Thursday, 5 April 2018

Medical Journal- March 2018

Medical Journal: Published volume-4, Issue-3, March 2018 with ad publications

Bacterial Examination of Wells of the Maâmora Tablecloth: A community based survey in Kenitra, Morocco

Abstract—Pollution of water resources is a global problem. Unfortunately, groundwater is more sensitive to contamination by industrial waste, agriculture, household waste and wastewater that lead to physicochemical (pesticides, heavy metals, nitrates) and biological (viruses, bacteria, parasites) pollution. Bacterial contaminations of water are responsible for the emergence of many serious epidemic diseases (Cholera, Typhoid, Tuberculosis etc). The purpose of this study is to find out the impact of farms intensification and untreated sewage discharges on the microbiological quality of Maâmora water wells. Initially, bacteriological analysis done to identify not only pathogenic faecal germs but also indicator germs which have the same origin and which indicate that the water has been in contact with feces. In a second step, these identified germs were counted. Germs included in this study were Escherichia coli and Streptococci. Analysis were done about total & faecal coliforms and faecal Streptococci from the raw water of 16 boreholes on the Maamora aquifer, Kenitra. Microbiological analysis of the waters of these studied boreholes were compared with WHO standards of potability i.e. Zero bacteria/100mL for Faecal Coliforms, Total Coliforms and Faecal Streptococci. This study reveal that there was more (33% to 42%) contamination in studied wells with total germs who attained 1 to 13 bacteria/1mL. These results calls for an improvement of the control water quality of the Maâmora and develop vigilance tools for decision-makers to managers.

Keywords— Pollution of water, Bacterial contamination, Maâmora Tablecloth, Morocco.

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Clinico-epidemiological study of wound infection: A case series type of descriptive study

Abstract—Surgical site infections (SSIs) are a substantial problem for patients undergoing procedures in spite of advances in surgical techniques and medical care. So this case series of SSI were studied to know the clinico-epidemiological profile of these cases to better know the etiology for better prevention. This study was conducted on 100 cases of SSI admitted and operated in surgical wards of upgraded department of surgery in Sawai Man Singh Hospital Jaipur, chosen at random irrespective of age, sex undergoing emergency laparotomies. It was observed from this study that most common sign and symptom was discharge (38%) followed by pain and tenderness (33%), raised local temperature (23%) and suture under tension/cut though (11%). Most of the wound infection was detected on 3rd to 5th post operated day. Regarding collection in wound it was observed that 60% was with seropurulent collection 18% with serous and purulent collection and 5% with fecopurulent collection. Etiological agent was found E. coli in 27% followed by Enterobactor (5%), Staphylococcus (2%) and Kleibsella (1%) and Pseudomonas (1%).

Keywords: Surgical Site Infections (SSI), Laparotomies.

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Micro-albuminuria in non-diabetic, non-hypertensive cardiovascular disease (CVD) patients: A case control study

Abstract—Cardiovascular disease (CVD) is a prominent health problem and micro-albunemia is one of the major causes of morbidity and mortality in these CVDs in developing countries. This case control study was designed to find out burden of micro-albuminuria in non-diabetic non-hypertensive CVD patients and its associating factors. In this study, 50 Non Diabetic Non Hypertensive CVD Patients were submitted to a complete clinical and laboratory evaluation. Patients with known micro-albuminuria, UTI and congestive heart failure were excluded. These cases were compared with matched controls. It was observed that 36% of non-diabetic, non-hypertensive CVD patients had microalbuminuric by Clinitek method. There was a positive association between dyslipidaemia and micro-albuminuria was also observed in this study. The microalbuminuric CVD patients (non-diabetic, non-hypertensive) had significantly elevated levels of serum cholesterol (p<0.05), triglycerides (p<0.05) and LDL (p<0.05) as compared to normoalbuminuric patients. It can be concluded from this study that the micro-albuminuria was present in more than one third of non-diabetic non-hypertensive CVD patients. Older age group, Body Mass Index (BMI) and lipid profile had significant relationship with the presence of micro-albuminuria.

Keywords: Cardiovascular disease (CVD), Triglycerides, Micro-albuminuria.

