Monday, 1 May 2017

IMJ Health April 2017

Medical Journal: Published volume-3, Issue-4, April 2017 with ad publications

Lipid Profile in Subclinical Hypothyroidism: A Case-control Study

Abstract—Subclinical Hypothyroidism is a much more common disorder with a world-wide occurrence as compared to overt Hypothyroidism. Overt Hypothyroidism is associated with abnormalities of lipid metabolism, but the significance of dyslipidemia in subclinical hypothyroidism (SCH) remains controversial.

Aims: To compare the lipid profile between subclinical hypothyroid patients & healthy controls (age & sex matched) so as to determine any association between lipid profile & subclinical hypothyroidism.

Materials and Methods: In a case-control study, Thyroid stimulating hormone (TSH), free T3, free T4, anti thyroperoxidase (TPO) antibodies, total cholesterol, high density lipoprotein(HDL) cholesterol, low density lipoprotein (LDL) cholesterol, Very low density lipoprotein (VLDL) cholesterol, serum triglycerides were measured in 50 patients with subclinical hypothyroidism and 50 age- and sex-matched Euthyroid controls after an overnight fasting.

Results: Mean serum triglycerides (TG) and very low-density cholesterol (VLDL) were significantly higher in patients with SCH than controls (P < 0.05). No association was found between serum total cholesterol, high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol and SCH.

Conclusions: Dyslipidemia is more common in SCH compared to controls. High serum triglycerides and VLDL were observed in patients with SCH.

Keywords: Subclinical hypothyroidism (SCH), TSH, Lipid Profile.

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Disseminated Intra-Abdominal Hydatidosis: A Case Report

Abstract—Hydatid cyst disease is a zoonotic disease caused by the larval stage of Echinococcus granulosus and Echinococcus Multilocularis. In human beings, apart from involving the liver and lungs commonly, it also affects other organs like brain, kidney and spleen. Rupture of Hydatid cyst into abdominal cavity causes disseminated abdominal hydatidosis which is a rare complication. Here this rare case was presenting as a 48 years old female patient of disseminated intra-abdominal hydatidosis. Disseminated abdominal hydatidosis occurs secondary to traumatic or surgical rupture of a hepatic cyst. Ultrasonography or Computed Tomography findings are helpful in making a definitive diagnosis. For localized hydatid cysts in liver or lungs, the management of choice is preferably surgical while the treatment for disseminated intra-abdominal hydatidosis remains medical. Albendazole is the treatment of choice for disseminated abdominal hydatidosis.

Keywords: Zoonotic, Disseminated, Abdominal, Hydatid Cyst

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Immune Reconstitution Inflammatory Syndrome (IRIS) Associated Multifocal Leukoencephalopathy (PML) in Patients with Human Immunodeficiency Virus (HIV) Infection: A Case Report

Abstract—Progressive Multifocal Leukoencephalopathy (PML) is seen mostly in advanced human immunodeficiency virus (HIV) infection. In some individuals, especially those with very low CD4+ counts, worsening of PML or new-onset PML can be observed after the initiation of highly active antiretroviral therapy (HAART). A case of IRIS associated PML is reported here which is much more rare as compared to PML in HIV patients unrelated to HAART. This is thought to be secondary to immune reconstitution inflammatory syndrome (IRIS). IRIS is defined as a paradoxical deterioration of a previously existing infection which is related to the immune system recovery. It is suggested to occur due to an imbalance of CD8+/CD4+ T cells. So in HIV cases with low CD4 counts and if one is on HAART then should be further investigated for IRIS and PML.

Keywords: PML, HIV, HAART, IRIS

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Role of 3-Dimensional Sonohysterography in Infertility

Abstract—3D ultrasound (3-dimensional sonography) when combined with sonosalpingography, it provides detailed information regarding internal and external contours of the uterus, without the need for radiation contrast material or surgical intervention. This study was done because of the need of such diagnostic modality that is highly accurate as well as least invasive. A descriptive study was conducted on 50 infertile females to assess the diagnostic value of 3-dimensional SHG in reference of diagnostic hystero-laproscopy (DHL) assuming as gold standard. It was found that sensitivity of 3-dimensional SHG reasons of tubal patency, ovarian pathology and uterine cavity was found 97.6%, 90.91% and 71.43% respectively. And diagnostic accuracy of 3-dimensional SHG in reference of DHL for tubal patency, ovarian pathology and for uterine cavity was found 96%, 92% and 96% respectively. So it can be concluded from present study that 3-Dimensional sonohysterography is an efficient tool to assess women with infertility. Its sensitivity, specificity, and diagnostic accuracy is comparable to hysterolaproscopy.

Keywords: Infertility, 3-dimensional SHG (SHG), Diagnostic Hystero-Laproscopy (DHL), Diagnostic Values.

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Medial Temporal Lobe Encephalitis associated to Chikungunya Virus Infection: A Case Report during First Epidemic in Americas

Abstract—Chikunguniya can be associated with encephalitis which is a rare complication of chikunguniya. Such a rare case was attended at National University Hospital (Hondura) in August 2015, which was studied in detail. A 64 years, Honduran patient was admitted during the convalescent period of an acute febrile illness with arthralgias one month prior. Two weeks later, he developed a severe inability to form new memories disorientation to date and time; forgetting family member´s names and daily routines. The patient exhibited spontaneous crying and sadness. Premorbid cognitive, behavioral and functional abilities were normal. Patient was evaluated and investigated. On investigation Chikungunya IgM antibodies were positive and on Brain MRI revealed predominantly right medial temporal lobe hyperintensities in Diffusion weighed images; also seen in FLAIR sequences. Patient was confirmed as Chikunguniya case associated with medial temporal lobe encephalitis. So it is suggested that patients presenting with a rapidly evolving amnestic syndrome after an acute febrile illness with polyarthralgias in an endemic region should be tested for the Chikungunya virus. More cases must be described and studied, however, to better characterize this condition.

