to 1st cervical vertebrae transmits vertebral vessels and sympathetic nerves. Presence of another foramen apart from FT in the transverse process of cervical vertebrae is called accessory FT. Anatomical knowledge of these variations are helpful for conducting cervical spinal surgeries by the surgeons in order to prevent injury to vertebral vessels and sympathetic nerves. Methods: The present study was conducted in the department of anatomy, UCMS and GTB Hospital, Delhi, India. A total number of 241 dried cervical vertebrae were collected from the bone bank of the Department of Anatomy. Presence of any variation from the normal anatomy of the cervical vertebrae were noted and photographed. Results: Out of 241 cervical vertebrae (typical and atypical), the accessory FT was noted in typical cervical vertebrae only. Accessory FT was seen in 37 (27.6%) vertebrae, out of 134 typical cervical vertebrae. These accessory FT were either bilateral complete in 4 (2.9%) or incomplete 9 (6.7%) or unilateral complete 6 (4.5%) and unilateral incomplete 12 (8.9%) were observed. Six (4.5%) typical cervical vertebrae showed presence of complete accessory FT on one side and incomplete accessory FT on the other side in the same vertebra. Conclusions: Knowledge of variations of the presence of accessory FT in the typical cervical vertebrae is not only important to anatomist but also to radiologist in identifying the presence of duplicate vertebral artery and hence helping the neuro surgeons in preventing accidental bleeding from the vertebral artery while performing surgery on the cervical spine.


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Cross-sectional comparative study of socio-demographic and health profile of children in a NGO- run open house and street children in a metropolitan city

2016-11-22T23-05-36Z
Source: International Journal of Research in Medical Sciences
Aniruddha A. Malgaonkar, S. Kartikeyan.
Background: Street children are underprivileged urban children who suffer poverty, deprivation of education, vulnerability to various types of abuse, lack of supervision by adults, and with varying status of street-based existence and contact with their families. The study compares the socio-demographic and health profiles of children in a NGO-run Open House and street children. Methods: Respondents satisfying intake criteria were interviewed using a pre-tested questionnaire and their height and weight were measured and the data were statistically analysed. Results: 72% were aged between 12-16 years. Their occupations included rag picking, unorganised labour, street vending, cleaning vehicles, hotel work and begging. The reasons for street living were parental abuse, poverty, parental death, or peer pressure. Between the two groups of children, there were significant differences in frequencies of genital lesions (p=0.014; OR=0.465), injuries (p=0.01; OR=0.5), scabies (p=0.01; OR=0.31), and pyoderma (p=0.03; OR =0.38). A majority from both groups chewed tobacco regularly, some were addicted to more than one substance and had started using addictive substances due to peer pressure or to alleviate depression. Conclusions: Multi-pronged interventions ought to focus on improving income levels and housing of impoverished families, curbing parental abuse, and providing educational and health care facilities, establishing more number of drop-in Open Houses, providing avenues for legal income, and educating on the hazards of promiscuity and substance abuse.


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Ultrasound evaluation of carpal tunnel syndrome in patients with bifid median nerve

2016-11-22T23-05-36Z
Source: International Journal of Research in Medical Sciences
Smiti Sripathi, Anurag Ayachit, Rebin Bos.
Background: Patients with high division of the median nerve proximal to carpal tunnel, or bifid median nerve, may present with carpal tunnel syndrome (CTS). Ultrasound (US) measurements indicative of CTS in this subset of patients differ from those in patients with non-bifid median nerve. The objectives were to evaluate the parameter ∆CSA [difference between the maximum cross-sectional area of bifid median nerve within carpal tunnel (CSAc) and outside tunnel (CSAp)] in the diagnosis of CTS, to compare sensitivity and specificity of ∆CSA with nerve conduction velocity studies (NCS), and to compare the cross-sectional area (CSAc, CSAp & ∆CSA) of bifid median nerve in CTS patients with that in asymptomatic controls. Methods: 20 wrists with bifid median nerves and symptoms suggestive of CTS were included in the study group. Nerve conduction velocity studies (NCS) were performed in all cases. 4 wrists of asymptomatic age-matched subjects had bifid median nerves and normal NCS and were included in the control group. High resolution ultrasonography was performed for all wrists and findings documented. Statistical Analysis: Receiver Operating Characteristics curves were used to obtain the level of significance (p-value) and assessment of correlation between ∆CSA and NCS findings. Results: There was significant correlation between ∆CSA and NCS. A cut-off value of 2.3mm2 gave the best calculated sensitivity (76.9 %) and specificity (100%). Conclusions: CSA criteria for diagnosing CTS in patients with bifid median nerves are different from those in patients with non-bifid median nerve. ∆CSA is a sensitive and specific parameter for confirming the diagnosis of CTS in patients with bifid median nerve with sensitivity approaching that of NCS.