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Comparison of pregnancy outcome with use of metformin versus insulin in management of gestation diabetes mellitus: An interventional study

Abstract—Gestational Diabetes Mellitus (GDM) is a problem which may occur during pregnancy. For treatment of GDM either the Metformin or Insulin is used. So this prospective randomized multicenter trial in women with GDM was conducted to compare the treatment outcomes of metformin and insulin. This study was conducted at Rajkiya Mahila Chikitsalaya, in Obstetrics & Gynaecology Department of Jawaharlal Nehru Medical College, Ajmer. This study was done on 110 women who were diagnosed GDM by DIPSI criteria with a singleton pregnancy and meet entry criteria are randomized to insulin or metformin treatment (55 cases in each group).It was observed that metformin is equally efficacious and safe as insulin with a lot of advantages like less costly, better compliance, less weight gain, less change of hypoglycaemic attack and more feasible as insulin require several daily injection with not much difference in perinatal outcome except statistically significant difference in baby weight, mean cord blood sugar level at birth, large for gestation age. So it can be concluded that Metformin treatment is suitable for non-obese as well as obese type 2 diabetes patients in pregnancy without complications. Metformin is a safer alternate to insulin in GDM management with no adverse maternal and fetal outcome.

Keywords: Gestational Diabetes Mellitus (GDM), pregnancy outcomes.

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Bio-socio-demographic study of individuals with Pteryzium: A case series type of descriptive study

Abstract— Pterygium is a common disorder in many parts of the world including India. So this study is designed to find out the bio-socio-demographic profile of Pteryzium cases which can help in understanding its distribution. This study observed that mean age of individuals with Pteryzium was 37.23±1.71 years. Maximum number of cases belongs to ≥26-50 years of age (83%). Pterygium was found slightly more in females was 55.71% as compared to males (44.29%). Most of the cases were housewife (52.86%) followed by labourer (14.29%). Majority (80%) cases were exposed to sunlight. Mean size of pterygium was 2.616±0.529 mm ranging from 2 mm to 3.8mm.In our study, with Keratometer, mean astigmatism was found 1.35±1.127D and from Scheimpflug imaging, mean astigmatism was found 1.22±0.95D in this study.

Keywords: Pterygium, Bio-socio-demographic factors, Astigmatism Scheimpflug imaging.

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Incomplete EEC (Ectrodactyly, Ectodermal dysplasia and cleft lip/palate) syndrome with bilateral Entropion: A Case Report

AbstractEEC syndrome is a very rare syndrome having ectrodactyly, ectodermal dysplasia and cleft lip/ palate as cardinal signs with other variable associated features. Very few cases being reported. It is mostly inherited in an autosomal dominant manner. Such cases need coordinated multidisciplinary approach for treatment. A case of incomplete EEC syndrome having ectrodactyly and cleft palate with absence of the signs of ectodermal dysplasia with no systemic anomalies was reported. Other features noted in this case were syndactyly of fingers and toes with bilateral entropion.

Keywords: Syndrome, Ectrodactyly, Ectodermal dysplasia, Syndactyly, Entropion.

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Saturday, 3 March 2018

IMJ Health : February 2018

Medical Journal: Published volume-4, Issue-2, February 2018 with ad publications

Effect of Yoga on Anxiety: An Interventional study

Abstract— Regular practice of yoga promotes strength, endurance, flexibility and facilitates characteristics of friendliness, compassion & self-control. So this study was conducted to find out the effect of yoga on anxiety. This study was conducted on 200 anxiety cases having age range of 18 to 55 years. Hamilton anxiety scale was used to measure the anxiety. These cases were divide into two group randomly i.e. study group and control group. Study group was given certain set of yogic exercise. Both the groups were followed and results were compared where independent variables yoga and dependent variable Anxiety was used. Chi-square, independent t test, was used for data analysis. It was observed that Anxiety was significantly decreased after the yogic intervention (P=0.042S). So it can be concluded that yoga can reduce perceived stress improve well-being even more significantly so its recommend to do yoga regularly.

Keywords: Anxiety, Yoga, Hamilton anxiety scale.

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Associating factors of insomnia and depression in Glaucoma: A Descriptive analysis

Abstract—The role of emotional factors in glaucoma has received wide recognition by investigators and clinicians from the very beginning. Prevalence of depression in glaucoma has been estimated to be 10 to 12 percent in previous studies. Insomnia is another psychiatric co-morbidity reported with glaucoma. Both depression and insomnia in glaucoma patients may significantly affect overall quality of life in these patients adversely. The present study explores the predictive factors of insomnia and depression in patients with Glaucoma. A case-series type of observational study was carried out on 100 glaucoma cases attended at ESIC Model Hospital, Jaipur (Rajasthan) India. The PHQ -9 and ISI were used to assess depression and insomnia respectively. Data in details were collected as per pre-designed Performa. Data collected were analyzed and inferred with chi-square test. Insomnia and depression was found in 37% and 36% respectively in glaucoma cases. Insomnia and depression both were found associated with Age, Visual acuity in both the eyes and severity of glaucoma. No other studied socio-demographic and disease variables had significant association with either insomnia or depression. It was concluded that insomnia and depression are commonly found with glaucoma. Both insomnia and depression were found significantly more in older agr group, less visual acuity and sever glaucoma than their counterparts.