Keywords: Temporal Lobe, Encephalitis, Chikungunya.

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Saturday, 1 April 2017

Medical Journal:: IMJ Health : March 2017

Medical Journal: Published volume-3, Issue-3, March 2017 with adpublications

Mefenamic acid induced Acute Generalized Exanthematous Pustulosis (AGEP): A Case Report

Abstract— Acute Generalized Exanthematous Pustulosis (AGEP) is a rare severe cutaneous adverse reaction mainly caused by drugs. It is characterized by an acute pustular eruption over the body along with fever and leukocytosis. It has been known to resolve spontaneously over a period of 2-3 weeks without long term sequelae. However it is of utmost importance for the physicians to clinically identify this condition as to prevent unwanted extensive management. Mefenamic acid is a non-steroidal anti-inflammatory drug (NSAIDs) prescribed over the counter for pain relief. A sixteen year old boy is reported here who developed AGEP after taking mefenamic acid for fever and joint pain. It was diagnosed with the help of history, clinicopathological correlation, AGEP validation score and recovery on withdrawal of the drug. To the best of our knowledge this is the first case report of mefenamic acid causing AGEP in the literature.

Keywords: Mefenamic acid, Acute Generalized Exanthematous Pustulosis, AGEP.

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Assessment of Willingness for Organ Donation: A cross-sectional descriptive study

Abstract—Organ donation is very important action by which a life can be saved, so it is advisable to determine fill the formalities for organ donation at least at the time of death. But due to lack of awareness along with myths and misconceptions add to the low percentage of organ donation in India. So this descriptive study was carried out on 815 more than 18 year aged participants with the aim to assess the willingness for organ donation in participants with reasons for willingness as well as for unwillingness. It was found willingness for donate their organ were only in 50.4% of participants whereas 20.9% did not want to donate and 28.7% did not decide. The most common reason found for willingness in this study was ‘I could save many life from donating my body' i.e. in 80.8% followed by ‘After death I will be alive' response (51.5%), ‘It’s saintly work' response (50.6%), 'Society will be benefited' response in 42.2% and 'On being motivated by media and people ' response in 35.8% of participants. And when reasons for not willing to donate their organ was discovered in this study, it was found that majority (55.9%) could not explain any reason for that while 17.1% were feared that family and doctors will not save them, 14% said that family members will sell their organ (14.0%) and few (12.9%) said that it’s against my religion. It can be observed that a quantifiable (35.8%) of participants were motivated for willingness for organ donation through media and people are having myths regarding organ donation. So to promote organ donation, awareness for organ donation and its related issues should be encouraged through various medias.

Keywords: Organ Donation, Willingness.

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Prevalence of Post-operative Surgical site infection in a district Hospital of western Rajasthan India

Abstract Wound infection is the second commonest complication of wound healing. This study was carried out on 250 post-operative cases operated at a district hospital of western Rajasthan, India with the aim the aim to find out prevalence of post-operative surgical site infection and its causing organism. After taking personal information and detailed clinical, operative and post-operative history of these cases, swab from post-operative wound was taken and sent for culture and sensitivity test in Microbiology. Association was inferred with Chi-square test. Post operative surgical site infection rate was found 11.6 % which was found significantly more in intestinal surgeries than the other. Most common causative organism for infection was Staphylococci cases followed by Streptococci, E. Coli and Klebsella. Out of total 11.6% infected cases, majority (8.8%) of patients had infection with more than one organism only 2.8% were having single organism.

Keywords Post-operative surgical Site Infection (SSI), Micro-organism, SSI Infection Rate.

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Comparison of Resistance and Sham Training of Expiratory Muscles on Pulmonary Functions in Patients with Spinal Cord Injury: An Interventional Study

Abstract— Respiratory complications are major sources of morbidity and mortality in spinal cord injury (SCI). Improvement in expiratory muscle strength may be associated with improved cough and clearance of secretions. So that expiratory muscle training are advised in SCI cases to improve expiratory muscle strength. This study was conducted to compare the effect of Resistance and Sham training on pulmonary function test in spinal cord injury cases. It was found the mean value of all the parameters of PFT of Sham training was found to increase from baseline to 1st and 2nd follow up. This difference was found significant in all the parameters of PFT at 2nd follow up, but FEV1 and PIFR of 1st follow up (p value < 0.05) only. Likewise, it is also observed that the mean value of all the parameters of PFT of test group was found to increase from baseline to 1st and 2nd follow up. This difference was found highly significant (p value <0.001) in all the parameters of PFT at 1st and 2nd follow up. So it can be concluded that however both the type of training improve PFTs but the improvement of high resistance training was significantly more than they were for sham training.

Keywords: Spinal Cord Injury (SCI), Pulmonary Function Test, Resistance Training and Sham training.

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Perimenopausal symptoms, quality of life and eating behavior in west Algerian women

Abstract— This study was conducted to find out the impact of menopausal transition symptoms on quality of life and eating behavior in west Algerian women.