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Role of staging laparoscopy in upstaging CT findings and influencing treatment decisions in gastric cancers

2016-11-22T23-05-36Z
Source: International Journal of Research in Medical Sciences
Abhinay Indrakumar, Ganesh S. Mandakulutur, Keerthi R. Banavara.
Background: It is estimated that 990000 new gastric cancer (GC) cases occur in the world annually. The aim of this study was to examine the accuracy of laparoscopy in staging patients with gastric cancer in comparison with preoperative computed tomography (CT) examination and to determine the influence of staging laparoscopy on treatment decisions in gastric cancers. Methods: This was a prospective study conducted in a tertiary care hospital between August 2014 and February 2016. Thirty patients out of a series of 60 patients with gastric adenocarcinoma underwent a preoperative staging CT followed by a staging laparoscopy. The strengths of the agreement between the CT stage, the laparoscopic stage, and the final histopathological stage were determined by the weighted Kappa statistic (Kw). The number of patients with treatment decision-changes was counted. Results: The strengths of agreement between the CT stage and the final histopathological stage were Kw- 0.314 (95% confidence interval [CI]; 0.03-0.66; P≥0.0001) for T stage and 0.00 (95% CI; 0.0-0.00) for M stage, compared with 0.668 (95% CI; 0.39-0.98; P≥0.0001) and 1.00 (95% CI; 1.0-1.0; P≥0.0001) for the laparoscopic T and M stages, respectively. Unsuspected metastases that were not detected by CT, were found in 12 patients at laparoscopy, all of whom had T3 or T4 locally advanced tumors evident on CT. Conclusions: Preoperative laparoscopic staging of gastric cancer is indicated for potential surgical candidates with locally advanced disease in the absence of metastases on CT and influences treatment decision making apart from preventing unnecessary laparotomies.


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Auditory and visual reaction times during the menstrual cycle

2016-11-22T09-16-44Z
Source: National Journal of Physiology, Pharmacy and Pharmacology
Christina Sudheer, Shivakumar Jagadeesan, Kararshah F Kammar.
Background: Menstrual cycle is due to cyclic variations in the levels of various sex hormones. The effects of these hormones are not limited to the reproductive system alone but affect other systems including the nervous system. Aims and Objective: To study the reaction times (visual reaction times [VRT]/auditory reaction times [ART]) during the three phases of the menstrual cycle, i.e., menstrual (M), proliferative (P), and secretory (S). Materials and Methods: This cross-sectional study was conducted on 50 healthy young unmarried females in the age group of 20-25 years, having regular menstrual cycles. VRT/ART was measured during the menstrual, proliferative, and secretory phases. The results of the reaction times were subjected to statistical analysis using Students paired t-test for comparison of means. P

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Depression and anxiety as comorbid disorders in patients with Type II diabetes

2016-11-22T07-55-59Z
Source: International Journal of Medical Science and Public Health
Gautami Nagabhirava, Maithili Umate, Swateja Nimkar, Akhil Goel, Avinash Desousa.
Background: India is on the verge of a potential epidemic for Type II diabetes with the second highest diabetic population in the world. Similarly, depression and anxiety are global mental health disorders of public health importance. Objective: The purpose of this study was to assess the relationship between comorbid anxiety and depression with patients of Type II diabetes mellitus in an urban metropolis. Materials and Methods: This research uses a cross-sectional study design with a sample of 100 consecutive male and female adult patients drawn from the study population of Type II diabetes mellitus patients. They were asked to complete the problem areas in diabetes scale (PAID), Patient health questionnaire-9, general anxiety disorder-7, and were clinically screened for depression. Patients socioeconomic status and diabetes-related healthcare utilization were also assessed. Results: The prevalence of depression and anxiety was 62% and 49%, respectively, while 39% of the subjects had comorbid anxiety and depression. There was a significant positive correlation between PAID scores and comorbid anxiety/depression (ρ = 0.663, P