Keywords: Insomnia, Depression, Glaucoma, PHQ -9, Insomnia Severity Index (ISI).

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Friday, 2 February 2018

Medical Journal- January 2018

Medical Journal: Published volume-4, Issue-1, January 2018 with ad publications

Vitamin D deficiency and its associating factors: A cross-sectional analytic study

Abstract— Vitamin D deficiency is widely prevalent throughout the world. Pregnant women, neonates and infants form most vulnerable groups for vitamin D deficiency. Hypovitaminosis vitamin D in pregnancy has been reported to cause various fetomaternal effect. So this study was conducted to find out proportion of vitamin D deficiency among pregnant women and to assess the effects and its associating factors. For this purpose 120 Pregnant women on their first visit to hospital irrespective of gestational age were taken. Apart from routine obstetrical investigation, serum vitamin D (total) level was estimated. All results were recorded and analyzed statically. It was observed that 84.1% were found to be vitamin D deficient. Mean age of vitamin D deficient group and non deficient group were 28.31±3.86 and 26.37±2.83 years respectively. Religion and parity of women was not found to be associated with vitamin D deficiency whereas age, type of diet and use of sunscreen was found to be associated. Vitamin D deficiency was found significantly more in elderly, vegetarians and users of sunscreen than their counterparts. Regarding maternal and neonatal outcomes, development of preeclampsia, LSCS as mode of delivery, delivery of pre term and LBW babies were having controversial findings. So it suggest much more researches in this regards.

Keywords: Feto-Maternal Outcome, Hypovitaminosis D, Maternal Blood Vitamin D, Vitamin D Status in Pregnancy.

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Knowledge behaviour and practices regarding Malaria in rural population of South Goa: A cross sectional study

Abstract Vector-borne diseases (VBDs) represent a substantial burden globally as well as in India. Frequent outbreaks of malaria occur in rural areas. Implementation of preventive and control strategies largely depends on the knowledge and behavior of the community towards the disease. Hence the present study was conducted on 140 participants in a rural area of Goa to assess the knowledge and behavioral practices regarding malaria. A cross sectional study among residents more than 18 years of age was conducted for a period of two months. Almost all i.e. 93.5% participants had heard about malaria, 85.5% knew that it is preventable and majority knew that it is transmitted only via mosquito bite. Around 51.2% of the participants thought mosquitoes spreading malaria breed in dirty water. Out of total 89.3% of the participants used some form of personal protective measure to avoid mosquito bite. Government sector was preferred for health care by 46.4% of the participants in case of fever while 10% did not want to take any form of treatment. Hence providing periodic health education is essential for raising awareness, achieving behavioral change and improving the health care seeking behavior.

Key words: Malaria, Rural, Knowledge, Health Care Seeking Behavior, Health Education

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Gilbert Syndrome in Pregnancy: A Case Report

AbstractGilbert syndrome is a rare condition and rarely diagnosed before pregnancy. A 36 weeks pregnant female presented with severe vomiting, nausea, myalgia, abdominal pain, headache and yellowish discoloration of sclera, yellowish discoloration of skin since four days. She gave history of similar complaints at 16 & 24 weeks in this pregnancy and was treated conservatively with IV fluids. She have similar episodes in second pregnancy. When she was investigated, she came out to a case of Gilbert syndrome which is a rare case. So she was examined and investigated thoroughly to prepare a case report to publish. To conclude when any patient presents with unconjugated hyperbilirubinaemia associated with stress, infection or dehydration Gilbert Syndrome must be excluded. Once this diagnosis is made patient must be reassured of its benign nature, excellent prognosis and normal life expectancy.

Key words: Gilbert syndrome, unconjugated hyperbilirubinaemia, Pregnancy.