Subjects and methods: A prospective cross sectional survey was conducted between February 22 and April 30, 2016 in Oran (west Algeria). Eighty (48±2 years) perimenopausal women participated to the study. A structured interview survey was developed on socioeconomic level, climacteric symptoms and quality of life. Daily energy expenditure (DEE) was assessed by an adapted questionnaire and food intake by a 24h "Recall and Record".

Results. Hot flushes, night sweats, palpitations, anxiety, headaches, memory loss and insomnia were the symptoms feeling by women. The quality of life assessment showed that 53% had a moderate quality of life (10 to 15 symptoms), 16% with poor quality of life (16-20 symptoms) whereas 25% had a good quality of life (5 to 10 symptoms) and 6% of women had an excellent quality of life (≤ 5 symptoms). At this time of the menopausal transition, 64% reported modification in their eating behavior.

Conclusion: Clinical symptoms of perimeanopausal period influence the quality life of women on menopausal transition.

Keywords: Perimenopause, Quality of life, Behavior food.

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Tuesday, 7 March 2017

IMJ Health : February 2017

Medical Journal: Published volume-3, Issue-2, February 2017 with adpublications

Relation between Back Extensor Strength, Bone Mineral Density, Kyphosis and Lordosis in Elderly Women

Abstract—Kyphosis and lordosis changes might be related to back extensor weakness and osteoporosis. The purpose of this study was to find out the correlations between thoracic kyphosis, lumbar lordosis with back extensor strength (BES) and bone mineral density (BMD).

Methods: Thoracic kyphosis, lumbar lordosis, maximal isometric strength of the back extensors and BMD of the lumbar vertebral were evaluated in 47 elderly (50-75 years old)women. BMD of the lumbar vertebral was measured using Dual-Energy X-Ray Absorptiometry (DEXA) and kyphosis and lordosis degree were assayed using a flexible ruler. The maximal isometric strength of the back extensors was measured using an isometric manual muscle tester (MMT). Data were analyzed using ANOVA and independent t-test at p≤0.05 level of acceptance.

Results: A significant reverse correlation was shown between BES and kyphosis (p=0.044, r=-0.30). No significant correlation were found between BES and lordosis degree, nor between lumbar vertebral BMD and, both, kyphosis and lordosis degrees. However, there was a significant difference in BES between three groups with various degree of kyphosis (p≤ 0.05).

Conclusion: It can be concluded that the severity of thoracic kyphosis may be influenced by BES. So, stronger back extensor can prevent thoracic kyphosis despite decreased BMD.

Key Words: Bone Density, Muscle Strength, Kyphosis, Lordosis.

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Pregnancy Outcomes of Oligohydramnios at Term diagnosed by Ultra Sonography (USG): A Case Control study

Abstract— This study was conducted to find out if AFI ≤ 5 cms has any clinical significance in identifying the subsequent fetal distress & associated maternal & perinatal outcomes, in pregnancies beyond 37 weeks.

Methodology: This is a prospective case control study done from July 2010 to July 2012 (24 months) at Dr Vasantrao Pawar Medical College, Hospital and Research Center. Adgaon, Nashik. It study the pregnancy outcome comparison of 58 Anenatal Cases(ANCs)as Study Group with diangosis of oligohydramnios (AFI ≤ 5 cms) by ultrasound after 37 completed weeks of gestation were compared with 58 ANCs (Control Group) with no oligohydramnios (AFI > 5 cms). These two groups were matched for other variables like age, parity, gestational age and any pregnancy complication.

Results: There was significant difference between two groups. Hypertension and Preeclampsia were found significantly more in ANCs with oligohydramnios. FHR deceleration was also significantly higher in women with oligohydramnios. Women require LSCS were also significantly more in women with oligohydramnios. Newborn borned by women with oligohydramnios had significantly more chances to admit in NICU than in newborn born by women without oligohydramnios.

Conclusion: It can be concluded from this study that women with oligohydramnios poor pregancy outcomes. Determination of AFI can be used as an adjunct to other fetal surveillance methods. Determination of AFI can be used as valuable screening test for predicting fetal distress in labour, requiring caesarean section.

Key Words: Amniotic fluid index, Oligohydramnios, Fetal Distress.

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A Case Series of 500 Melasma Cases: A descriptive study

Abstract—Melasma is a third most commonly cited skin disorders was pigmentary problem diagnosed most often, other two are post-inflammatory hyperpigmentation and vitiligo. So this study was conducted on 500 cases of Melasma attending at skin OPD of Charak Bhawan, a hospital attached to SMS Medical College, Jaipur (Rajasthan) with the aim to study its clinical pattern. Severity of Melasma was assessed by MASI. It was observed from this study that centro-facial distribution was found most prevelent (52.2%) pattern of Melasma followed by Malar pattern. Although mean MASI scores was found 12.47±5.093 but majority (53.2%) of cases were of sever grade followed by moderate and mild grade of Melasma. Malar area was most affected area (99.8%) followed by forehead area and chin area. Variation of area affected with Melasma was found significant (p<0.001). It was also observed that darkness as well as homogenecity was significantly more at malar region than that of forehead and chin. So it was also be concluded from this study that Melasma cases who are attending at Skin OPD are having melasma lesion on malar region and of sever grade. Reasons for this observation is o be explored with further research.

Key Words: Melasma, MASI scores.