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Correlation of some demographic parameters with clinical parameters of metabolic syndrome, bipolar affective disorders, and its therapeutics

2016-11-22T07-55-59Z
Source: International Journal of Medical Science and Public Health
Dinesh Singh Rathor, Mujahed M, Sudhir Kumar, Rakesh Kumar Jain, Anil Kumar Sisodia.
Background: Metabolic syndrome (MetS) has been found to be highly prevalent worldwide ranging from 11.2% to 47%. It is suggested that bipolar affective disorder (BPAD) and MetS share common risk factors including the treatment of the latter one, especially second-generation antipsychotics. The study tries to find out a significant correlation among various parameters, if any. Objectives: (i) To determine physical parameters such as blood pressure (BP) and waist circumference in drug-naïve and drug-free patients vis-a-vis in control subject across various sociodemographic parameters; (2) to find out the prevalence of MetS in drug-naïve/drug-free patients of bipolar disorder and control subjects and to compare with that of control subjects. Materials and Methods: The study was a comparative, cross-sectional, case-control, hospital-based study using purposive sampling method. Patients were taken up for the study from October 2013 to June 2015. The study included cases (79 = drug-naïve 36 + drug-free 43; aged 16-55 years) and control (50). For control, people with General Health Questionnaire 12 score


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Survey of different types of anemia

2016-11-22T07-55-59Z
Source: International Journal of Medical Science and Public Health
Mital J Gamit, Hemlata S Talwelkar.
Background: Anemia is a major public health problem of considerable importance in the developing countries in the world. Objective: The aim of present study is to determine the prevalence of anemia and various types of anemia in admitted patients in PDU Hospital, Rajkot. Materials and Methods: The duration of this study is 6 months since December 2015-May 2016. A total of 4775 cases were studied, out of 27,033 which were indoor patient admitted in various wards in PDU Hospital, Rajkot. The samples for test were collected in ethylenediaminetetraacetic acid tube and received at central clinical laboratory in our hospital. The slides were prepared and stained with field stain. The samples were run in hematology cell counter Sysmex KX-21 for hematology indices and other parameters. Microscopic examination of slides was done for peripheral smear examination and complete blood count estimation. Results: In our study, anemia found in 4775 (17.66%) cases out of 27,033 admitted in different wards of PDU Hospital, Rajkot; 3187 (66.74%) were females and 1588 (33.25%) were males. Maximum cases 2942 (61.605) are found in age group of 21-40 years. In our study, microcytic hypochromic anemia was found in 2410 (50.47%), normocytic normochromic anemia in 2260 (47.32%), dimorphic anemia in 314 (6.57%), hemolytic anemia in 193 (4.04%), macrocytic anemia in 188 (3.93%), pancytopenia in 51 (1.06%), and sickle cell anemia in 38 (0.79%). Conclusion: The prevalence of iron deficiency anemia is increasing in female, mainly in reproductive age group in developing countries. A diagnosis of anemia needs adequate clinical attention, to find out the cause, type, and severity and this forms the basis for treatment of anemia.


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Histopathological study of malignant lesions of oral cavity