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A study of functional erythropoietin deficiency in patients with type-2 diabetes and anemia

Abstract— Anemia is a common finding in diabetes, particularly in patients with diabetic nephropathy or renal impairment. This study was designed to assess the prevalence of functional erythropoietin deficiency in patients with type-2 diabetes and anemia. In a hospital based observational descriptive study, 60 diagnosed diabetic patients were included. They were divided into 2 groups: group I had diabetic patients without anemia with/without diabetic nephropathy and group II had type 2 diabetics with anemia with/without diabetic nephropathy. Most of the subjects (50%) in group I without diabetic nephropathy had their serum erythropoietin levels in the range of 15-30 IU/L with a mean value of 19.01± 2.11 IU/L. All the subjects in group I who had diabetic nephropathy had their serum EPO levels between 15-30 IU/L with a mean value 24.17±3.03 IU/L. In group II with diabetic nephropathy, most of the subjects (72.5%) had their serum EPO value <15 IU/L with a mean value of 10.45± 1.61 IU/L and all the subjects without diabetic nephropathy had their serum EPO level above 30 IU/L with mean value 36.41±3.0 IU/L. Comparison of both groups showed highly significant difference in EPO levels statistically (P<0.001). This study suggest further researches to find out relation of functional erythropoietin deficiency with a pattern of damage to the renal tubulointerstitium and microvasculature in diabetic kidney restricting the production of erythropoietin to maintain red cell mass in response to tissue hypoxia or a defect of "Anemia sensing" mechanism.

Keywords: Anemia, Diabetes, Erythropoietin, Hemoglobin (Hb), Diabetic Nephropathy.

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Retinal thickness in multiple sclerosis: evaluation with optical coherence tomography

Abstract— In various neurodegenerative diseases ocular manifestations are very common which can be examined and monitored in vivo by a novel imaging technique Optical Coherence Tomography (OCT). So this study was conducted to compare retinal nerve fiber layer (RNFL) thickness and ganglion cell complex (GCC) between multiple sclerosis (MS) patients and healthy individual by optical coherence tomography (OCT). For this study 40 eyes of twenty consecutive MS patients and 40 eyes of 20 age matched healthy controls were taken. Comprehensive standardized ophthalmic examinations included visual acuity, cycloplegic refraction, color vision and intraocular pressure. Optical coherence tomography was performed using 3D Topcon OCT; RNFL thickness and ganglion cell complex (GCC) was detected with the inbuild software. Mean values for the thickness of the peripapillary RNFL and ganglion cell complex (GCC) were calculated and compared between both groups. It was observed that the RNFL thickness in each quadrant and ganglion cell complex (GCC) in MS patients were all significantly decreased in comparison to healthy controls. So it can be concluded that OCT is a valuable research instrument for evaluation and monitoring MS progression by measurement of the retinal nerve fiber layer (RNFL) as purely axonal structure (indicative for axonal loss) and the macular ganglion cell complex (evidence of neuronalloss).

Keywords: Optical Coherence Tomography, Multiple Sclerosis, Retinal Nerve Fiber Layer Thickness.

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Voluntary Blood Donation: Perception and Practices among Adult Population of a Semi-Urban Area of Udaipur, India

Abstract— There is a need to strengthen blood donor management in order to reduce the demand supply gap. Efforts are needed in this direction at all levels including educating and motivating more individuals to be involved in voluntary blood donation and converting them to retention donors. In order to develop rational and evidence based systems to be address blood shortage, it is needed to assess the current donor services and improve them to encourage more future donations. The present study explores the perceptions and practices of adults in a semi-urban area of Udaipur regarding blood donation and trying to identify the factors associated therewith. This cross sectional study was conducted on 3087 adult participants of semi urban areas of Udaipur from June 16, 2016 to August 15, 2016. It was observed that 91.2% of the participants were aware that blood donation is important for saving lives and 78.7% had a favorable attitude towards blood donation. However, in practice, less than 20% had ever donated blood. On further analysis educational level had found to have a significant effect on the knowledge regarding blood donation with p-value<0.00. So it can be concluded from this study that although the awareness about blood donation is quite high but very few people have actually donated blood voluntarily. Motivational interactive sessions at the community level are needed to allay the fears and misconceptions related to blood donation.

Keywords: Blood donation, Perceptions, Practices.