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Accredited Social Health Activist (ASHA) Performance Indicator Assessment of Jaipur City: A Cross-sectional Study

Abstract NUHM was launched in 1 May 2013 to improve the health status of the urban population particularly slum dwellers and other vulnerable urban section by facilitating their access to quality health care. And ASHAs are a ‘bridge’ or an interface between the community and health service outlets. NHM set some standard for working of ASHAs. So this study was conducted to assess the status of performance indicator for ASHA in area of Jaipur city. This cross-sectional study was conducted on 172 ASHAs working in Jaipur city. It was observed in this study that more than 80% was achieved in percentage of families counselled, ANC adequately covered, Institutional deliveries and completely immunized for age in 12-23 months age children among ASHA performance indicators. Newborn visit within 1 week of delivery, JSY claims made and newborn who were weighed by ASHAs were achieved of 70-80%. And less than 50% achievement was regarding percentage of children with diarrhoea received ORS and fever cases who received Chloroquine within first week. It can be concluded from this study that best ASHA performance indicator achieved was of percentage of institutional deliveries which is 82.53%, followed by regarding ANC adequately covered with at least 4 visits, Immunization of 12-23 months age, families counselled, newborn visit within 1 week of delivery, JSY claim made, newborn who were weighed, deliveries escorted, children with diarrhoea received ORS and fever cases who received Chloroquine within first week.

Key words: ASHA, Performance Indicators of ASHA.

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Determinants of Anemia in Antenatal Cases: A Cross-sectional Analysis

Abstract— Anemia in pregnancy is a major health problem in developing country like India. So this present study was carried out at Dr. Kusum Sharma Hospital Bharatpur (Rajasthan) India, with the aim to find out the determinents of anemia in Antenatal cases attended for delivery. period on pregnancy outcomes. For this study, 100 Antenatal Cases (ANCs) attended for delivery at Dr. Kusum Sharma Hospital Bharatpur (Rajasthan) India were included in this study. These ANCs were interrogated and investigated for hemoglobin estimation. It was found in this study that 63% of proportion of ANCs were having Anemia. Anemia was found to associate with age, residence, education, occupation and parity of ANCs but not with BMI and bad obstetric history of ANCs. Anemia was found significantly more in younger age, less educated and housewives than their counterparts. Likewise ANCs of rural area had more chances of Anemia than those residing in urban areas. And ANCs having either zero parity or parity more than two had more probability to have anemia than their counterparts.

Keywords: Antenatal Cases (ANCs), Anemia in pregnancy, Determinants of ANCs

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Monday, 6 February 2017

IMJ Health : January 2017

Medical Journal: Published volume-3, Issue-1, January 2017 with adpublications

Status of major Infectious diseases of IDSP at a tertiary level hospital in western Rajasthan in year 2015: A Record base analysis

AbstractThe frequent occurrence of epidemics even after the launching of the Integrated Diseases Surveillance Programme (IDSP) was an indication toward inadequacy of the control system. These epidemics/outbreaks may be identified if disease status analysis is done properly. The aim of the this study was to find out status of some of major diseases included in the IDSP in a tertiary level hospital of western Rajasthan. It was a record-based analysis carried out in hospitals attached to SMS medical College, Jaipur (Rajasthan) India. Weekly report of IDSP in 'L' Form was collected of year 2015 from SMS Medical College, Hospitals. Data related to major diseases of IDSP were gathered from these reports. These reports were analysed in percentage and proportion. It was observed among major six diseases studied in this present study, majority of cases were of Swine flue followed by Dengue, Scrub Typhus and Malaria. There was no case of Chikungunia and Enteric Fever. When deaths due to these major six diseases were observed it was found that majority of deaths occurred due to Swine flue followed by Dengue, Scrub Typhus and Malaria. Malaria death was due to Plasmodiun Falcifarrum. Maximum PCR was of Swine flue (42.32%) followed by Dengue (29.16 %), Scrub Typhus (21.87%) and Malaria (6.65%). Maximum PDR was of Swine flue (93.08%) followed by Dengue (3.08%), Scrub Typhus (3.08%) and Malaria (0.77%). Overall Case Fatality (CFR) of these diseases was found 9.2%. Regarding variation CFR of these diseases it was found that maximum CFR was of Swine flue (20.23%) followed by Scrub Typhus (1.29%), Dengue (1.06%) and Malaria (0.97%). This variation of CFR as per the type of diseases was found with significant variation (p<0.001).So more emphasis should be given to more fatal disease like swine flue.

Key words: Communicable Diseases, Survillance, IDSP, PCR, PDR, CFR
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Seasonal variation in major post surgical site infection micro-organism in SMS Hospital Jaipur (Rajasthan) India

Abstract Season seems to have its role in wound infection which is the second commonest nosocomial infection and most troublesome disorder of wound healing. This study was carried out on 100 post-operative cases of Surgical Unit 1st of General Surgery Department of Sawai Man Singh Hospital, Jaipur (Rajasthan) India in years 2014. This study aimed to find out the seasonal trend in Post-operative wound infections (PSI). After interview of these, swab from post-operative wound was taken and sent for culture and sensitivity test in Microbiology. Results were inferred by Chi-square test. In this study, post-operative wound infection rate was found 21%. In majority of cases, causative agent found in post-operative infected wound was Staphylococci (90.48%) followed with Streptococci, E. Coli, Klebsella and Pseudomonas. Maximum cases were found in April followed by March, January and none was found in other months but this variation was not found significant.

Keywords— Post-operative wound Infection, Seasonal Variation, Micro-organism.

