Showing papers in "International Journal of Research in Medical Sciences in 2016"
TL;DR: The lipid ratios contribute significantly to the estimation of CVD risk in type 2 diabetes mellitus especially, when the absolute values of lipid profile seem normal or not markedly deranged or in centres with insufficient resources.
Abstract: Background: Cardiovascular disease (CVD) is responsible for morbidity and mortality in type 2 diabetes mellitus (T2DM) patients. Diabetes alters the utilization of lipids and lipoproteins which lead to diabetes induced atherogenic dyslipidemia, one of the most important risk factor for the development of atherosclerosis. The relationship between elevation of serum lipids and vascular complications of diabetes has long been of interest. The use of LDL-c alone for assessment of cardiovascular risk would ignore the TG-rich lipoproteins. Lipid ratios, atherogenic coefficient and atherogenic index of plasma have been found to indicate an atherogenic risk and are better predictors of cardiovascular risk than lipids alone. Hence the present study is taken up to evaluate the lipid ratios, atherogenic coefficient, atherogenic index of plasma in assessing the CV risk in type 2 diabetes mellitus. Methods: This case-control prospective study included three groups. (Group 1: control, group II: T2DM without complications, group III: T2DM with complications, n=25). Total cholesterol, triglycerides and HDL-c were analysed using commercially available kits on spectrophotometer. Nitric oxide was estimated spectrophotometrically by Griess method. VLDL, LDL, Lipid ratios, non-HDL cholesterol, AC and AIP were calculated in all the three groups. Statistical analysis was performed using SPSS version 22.0. Results: All of the atherogenic indices were found to be significantly different upon comparing these indices in both patients and control groups. Conclusions: The ratios contribute significantly to the estimation of CVD risk in type 2 diabetes mellitus especially, when the absolute values of lipid profile seem normal or not markedly deranged or in centres with insufficient resources.
39 citations
TL;DR: The main objective of this study was to determine the prevalence of dermatophytoses, isolate and identify the dermatophyte from samples of clinically suspected cases attending tertiary care centre using conventional and molecular methods.
Abstract: Background: Dermatophytes are group of fungi that infect keratinized tissues of human and animals. The group consist of three different genera namely, Trichophyton, Microsporum, Epidermophyton and several species within each genera. Among Trichophyton, Trichophyton rubrum is predominant, followed by various strains of Trichophyton mentagrophytes , which include both anthropophiles and zoophiles. Prevalence of dermatophytes varies with location and environmental condition. The infection is common worldwide with higher prevalence in tropical countries like India. Molecular diagnosis renders accurate identification of clinical dermatophyte isolates to species level. The main objective of this study was to determine the prevalence of dermatophytoses, isolate and identify the dermatophyte from samples of clinically suspected cases attending tertiary care centre using conventional and molecular methods. Methods: A total of 210 patients showing lesions typical of dermatophytes infection from outpatient Department of dermatology were sent to mycology unit, Department of Microbiology for the period of April 2011-March 2014 were studied. Diagnosis was confirmed by conventional and polymerase chain reaction - restriction fragment length polymorphism (PCR-RFLP) technique. Results: Out of 210 samples received, tinea corporis was the predominant clinical site which was followed by tinea cruris . A total of 143 dermatophytes were isolated from the clinical samples. T. rubrum was the predominant etiological agent with 70/143 isolates and T. mentagrophytes was the second most common with 64/143 isolates. Amplification of internal transcribed spacers (ITS) was successful in all the clinical isolates by PCR and produced species specific banding pattern in RFLP using restriction enzyme Mva I. Conclusions: Among dermatophytoses, T. rubrum was the predominant etiological agent present in the whole of Chennai District and T. mentagrophytes takes the second place.
29 citations
TL;DR: There should be a continuous training programme for all health personnel with special focus on sanitary staff and knowledge, attitude and practices regarding biomedical waste management of class IV employees were found to be very low.
Abstract: Background: The amount of biomedical waste being generated in our country is increasing day by day. Biomedical waste if not handled properly can pollute the environment and can spread many harmful diseases. Health care workers in our country are still not fully aware about proper BMW handling and disposal, despite increasing global awareness on it. The objective of the study was to understand the level of awareness regarding BMW handling and disposal among health care professionals in our institution. Methods: After taking written informed consent doctors, nurses, lab technicians and class IV employees working in our institution were included. A pre designed questionnaire was used for data collection. Data was analysed using SPSS software and results were interpreted into percentages. Results: 305 participants took part in the study. Doctors, nurses and lab technicians had good knowledge, attitude and practice regarding biomedical waste management but there was scope of improvement in certain areas. Knowledge, attitude and practices regarding biomedical waste management of class IV employees were found to be very low. Conclusions: There should be a continuous training programme for all health personnel with special focus on sanitary staff. Biomedical waste management rules should be strictly implemented at all levels.