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Monday, 1 January 2018

Medical Journal- December 2017

Medical Journal: Published volume-3, Issue-12, December 2017 with ad publications

Communication on Educational-therapeutic method in language development in children with trisomy 21: A review

Abstract— This paper provides general information on the language of children with Trisomy 21, on their development and on the methods of educational-therapeutic intervention. I defined the means of applying of Total Communication in the development of communication and of the language in 21-trisomic children. Mental retardation in 21-trisomic children impairs learning ability in many fields, with a negative impact on children’s communication ability; these communication possibilities should be improved throughout their entire life. This paper highlights the methods of intervention using Total Communication, the evolution throughout therapy; the therapy will continue in order to attain the objectives determined within the complex educational therapy program. An early educative intervention contributes to the systematisation of all chances of obtaining a more rapid psychological development of 21-trisomic children until the level becomes easy to achieve.

Keywords: Communication, Trisomy 21, Language.

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A rare case of unruptured ectopic pregnancy in a rudimentary horn with a dead foetus of Fifteen weeks: A Case Report

Abstract— Pregnancy in non-communicating rudimentary horn is very rare and life threatening. It is often not diagnosed unless it terminates by rupture in the second trimester. Prerupture diagnosis of rudimentary horn pregnancy with USG is technically difficult, with sensitivity of 30%. Here a case of unruptured ectopic pregnancy in non-communicating rudimentary horn of unicornuate uterus at 15 weeks of gestation is presented. This patient presented in emergency department as a case of intrauterine fetal death. Laparotomy was carried out and excision of rudimentary horn was done.

Keywords: Ectopic Pregnancy, Rudimentary Horn, Unicornuate Uterus Foetal Death.

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Knowledge attitude and practices regarding animal bites and rabies in urban population of North-Goa

Abstract Rabies is an endemic zoonotic disease in India. Dog is the main reservoir of rabies in India and other developing countries? An estimated 20565 deaths are reported in India due to rabies annually. It is a universally fatal disease but preventable by timely post-exposure prophylaxis. The current study was undertaken to assess the knowledge, attitude and practices towards animal bites and rabies in an urban community catered to Urban Health Centre, Santa Cruz, North Goa. 150 adult family members, one from each randomly selected family from the urban community catered to Urban Health Centre, Santa Cruz, North Goa were interviewed using a semi-structured questionnaire regarding their personal details and their knowledge attitude and practices about animal bites and towards rabies. Out of the 150 study participants, 132 (88%) were aware of the disease rabies and majority i.e. 140 (93%) knew that dog bites lead to rabies. However only 60 (40%) were aware of other animal bites causing rabies. 116 (77%) of study subjects preferred a hospital for wound treatment. However a significant 34 (22%) preferred traditional remedy or healer. Nearly one third i.e. 44 (29%) of the study subjects preferred to observe the dog for at least ten days following dog bite before being advised the same at health facility. 47 (31.33%) of the study participants had been bitten by a dog in the past of which 35 (74.47%) were bitten by a stray dog. 62 (41.33%) owned a pet dog of which 32 (51%) were vaccinated.

Keywords: Knowledge, Attitude and Practices, Rabies, Dog bites.

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Central Neuropathic Pain after Acute Spinal Cord Injury (NP in SCI): A Case series of 494 SCI cases

Abstract Pain following Spinal Cord Injury (SCI) is very common. So this study was conducted to find out prevalence, associated factors and pattern of Neuropathic Pain (NP) among SCI patients, for which 494 consecutive eligible patients of Spinal Cord Injury (SCI) admitted in the Department were evaluated for NP. It was observed that 13.76% of SCI patients complained of neuropathic pain. In 21 to 30 years age group 23.13% and 61.76% cases of neuropathic pain had dorso-lumbar injury. 48.30% cases of neuropathic pain had onset in 2­nd and 3rd week. Discomfort was more at night (36.76%), in below the knee area and dorsum of the foot. Hot burning type of sensation was the commonest descriptor of NP and range of movement (ROM) exercises and tepid cold water sponging were relieving factors.

Keywords: Spinal cord injury, Neuropathic pain.