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Effect of Anemia on Pregnancy outcome: A Case-control study

Abstract— Anemia in pregnancy is commonly considered as risk factor for poor pregnancy outcome and can threaten the maternal and fetal life also. So this present cases control study was carried at R. K. Joshi District Hospital Dausa (Rajasthan) India, with the aim to find out the effect of anemia in Antenatal period on pregnancy outcomes. For this study, 50 Antenatal Cases (ANCs) with anemia were selected as study group among ANCs attending for delivery in district hospital Dausa. For control group age and BMI matched 50 normal healthy ANCs without anemia were selected from the same area. ANCs with any other diseases were excluded from the study. It was found in this study that although proportion of ANCs with LSCS, PPH and Sepsis were higher in anemic ANCs but it was not found significant. Likewise IUGR, LBW babies, premature births and still births were more in anemic ANCs but it was found significant only in case of LBW babies. So it can be concluded that anemia in ANCs effect weight of newborn babies born by ANC with anemia.

Keywords: Antenatal Cases (ANCs), Anemia in pregnancy, Pregnancy outcomes IUGR , LBW babies

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Role of Serum Lipids and Free Radicals in Myocardial Infarction in NIDDM: A Case Control Study

Abstract—Abnormalities that characterizes lipoprotein metabolism in non-insulin dependent diabetes mellitus (NIDDM) patients, fasting concentration of triglyceride rich lipoprotein especially very low density lipoprotein (VLDL) are higher and those of HDL, commonly measured as HDL-c, are lower than among people without diabetes, which leads to increased triglyceride HDL-c ratio and insulin resistance. This type of diabetic dyslipidemia is a major cause of oxidative stress which promote and accelerate atherosclerosis and thus, end organ damage AMI. This present study was carried at the Central Clinical Laboratory MIMSR Medical College Latur, with the aim to find out the role of lipoprotein-triglyceride in myocardial infarction in NIDDM. For this study, patient with myocardial infarction with NIDDM were selected after admitting in MIMSR Medical College Latur. These 25 cases were included in study group and age-matched to these cases 50 healthy subjects were selected as Control group. The lipid profile and total serum lipid peroxides (malondialdehyde) of study and control groups were assessed & compared. It was found that in the control group mean values of total cholesterol was 180.21 ± 18.13 mg % whereas it was 229.21± 23.58 in study group, which was significantly higher in study group. Likewise, mean Serum Triglycerides and Serum Lipid Peroxides (MDA) of study group were also found significantly (p<0.001) higher that of control group (228.14 v/s 99.9 and 410.22 v/s 180.96 respectively). It was also revealed in this study that mean Serum HDL-Cholesterol was found significantly lower in study group whereas LDL-Cholesterol (28.72 v/s 53.83) and VLDL-Cholesterol were found significantly higher in study group that control group (150.61 v/s 106.60 and 46.30 v/s 19.8). So it can be concluded that AMI patients with NIDDM have higher Total Serum Cholesterol, Serum Triglycerides, Serum Lipid Peroxides (MDA), LDL- Cholesterol and VLDL- Cholesterol with lower HDL- Cholesterol.

Keywords: Diabetic dyslipidaemia, Insulin Resistance, Oxidative Stress Malanodialdehyde and Myocardial Infarction.

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Saturday, 31 December 2016

IMJ Health : December 2016

Medical Journal: published its volume-2, Issue-12, December 2016 with AD Publications

Experiencing Social Marketing: An Attitudinal Study on Family Planning in Addis Ababa, Ethiopia

Abstract— Issue of family planning has gained attention due to its importance in decision-making about population growth and areas related to the overall socio-economic development of a nation. Social marketing, on the other hand, has gained popularity in addressing issues related to change in social behaviors such as family planning, and particular to developing nations like Ethiopia. This study makes an attempt to relate the idea of social marketing, as an approach of bringing attitudinal changes in the behaviors of individuals toward the concept of family planning and usage of contraceptives. Specifically, the objectives include an examination of the role of social marketing-mix in family planning experiences and to compare the attitudes of men and women toward family planning.

In order to gather the primary data, structured (draft) questionnaire was prepared and tested through a pilot-study (with 35 respondents). The final survey comprises 150 respondents, selected accidently by having a quota of 50% for each gender. Factor and reliability analysis were used to test the validity and reliability of the scale items. The result revealed that attitude towards family planning and contraceptives usage found being highly affected by the awareness and responsibility towards society/service usage. Therefore, as the marketing activities like promotion increases, awareness is expected to increase, which finally determines favorable attitude towards family planning products/techniques (e.g., contraceptives).

Keywords: Social Marketing, Family Planning, Contraceptives, Attitudes, Behavior, Ethiopia.

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Status of qnr and aac(6’)-lb-cr Genes in Quinolone-Resistant Non-Fermenters

Abstract— Non-fermenters are aerobic non-spore forming Gram-negative bacilli that either incapable of catabolized carbohydrates as a source of energy or degrade them via oxidative rather than fermentative metabolic pathways. In the group of non-fermenters Pseudomonas aeruginosa is eminent pathogen followed by Acinetobacter baumanni. Both of these organisms are reported for their intrinsic resistance against antibiotics and their ability to acquire gens that encode resistance. Resistant against quinolones like ciprofloxacin is common against Gram’s negative non-fermenters. For most of the mechanism of resistant in both of these organisms against quinolone, is the production of aminoglycoside modifying enzymes, mutations in topoisomerases, up-regulation of efflux pumps and presence of plasmid mediated qnr genes. In this study, during the study period total 94 non-fermenters were isolated from 378 numbers of different clinical specimens. Out of 94; 21 isolates were found resistant against quinolone antibiotics like ciprofloxacin-5 µg, levofloxacin-5 µg , norfloxacin-10 µg, which were subjected for PCR studies to detect resistant genes, only five (23.81%) isolates were found to be associated with aac(6’)-lb-cr and two (9.52%) were found positive for carrying qnrD gense as additional with aac(6’)-lb-cr genes. Organisms that processed qnrD and aac(6’)-lb-cr gens were, Pseudomona aeruginosa, Acinetobacter baumanni , Alcaligenes faecalis , Acinetobacter calcoaceticus, and Pseudomonas sp.