2016-11-22T07-55-59Z
Source: International Journal of Medical Science and Public Health
Pooja Y Shah, Ravi G Patel, Shridhan G Prajapati.
Background: Oral cancer is a heterogeneous group of cancers arising from different parts of the oral cavity, with different predisposing factors, prevalence, and treatment outcomes. It is the sixth most common cancer reported globally with an annual incidence of over 300,000 cases, of which 62% arise in developing countries. In comparison with the US population, where oral cavity cancer represents only about 3% of malignancies, it accounts for over 30% of all cancers in India, posing a significant challenge to health services by both preventive and diagnostic means. Incidence of oral cancer in India continues to rise and accounts for 50-70% of total cancer mortality. Objectives: (i) To study histopathology of malignant lesions of oral cavity, (ii) to study malignant lesions of oral cavity in relation to age, sex, and site, (iii) to compare observed findings with the similar studies done by other authors. Materials and Methods: This study was carried out in Department of Pathology, at a tertiary care hospital in Ahmedabad for the duration of 18 months, from January 2014 to June 2015. As a part of this study, 477 specimens of lesions of oral cavity were studied with main focus on histopathology of the lesion and keeping the following features in mind: age, sex, and site of lesion. Results: During the study, there were 477 cases of lesions of oral cavity. Among the malignant lesions of oral cavity, squamous cell carcinoma (SCC) was the most common finding and most common site affected by malignant lesions was buccal mucosa (BM). Most common age group affected by malignant lesions was 31-40 years (28%) with male:female ratio of 2.57:1. Incidence of SCC was 90.67%. Among the SCC, moderately differentiated SCC was most common grading. Most common age group affected by SCC was 31-40 years (27.94%) and 41-50 years (23.53%). Out of 68 cases of SCC, 50 (73.5%) were male and 18 (26.5%) were female with male:female ratio of 2.77. Most common site affected by the SCC was BM (41.18%) followed by tongue (39.71%) in the present study. Conclusion: Our study has revealed that SCC was the most common malignant lesions seen in oral cavity and moderately differentiated SCC was the predominant tumor type. Most common age group affected by malignant lesions was 31-40 years (28%) with male:female ratio of 2.57:1 and most common site involved was BM. The possibility of lymph node metastasis from oral SCC can be predicted with the help of certain factors such as site, size, and histological differentiation of the tumor. Hence, the study of site and differentiation is important.


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Evaluation of benign prostatic hyperplasia: A cystometric and clinicopathological study

2016-11-22T07-55-59Z
Source: International Journal of Medical Science and Public Health
Banothu Srinivas, Madhu Mohan Reddy B.
Background: Benign prostatic hyperplasia (BPH) is characterized by the nonmalignant overgrowth of prostatic tissue surrounding the urethra, ultimately constricting the urethral opening, and giving rise to associated lower urinary tract symptoms. Objectives: Diagnosis of BPH is made based on histologic examination of prostatic tissue. This study aimed to evaluate the clinicopathological and cystometric changes in BPH patients. Materials and Methods: In this study, 61 elderly males who were suffering from clinical BPH were included. Patients of different age groups ranging from 50 to 80 years and more were considered. All patients were undergone clinical, urine examination, and ultrasound scan was performed to confirm the hypothesis. The patients were divided into three subgroups according to the International Prostate Symptom Score as mild, moderate, and severe. Results: In mild group of patients, the mean compliance was 44.11; in moderate, it was 21.90; and in severe group, it was 17.54. Conclusion: This study concluded that as severity of bladder outlet obstruction increases, the compliance of bladder decreases. Cystometric evaluation of bladder compliance should be an essential part in pre-operative evaluation of symptomatic BPH patients.


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Adverse drug reactions in Type 2 diabetes mellitus patients on oral antidiabetic drugs in a diabetes outpatient department of a tertiary care teaching hospital in the Eastern India

2016-11-22T07-55-59Z
Source: International Journal of Medical Science and Public Health
Tirthankar Deb, Abhik Chakrabarty, Abhishek Ghosh.
Background: Diabetes mellitus is a major healthcare problem in India. Pharmacovigilance of antidiabetic drugs is crucial in detecting adverse drug reactions (ADRs)and providing feedback to physicians on their possibility. In India, few reports are available on the ADR profile of antidiabetic agents. Objectives: This study aims to detect frequency and total burden of different ADRs due to oral antidiabetic drug (OAD)use in a diabetes outpatient in a medical college in Eastern India. Materials and Methods: An observational study was conducted on Type 2 diabetes mellitus patients on oral antidiabetic agents, attending Diabetes Clinic of a Tertiary Care Teaching Hospital in West Bengal between April and September 2013. Details of adverse event history, history of medication suspected of having caused the ADR were recorded in the format followed in the Pharmacovigilance Programme of India. The causality relationship was assessed by the World Health Organization-Uppsala Monitoring Centre criteria. Results: A total of 1000 patients were screened, of which 276 were suspected of having at least one ADR. On causality assessment, 43 of these 276 cases had insufficient evidence about causality and were excluded from the analysis. Out of the remaining 233 patients, 275 suspected ADRs were detected. Among them, metformin contributed 51% of total ADR reported, in the form of dyspepsia and diarrhea, followed by glimepiride-induced hypoglycemia. Voglibose-induced dyspepsia, pioglitazone-induced pedal edema were also common. Conclusions: ADRs due to OADs is a frequent problem. Few multicentric studies are needed for a strong antidiabetic drug ADR database in India.