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Friday, 8 December 2017

Medical Journal- November issue 2017

Medical Journal: Published volume-3, Issue-11, November 2017 with ad publications

A study of reproductive health, mental health & addictions among adolescents in Margao City of Goa

Abstract—Reproductive health development depends on the menstrual hygiene in adolescence. Half of all mental health disorders in adulthood start during adolescence. Drug, alcohol and tabacco use is major concern in this group. This study was conducted to study the reproductive health, mental health and various addictions in urban adolescent. This cross sectional study was conducted among 506 adolescents from standard 9th and 10th in a high school in Margao city of South Goa district in year 2015. For this study, 506 participants sampled by census method were interviewed by using a pretested, structured questionnaire. The mean age of study participants i.e. in girls it was 16.30 years & in boys it was observed 16.43 years. 85.4% of the study participants experienced one of the feelings of being anxious, sad, irritable or stressed, 74.4% of the study participants experienced feelings suggestive of psychosomatic disorder and 48.4% participants felt they were good for nothing. 58.1% had normal cycles of 21-35 days while 30.7% and 11.2% of the girls had cycles of < 21 days & 36-60 days respectively. 49.2% experienced mild symptoms of dysmenorrhoea, equal percentage experienced moderate symptoms and 1.6% experienced severe dysmenorrhoea. 40.4% had curdy white vaginal discharge, 5.5% had greenish yellow discharge and 19.8% had blood stained vaginal discharge. 5.5% of the adolescents smoked.1.2% of the participants chewed Gutkha. 26.5% had consumed alcohol & 3.8% had tried drugs. The study shows that adolescents faces various problems for which they need to be addressed.

Key Words: Reproductive Health, Menstrual Hygiene, Mental Health, Addictions, Urban Adolescent.

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Isolated Medial Rectus Cysticercosis mimicking pre-septal cellulitis: A Case Report

Abstract— Man is the intermediate host in the life cycle of the pork tapeworm Taenia solium. Its larval form Cysticercus cellulosae is the causative agent of cysticercosis. Both intraocular and extra ocular cysticercosis are observed in tropical countries like India. A case of extra ocular cysticercosis is reported here. An eight year old female patient who was brought to emergency department with pain and swelling around peri-orbital region, diminution of vision along with ptosis in left eye. CT scan showed scolex of Taenia solium in left medial rectus muscle. The patient recovered completely with oral albendazole steroids for four weeks. So a case with pain and swelling around peri-orbital region, diminution of vision along with ptosis in left eye should be investigated for cysticercosis.

Keywords: Taeniasis, Extra ocular Cysticercosis, Medial Rectus, Peri-Orbital Region.

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Association of Age and sex with Episodes of Acute Illness in Geriatric population of Jaipur

Abstract Elderly population is increasing due to demographic shift in favor of geriatric population. This age group is susceptible for many health problems. So this cross-sectional study was carried out from September 2009 to August 2010 on 1620 elderly residing in Municipal corporation area of Jaipur city with the aim to study episodes of acute illness and its associating factors. Study population consist of 1620 elderly with M:F ratio 0.95. Mean age of elderly was 66.08 years with slight female predominance i.e. 1048 females for 1000 males in Jaipur city. It can be concluded from this study that 44.37% of elderly had one or more episodes of acute illness in last one month. These numbers of episodes of acute illness in last one month was found more in males and in older age groups.

Key words- Elderly, Geriatric, Acute Illness, Age & Sex association.

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Thursday, 9 November 2017

Medical Journal- October issue 2017

Medical Journal: Published volume-3, Issue-10, October 2017 with ad publications

Indoor environment: Is it possible to use outdoor air in densely populated areas as an indicator of indoor air quality in Swedish buildings

Abstract— In the last few decades, indoor air problems have increased in Swedish housing, office and school buildings. The problems that are mentioned are mucosal and respiratory symptoms, asthma, skin symptoms, fatigue and headache. In the environmental health report compiled by the responsible authorities, it is shown that the scope of the problem has been constant since the early 1990s. This is done despite the fact that extensive efforts have been made and extensive resources have been used in research, government investigations with new industry directives and through measures taken in buildings. There is a great need for validated analysis and measurement methods, as well as finding level values for the air environment in Swedish housing, office and school buildings. The purpose of this project is to evaluate whether outdoor air can be used as an indicator and level sensor for the quality of the indoor air environment. Outdoor air is an indicator where the number of particles, preferably those larger than 5.0 μm, is a valuable parameter. The long-term goal should be to build a bank with values from the outdoor air. This bank should include values with an even distribution that include temporal variations, the Swedish seasonal variations and the longer-term variations that occur annually. In addition, it should cover a uniform distribution across the whole of Sweden. This bank should be a better basis for assessing the environment in each object, instead of using the value of the level outside the building at the current time of measurement. An important issue is the calibration of measuring instruments to make the results comparable. In this project, this is not a problem since only one and the same instrument is used, but when using several instruments, the relationships actualized.

Keywords: Air quality, Hygiene and Health, Indoor Environment, Particle Amount, Particle Measurements, Particle Size.