Key word: Non-fermenters, Quinolone resistant, PCR studies, QNR, aac(6’)-Ib-cr.

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Knowledge Status of Accredited Social Health Activist (ASHA) of Jaipur City

AbstractGovernment of India launched the National Rural Health Mission (NRHM) on 12th April 2005, to provide accessible, accountable, affordable, effective and reliable primary health care, especially to the poor and vulnerable sections of the population. And ASHAs are a ‘bridge’ or an interface between the community and health service outlets. NHM set some standard for ASHAs. So this study was conducted to assess the knowledge of ASHA of Jaipur city. This cross-sectional study was conducted on 172 ASHAs working in Jaipur city. In the present study, all the ASHAs know their role about Immunization, Ante Natal Care and to inform Sub Centre/PHC/CHC about births and deaths in the village & outbreak of health problem/disease in the community. The majority (>80%) ASHAs knew their role in Post Natal Check-up, counseling women for Birth preparedness, safe delivery, exclusive Breast feeding, complementary feeding, Personal hygiene and sanitation. Promoting hand washing after toilet and before food handling was known to 153 (88.95%) of ASHAs. It was concluded from the study that majority of ASHAs know their role and details of their practices in all expected field except regarding basic sanitation and hygiene. Knowledge of ASHAs regarding their role about basic sanitation and hygiene of community i.e. to 19.19% of ASHAs only. Likewise regarding promote construction of toilet was also known to only 17.44% of ASHAs. Even only 37.79% of ASHAs knew about immunization may be given in mild fever.

Key words: ASHA, Knowledge Status of ASHA.

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Comparative Outcome of Basi-Cervical Neck of Femur Fractures Fixed Using DHS with and without De-Rotation Screw

Abstract— Basicervical fracture necks of femur are intermediate between femur neck fracture and intertrochantric fracture. These fractures having axial and rotational instability are traditionally being treated with DHS. DHS allow solid fixation in two planes only, additional derotation screw allow stability in third plane also.

Objective: To compare outcome of basicervical fracture neck of femur treated with and without derotation screw.

Material and Methods: Patients were divided in two groups i.e. group 'A' and group 'B' each group having 30 patients. Group 'A' patients were treated with DHS with derotation screw and group 'B' patients with DHS alone.

Results: At 12 months postoperatively patients were clinically and radiologically evaluated. All frcture were united in Group 'A' within an average period of 12.5 week while three patients (10%) ended up in non-union in group 'B'. Mean sliding distance in group 'A' was 5.6 mm while it was 6.2 mm in group 'B'. Mean shortening of limb was 3.8 mm in group 'A' which was 4.3 mm in group 'B'. In group 'A' there was no major displacement between the fracture but in group B there was >3 mm displacement in five patients (16.66%). According to modified Harris hip score in group 'A' 26 patients (86.66%) had excellent results, two patients(6.66%)had good results, one patient(3.33%) had fair results and in one patient(3.33%)poor results was obtained.

Conclusions: It can be concluded from study that there were better radiological and clinical outcome in DHS with derotation screw than DHS alone in basicervical fracture neck of femur.

Key words: Basicervical fracture, DHS, Derotation screw.

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Tuesday, 6 December 2016

Medical Journal: November 2016 Issue

Medical Journal: AD Publication had published its Volume-2, Issue-11, November 2016 Issue with International Multispeciality Journal of Health (IMJ Health)

Outcome Analysis of Outpatient Total Knee and Total Hip Arthroplasty: A Follow up upto three Months

Abstract— Traditionally total knee and hip arthroplasty surgeries requires long duartion of hospital stay. More duration of stay has its own disadvantages. So it was tried to developed an accelerated clinical pathway for patients undergoing total knee arthroplasty (TKA) and total hip arthroplasty (THA) who are considered healthy enough for early discharge. Between March 2013 – April2014, 89 TKA and 116 THA were performed to different patients at a single institution by a single orthopedic surgeon. 71 (31 TKA, 40 THA) met the inclusion criteria for the study. All patients received 2 grams of tranexamic acid and 750 mg cefuroxime sodium intravenously at 30 minutes prior to surgery. A multi-modal protocol for perioperative pain management was used for all patients. Out of total 71 patients (12 males, 59 females) with a mean age of 59 years (range, 24-79 years). The mean length of hospital stay was 27,3 hours (range, 15-60 hours). The mean duration of surgery was 92 minutes (range, 75-128 minutes) for TKA, 72 minutes (range, 48-81 minutes) for THA. Combined spinal epidural anesthesia was performed in 55 patients (77%) and general anesthesia in 16 patients (23%). Of the total 71 patients, 51 (71,8%) were discharged within 23 hours after surgery. Only 11(15.5%) were re-addmitted because of minor complains. These results of this study demonstrated that early discharge does not result in significant complications related to the outpatient procedure in selected patients up to three months postoperatively.

Keywords: Outpatient, Total Hip Arthroplasty, Total Knee Arthroplasty, Anesthesia.