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Chromoblastomycosis as a mimicker of neoplastic lesion: A case report

2016-11-22T07-55-59Z
Source: International Journal of Medical Science and Public Health
Manisha Sarkar, Dipanwita Das, Anindita Sinhababu.
Chromoblastomycosis, a rare fungal infection, occurs most commonly in tropical and subtropical countries. Persons involved in agricultural works are most commonly affected. Traumatic injury by contaminated wood particles/thorn predispose to chromoblastomycosis. We are reporting a case of chromoblastomycosis in a 50-year-old male presenting with a nodular swelling in the right foot for 2 months. It was clinically suspected to be a neoplastic lesion and was subjected to surgical excision and histopathological examination that demonstrated the presence of fungal hyphae, spores, and the typical sclerotic bodies. Surgical excision is not needed in chromoblastomycosis as it can be treated by antifungals. Chromoblastomycosis needs to be considered in the initial differential diagnosis of verrucous cutaneous lesions of foot, particularly in agricultural workers.


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Homocysteine level in Coronary artery disease patients of Ahmedabad population

2016-11-22T07-55-59Z
Source: International Journal of Medical Science and Public Health
Jatin D Patel, Kirankumar P Chauhan, Chandan Chakrabarti, Hiran I Sanghani.
Background: Coronary artery disease (CAD) is a major cause of morbidity and mortality in the modern society. The cost of managing CAD is a remarkable economic burden and so prevention of CAD is very essential step in its management. The majority of CAD patients have at least one cardiovascular risk factor, but 20% of them have no traditional risk factors. Persistent focus on newer risk factors is necessitate as they may further step forward our ability to predict future risk and determine treatment. Recently, homocysteine has been recognized as a risk factor for CAD. This study was conducted to find out the homocysteine as one of the risk factors of CAD in population of Ahmedabad. Objective: The aim of this study is to categorize homocysteine as a risk factor for CAD and to find out the effect of age on homocysteine level. Materials and Methods: Totally, 100 patients with CAD and 100 normal controls were included in study and homocysteine concentration is measured using standard reagent kit on Abbott AxSYM close system. Result: 78% of patients in the study group and only 5% of participants in control group have high homocysteine level above biological reference interval, and its concentration was significantly high in study group patients compared to the normal control group participants (33.02 ± 17.41 and 13.88 ± 3.86 respectively, P

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Testicular and Epididymal Characteristics of Rabbit Bucks fed Tephrosia bracteolata leaf meal

2016-11-22T04-51-20Z
Source: International Journal of Livestock Research
Adakole Hyacinth Abu, Ibrahim Abel Okwori, Terzungwe Ahemen, Leo Daniel Ojabo.
Twenty crossbred rabbit bucks aged 9 - 11 weeks were used to study the effects of varying levels of Tephrosia bracteolata leaf meal on testicular and epididymal morphometry, and cauda epididymal sperm characteristics. The rabbit bucks were randomly assigned into four experimental treatments designated as T1, T2, T3 and T4 of five animals and was replicated five times with one rabbit buck per replicate in a completely randomized design. The results showed no significant (P>0.05) decrease on the morphometric dimensions of testes and epididymides, except the weights of testes and epididymides were significantly (P0.05) among the treatment groups. The findings of this study indicated that dietary inclusion of Tephrosia bracteolata leaf meal up to 15% per feed had no adverse effect on the epididymal sperm quality of rabbit. It is therefore suggested that Tephrosia bracteolata leaves could be used in rabbit diets.


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