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Effect of Root Heal Therapy (RHT) on Melasma: A Quincy Experiment

Abstract—Melasma is a very common skin disorders which has no fix treatment schedule and is very difficult to treat. This present study was planned to compare the effect of traditional treatment alone and in combination with Root Heal Therapy on Melasma cases. A Quincy experiment was conducted on 60 patients of Melasma, who were taking treatment from a same physician working in Charak Bhawan, a hospital attached to SMS Medical College, Jaipur (Rajasthan). Out of these 67 melasma cases were completed the protocall, out of that 35 were in group who has received traditional treatment, 32 were in group who has received RHT along with traditional treatment. Baseline status of Melasma with its Severity its impact on quality of life was assessed. Severity of Melasma was assessed through MASI scores and quality of life was assessed by Dermatology Life Quality Index (DLQI) scores. These cases were followed for 6 months; again they were assessed as per MASI. Changes in over this period Melasma severity in both the groups were compared with Chi-square test and Unpaired’t’ test. It was found that significantly more cases were benefited with this RHT in the form of number of severity of Melasma and quality of life was also significantly improved with RHT. Further researches are required for further details.

Key Words: Melasma, MASI scores, Dermatology Life Quality Index (DLQI), Root Heal Therapy (RHT).

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Saturday, 14 October 2017

Medical Journal- September issue 2017

Medical Journal: Published volume-3, Issue-9, September 2017 with ad publications

Isolated Medial Rectus Cysticercosis mimicking pre-septal cellulitis: A Case Report

Abstract— Man is the intermediate host in the life cycle of the pork tapeworm Taenia solium. Its larval form Cysticercus cellulosae is the causative agent of cysticercosis. Both intraocular and extra ocular cysticercosis is observed in tropical countries like India. A case of extra ocular cysticercosis is reported here. An eight year old female patient who was brought to emergency department with pain and swelling around peri-orbital region, diminution of vision along with ptosis in left eye. CT scan showed scolex of Taenia solium in left medial rectus muscle. The patient recovered completely with oral albendazole steroids for four weeks. So a case with pain and swelling around peri-orbital region, diminution of vision along with ptosis in left eye should be investigated for cysticercosis.

Keywords: Taeniasis, Extra ocular Cysticercosis, Medial Rectus, Peri-Orbital Region.

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Superior orbital fissure syndrome due to Metastatic prostatic malignancy: A Case Report

Abstract— Superior orbital fissure syndrome (SOFS) is a rare disease. So when a case of this came at Aravind Eye Institute, a detailed case report was prepared to publish. 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 extraocular 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.

Keywords: Ptosis, Prostate, Metastasis.

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Clinico-epidemiology and outcome of ectopic pregnancy: An experience of 7 years in St. Stephen’s hospital, Delhi

Abstract— Ectopic pregnancy is an important cause of maternal morbidity & mortality in the first trimester. Treatment of ectopic pregnancy was limited to surgery. In spite of advancement of diagnosis & management it is still a very serious threat to maternal safety, so this case-series type of study was conducted on 58 ectopic pregnancies to study the clinico-epidemiology and outcome of medically managed ectopic pregnancy at a tertiary level hospital. Out of total 20,354 pregnancies, 443 (2.1%) were ectopic pregnancies. Most common site of ectopic pregnancy was Fallopian tubes in 94.8% cases followed by ovary in 3.4% cases and heterotopic in 1.7%. Age range was 17 years to 36 years with mean age 28.12 ± 4.10 years. Parity wise maximam were nulliparous (53.4%) followed by para one (25.9 %), para two (19%) and para three (17.2 %). Ectopic pregnancies on right side were found in 55.2% while in left side in 44.8% 75.8% had bleeding per vaginum and 74.1 % had pain abdomen as their chief complaints. History of abortion was found in 44% cases and past history of ectopic pregnancy was found in 8.6% cases whereas past history of pelvic inflammatory disease in 22.4% cases and infertility in 13.8% cases. 1.7% cases had IUCD in situ while 5.2% cases had history of past IUCD insertion. History of ovulation induction was present in 8.6% cases, 3.4% cases were IVF conceived and 1.7% underwent laparohysteroscopy for infertility treatment. In this study success rate of methotrexate therapy was found 93.1%. Emergency surgery was needed only in 6.9% of cases. So it can be concluded that bleeding per vegina and pain abdomen may be investigated for ectopic pregnancy and ectopic pregnancies should be treated first line with methotrexate before surgery.