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Determination of patterns in the EEG signals during relaxation through music using Bayesian Networks

Abstract—Today it is known that the brain waves behave during relaxation through music, however, it is not yet known whether there is a pattern of dependencies between different EEG frequencies during those processes. Brain oscillations are often underestimated as compared to slower oscillations. Mean power spectra of scalp EEG signals exhibit distinct peaks emerging from the general decrease in power with increasing frequency, suggesting the existence of characteristic dependence oscillatory modes in cortical field potentials. The interactions between peaks in different frequency bands, within and between cortical EEG sources, are not well understood. The reviewed evidence supports the theory that relaxation through music can lead to behavioral and neuron chemical changes with benefic effects. This study was to address this concept by focusing on Bayesian Networks (BN) to describe the relationship between the EEG frequencies during relaxation through music. It was obtained a model with 97.7% to accuracy, in which shows the relations between each EEG signals. The dependency probability distribution was calculated, according to the signal amplitude behavior. Music changes the behavior of the low frequency signals, synchronizing them inversely proportional. Delta and theta interactions over Alpha promote increase Alpha 1 powers in relaxation through music. This event is accompanied by synchronized interaction of low-sequence signals, from Beta 1 to Gamma. Alpha 2 remains an independent variable. Further studies are needed to understand the differences between music and their subsequent effects on behavior. However, Bayesian Networks has been show to an excellent tool of EEG signal Analysis.

Key word: Bayesian Networks, Brain, Machine learning, Data mining.

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Fuzzy Inference Modeling of Risk Factors in Coronary Diseases : A Review

Abstract- To estimate the variation in the major risk factors for cardiovascular disease (Hemoglobin HGB; mean corpuscular volume MCV; Mean corpuscular hemoglobin concentration MCHC; Fe and Folic acid), we try preventing according coronary heart disease risk factors observed in elderly men and women in the region of Setif – Algeria. Participants.100 men and women aged 26 to 86 years for whom the physiological parameters were recorded. These parameters are risk factors for cardiovascular disease. The expected analysis was estimated using an artificial intelligence model including the principles of fuzzy logic. Risk factors are inputs of the system and the incidence of coronary heart disease is output. The observed data recorded from Analysis Central Laboratory of Setif university hospital - Algeria. Factors that promote coronary heart disease are inaccurate and uncertain. The effect of these factors varies from person to person. Their consideration as fuzzy variables is perfectly adequate. A database is established. Fuzzy inference rules are highlighted according to the recorded values. An algorithmic application is established making it possible to read instantly the number likely the person with a coronary disease just by the random introduction of the variables at the input of the system.

Keywords: Coronary diseases, Risk factors, Artificial intelligence, Fuzzy logic.

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Clinico-etiological profile of Empyema Thoracis in children: A Descriptive Analysis

Abstract—Empyema is an uncommon complication of childhood pneumonia. Although mortality rates in pediatric empyema are very low, empyema causes significant morbidity including substantial health care costs and burden of care. A descriptive observational study was conducted on 40 Empyema Thoracis in 0-12 years aged. Empyema was diagnosed as per “GOLDEN CRITERIA. Clinical profile including signs and symptoms was recorded with biosocial profile. Blood and Plural fluid examinations were also done. Microbiology and histo-pathological examinations were also done. Data collected were analysed, qualitative data were expressed in percentage and quantitative data were expressed in mean ± SD. Mean age of children was 5.01 years with slight female predominance (M:F = 2:3). Mean haemoglobine was 9.45 g/dl, Total leucocytes count (TLC) 17,293 with platelet counts 2.69 lakhs. PH of blood and plural fluid was 7.39 and 6.98 respectively. Cough was the most common complain (in 72%) followed by fever, breathlessness and chest pain. Likewise tackypnea was the most common sign elicited followed by pallor conjunctiva and cervical lymphadenopathy. On examination trachea was shifted either on right or left side in 52% cases, Creptations were observed in 72.5% of cases and Ronchi were observed in one (2.5%) case. Dullness on percussion, decrease air entry and decreased vocal resonance was observed in all the cases. Gram positive cocci and Gram negative bacilli were observed in 25% and 2.5% cases respectively. Out of these micro-organism, Streptococci, Staphylococci and Klebsela Pneumonae were found in 7.5%, 12.5% and 2.55 of cases respectively. Acute inflammation was found in 7.5%, chronic inflammation was found in 7% whereas Koch's was found in 18% of cases in histology.

Key word: Children, Empyema Thoracis, Clinico-Etiological Profile.

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Maternal polycystic ovary syndrome (PCOS) and Antenatal (ANC) Complications: A Case Control Study

Abstract Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women. Evidences shows variable finding regarding it's effect on pregnancy outcomes. This present study was conducted to determine whether maternal polycystic ovary syndrome (PCOS) is associated with adverse pregnancy outcomes in antenatal period. Prospective observational study, carried out in the department of Obstetrics and Gynecology, Indraprastha Apollo Hospitals, New Delhi, including 64 women with PCOS and 64 normal pregnant women between January 2013 and November 2014. It was found that Gestational diabetes mellitus (GDM) was significantly more frequent in the PCOS group than in the control group (p value = 0.009; OR=2.698 (1.213-6.001), this difference was not found statistically significant. Pregnancy induced hypertension (PIH) was also found significantly more frequent in the PCOS group than in the control group (p value=0.014; OR=3.41 (1.176-9.885). Miscarriage rate was not significantly different among two groups. So it can be concluded that women affected by PCOS carry an increased risk of adverse pregnancy outcomes specially GDM and PIH.

Key word: Polycystic ovary syndrome (PCOS), ANC Complications, GDM, PIH.

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Factors associated with Physical Quality of Life in Diabetes Mallitus

Abstract—Diabetes is a disease of development involving multisystem so intend to affect quality of life of patients in many ways i.e. Physical, Mental, Social and environmental. So this study was conducted on 250 Diabetes Mellitus patients to study their physical quality of life and its associating factors. It was found that 9.6% of diabetes patients had poor physical quality of life in this study. This physical quality of life is associated with education and socio-economic status of patient but not with age, sex and occupation. Physical quality of life was observed more poor in either illiterates or in secondary educated patients than their other counterparts. Likewise physical quality of life was observed more poor in Class III and IV than Class I, Class II and Class V.

Keywords Diabetes Mellitus, Physical Quality of Life.

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Friday, 4 November 2016

Medical Journal:: IMJ Health:: October 2016 Issue

Medical Journal: AD Publication had published its Volume-2, Issue-10, October 2016 Issue with International Multispeciality Journal of Health (IMJ Health)

Modeling and Preventive Measures of Ebola: An Analysis of an Epidemic in Libya

Abstract—Ebola is a rare virus, which can cause severe acute hemorrhagic fever and high mortality for humans and non-human primates. In 2014, Ebola virus out breaking in West Africa triggered a grave disaster to the people of the world, finally, it has been inhibited successfully under the vaccine and effective drug. In this article, data from patients and deaths due to Ebola were collected, which were reported by WHO. These data were analyzed and researched the spread of Ebola by SEIR model. In this model, basic reproduction number obtained was 15, which was based on the number of dead and patients from June to September in Libya. And according to the sensitivity analysis for basic reproduction number, it was proved that improving vaccination rate and recovery rate of infectious are two effective ways to suppress the spread of the Ebola epidemic. This article gives a detailed and direct scientific theory basis for the control of Ebola virus in the end.

Keywords Ebola, Differential Dynamic Equations, Basic Reproduction Number.

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Menstruation and Menstrual hygiene among Adolescent girls of Ahmadabad city: A Descriptive Analysis

Abstract—Adolescence proves to be the most vulnerable phase in the path of human life cycle after infancy. Adolescent Girls (AGs) have many issues related to menstruation which is seldom addressed. Unhygienic practices during menstruation endanger the reproductive health and well being of AGs. Hence, a study was undertaken to assess the reproductive health status of Adolescent AGs.

Methodology: A cross-sectional study was carried out among 467 AGs attending Adolescent Friendly Health Service (AFHS) clinics in Ahmadabad city during May 2011 to august 2012.

Result: Mean age of AGs was 14.5+2.4 years. Out of 467 AGs, 296 (63.3%) had attained Menarche. Mean age at Menarche was 13.31+1.31 years in this study (Fig 1). Source of information regarding menstrual cycle was mother in 77.7% AGs in this study. Dysmenorrhea was present in 59.9% AGs. Dysmenorrhea was seen in 107(67.3%) AG in the late adolescence, 68(53.1%) in mid adolescence and 2(22.2%) in early adolescence. The difference in occurrence of Dysmenorrhea observed in different phases of adolescence was significant (χ2=37.423,Df=2,p<0.0001). Pre-menstrual tension was complained by 27.7% AGs and Vulval pruritus by 2% AGs.

Conclusion: This study highlights the need of AGs to have correct and complete information regarding menstruation at appropriate age from formal channels of communication which is mother in this case. Informal channels such as friends and sister tends to increase the misconception and improper menstrual hygiene which could make the AGs vulnerable to infection.

Keywords Adolescent girls, Menstruation, Dysmenorrhea.

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Superior Orbital Fissure Syndrome due to Metastatic Prostatic Malignancy – A Case Report

Abstract— A 56 years old male patient, a known case of prostatic malignancy with skeletal metastasis presented with ptosis, exotropia, diminished pupillary reflex and limitations in extra-ocular movements of left eye. MRI brain revealed diffuse skull base and leptomeningeal metastasis. Whole body CT scan showed metastasis in ribs, scapula and in pelvic bones. He was diagnosed to have superior orbital fissure syndrome due to metastatic prostatic malignancy and was offered steroids and radiotherapy.

Key Words: Ptosis, Prostate, Metastasis.

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Sex determination using mastoid process measurements of dry skull bone: A Descriptive Analysis

Abstract—Study on human skeletal for sex determination has been a topic of interest among researchers. It appears to be the main reliable bone exhibiting sexually dimorphic traits, specially the mastoid region. Present study aims to determine the difference in mastoid morphometry between male and female bone for sex differentiation.

Material and methods: A descriptive observational study was conducted at Department of Anatomy, SMS Medical College, Jaipur between April- December 2014. Forty dry macerated adult Human skulls of age group above 18-25 yrs of known sex were included in which suture between the basiocciput and basisphenoid were united. Vernier Caliper was used for measurements of Mastoid process in Frankfurt’s Plane.

Results: Mastoid length was significantly larger in males as compared to females on both sides (p value <0.05). Cut-off of right mastoid length of 32.39mm and left Mastoid length of 31.71mm were highly accurate in differentiating male and female skull.

Conclusion: The parameters like mastoid process length can be used as predictors to determine gender and could be of immense use in forensic medicine and anthropology and will also serve as a future framework for estimating the craniofacial dimensions of other Indian population.

Key word: Mastoid Length, Sex Differentiation, Sex Determination.

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