Keywords: Ectopic Pregnancy, Methotrexate, Clinico-epidemiology.

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Clinico-epidemiological study of cutaneous tuberculosis in a tertiary care hospital of Rajasthan

Abstract—India constitutes about one fourth of the Global TB burden. Cutaneous TB is less common clinical form of tuberculosis accounting for 1-2 % of the total extra-pulmonary cases. Objective of this study was to describe the clinical and epidemiological pattern of Cutaneous TB presenting in the Skin Outpatient Department (OPD). Patients presenting with clinically suspected skin lesions of Cutaneous TB from January 2015 to August 2016 were included in the study. Dermatological and systemic examination was carried out and histopathogical examination of skin punch biopsy was done. It was observed that out of a total of sixty patients, 45 (75%) patients were found to have features of Cutaneous TB on histopathology. Lupus vulgaris (42.2%) was the most common form of Cutaneous TB. Most patients were in age group of 11-30 years. Male to female ratio was 1.6:1. Most common sites of involvement were lower limbs and neck. Mantoux test was positive(≥15 mm induration) in 66.7% cases. Typical tuberculoid histology was found in 91.1% cases. No cases of tuberculids were seen and non-specific chronic inflammation was seen in six cases. It was concluded that Cutaneous TB may present with different morphological patterns resembling other inflammatory, infective and neoplastic conditions. Proper and thorough investigations are necessary for detection of Cutaneous TB as the annual incidence of total TB cases in India is high.

Keywords: Cutaneous TB, Lupus vulgaris, Mantoux test, Clinico-epidemiology.

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Menstrual pattern among school girls with special reference to determinants of amount of menstrual blood loss: A cross-sectional study in Jaipur city

Abstract— Menstruation had many tremendous psychological response in adolescent. And there are many myths prevalent regarding menstruation. So this study was conducted with the aim to study menstrual pattern in adolescent school going girls and association of menstrual blood flow with their BMI, diet, sports activities and gadgets. This study is a descriptive type of cross-sectional study in which adolescent girls who attained menarche were included. Present study was carried out on in government schools Jaipur City (Rajasthan) on 1233 girls aged between 13 to 19 years. BMI was significantly associated with amount of blood loss. Girls whose BMI was <18.5 kg/m2 or underweight had moderate to severe degree of dysmenorrhoea compare to those BMI 18.5-24.9 kg/m2. Proportion of girls involved in sports activities were having less amount of blood loss compared to those who were leading sedentary life. B So it can be concluded that BMI has direct co-relation with menstrual blood loss; the girls involved in sports had less amount of menstrual blood loss.

Keywords: Menstrual Pattern, Menstrual Blood Loss, Adolescence, BMI, Sports Activities.

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Dosimetric evaluation of carcinoma nasopharynx using Volumetric Modulated Arc Therapy (VMAT): An institutional experience from Western India

Abstract— Treatment of nasopharyngeal carcinoma is done by advanced radiotherapy techniques like VMAT (Volumetric Modulated Arc Therapy) where dose to critical organs around tumour is of concern. Present study aimed to describe radiation dose to critical organs in nasopharyngeal cancer patients using VMAT technique. Study was conducted on 10 carcinoma nasopharynx patients treated by VMAT technique at a super-specialty cancer institute in Rajasthan. The structures were contoured using RTOG (Radiation Therapy Oncology Group) guidelines and dose prescription to PTV (Planning Target Volume) was such that 95% iso-dose covered 100% of PTV. Constraints to the OARs (Organs at risk) were as per QUANTEC (Quantitative Analysis of Normal Tissue Effects in the Clinic). VMAT planning was done by double arc using Eclipse (v 10.0.42) treatment planning system. Mean dose to brain stem, spinal cord and optic chiasma were 51.79 Gy, 45.92 Gy and 18.8 Gy respectively. Mean dose to left and right temporal lobes was 22.7Gy and 24.3Gy. Dose to right and left eye were 20.6 Gy and 19.2 Gy while dose to right and left lenses were 5.9Gy and 5.8 Gy respectively. Dose to brain stem, spinal cord, optic chiasma, eyes, lens and temporal lobes were below the dose constraints. VMAT is an effective way to deliver maximum radiation to tumour tissue while providing better sparing of normal tissue and less doses to OARs in carcinoma nasopharynx.

Keywords: Nasopharyngeal carcinoma (NPC), Volumetric Modulated Arc Therapy, Radiation Therapy Oncology Group.

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