27 citations
TL;DR: Investigation in India finds that incidence of invasive cervical malignancy can be prevented if Pap screening program is effectively implemented in target population.
Abstract: Background: In India cervical cancer is the leading cause of morbidity and mortality. Cancer of cervix is preventable, and can be diagnosed at the pre-malignant/pre-invasive stage with adequate and repetitive cytological screening by Papanicolaou (Pap) smears. Methods: The prospective study includes total 1425 patients who were presented with various gynecological problems. Samples were taken and prepared smear were stained with PAP stain. Reporting was carried out by two independent cytopathologist as per Bethesda system. Results: Total 1425 patients were screened; there were 1034 (72.56%) abnormal Pap smears, with 354 (24.84%) normal cases and 37 (2.59%) unsatisfactory or inadequate samples. Total 27 (1.89%) cases showed epithelial cell abnormalities. ASCUS was the most commonly found (40.74%) epithelial cell abnormality out of 27 cases. Conclusions: Incidence of invasive cervical malignancy can be prevented if Pap screening program is effectively implemented in target population.
24 citations
TL;DR: The modified BG Prasad socioeconomic scale is a simple and widely used scale used by researchers to determine the socioeconomic status of study subjects in health studies in India and has to be constantly updated to take inflation and depreciation of rupee into account.
Abstract: Modified BG Prasad socioeconomic scale is a simple and widely used scale used by researchers to determine the socioeconomic status of study subjects in health studies in India. It is a scale based on the per capita income of an individual and hence has to be constantly updated to take inflation and depreciation of rupee into account. The consumer price index (CPI) for industrial workers (IW) is used to calculate updated income categories. The Consumer Price Index is updated every month and the same is available at the Labour Bureau of India website on the last day of every month. State-specific CPI values are also available on the Department of Labour website and should be used to determine more accurate income categories for the study area.
23 citations
TL;DR: The knowledge about the different shape and dimensions ofglenoid are very important during designing and fitting of glenoid component for total shoulder arthroplasty and also helpful during evaluation of different pathological conditions like rotator cuff disease, osteochondral defects and Bankart lesion.
Abstract: Background: The lateral angle of scapula becomes truncated and broadened and form the glenoid cavity which shows variable morphology. There is a notch present on its anterosuperior part which gives its different shape. When this glenoid notch is indistinct its shape is piriform, when it is distinct it looks like inverted comma shape and when it is absent its oval shape. The shoulder joint is one among the most commonly dislocated joints in the body. The fracture of glenoid with dislocations is very common in the trauma. The detail knowledge about variation in anatomy of glenoid cavity like different shape, size and dimensions are important during designing and fitting of glenoid component for total shoulder arthroplasty. The objective of present study was to obtain anthropometric data of scapulae and the glenoid cavity specifically the diameters and various shape of glenoid belongs to population of Bihar and compare it to findings from other races of the world. Methods: The present study was a cross sectional study which has been carried out on 228 undamaged dry adult human scapulae in which 126 belongs to right side and 102 belongs to left side. The age and gender of the bones used in the study was not predetermined. Results: The most common shape of glenoid cavity recorded in the present study was pear shape (50.44%) followed by inverted comma shape (35.96%). The least common shape was oval (13.6%). The mean length of scapula was observed as 135.07±14.23mm, the mean breadth of scapula was 97.55±9.63 mm, the mean supero inferior glenoid diameter was 35.80±3.14mm, the mean antero posterior glenoid diameter 1 was 23.63±2.50mm, and the mean antero posterior glenoid diameter 2 was 16.17±2.24mm and mean glenoid cavity index was 66.40±8.14%. In all the above measurements bilateral differences was not statistically significant. Conclusions: The knowledge about the different shape and dimensions of glenoid are very important during designing and fitting of glenoid component for total shoulder arthroplasty. It is also helpful during evaluation of different pathological conditions like rotator cuff disease, osteochondral defects and Bankart lesion. Since the present study is conducted on a limited number of scapulae further cadaveric, radiological and clinical studies are indicated.
21 citations
TL;DR: The incidence of uropathogenic E. coli among people in Zakho city, Iraq is comparable with reports from elsewhere, and isolates are highly susceptible towards imipenem, and meropenem antibiotics, and highly resistant towards β-lactam and cephalosporins antibiotics.
Abstract: Background: Antimicrobial resistance in uropathogenic E. coli is of major concern worldwide due to its increasing resistance to several commonly prescribed antibiotics. The aims of this study were to determine the prevalence and to evaluate the presence and antibiogram pattern of uropathogenic E. coli among people in Zakho city, Iraq. Methods: 1120 urine samples were collected from people. Samples were screened for E. coli isolates and their susceptibility to different antibiotics was analyzed. Results: Diagnoses tests showed that only 106 (9.4%) isolates were E. coli . Females (90, 85%) were more susceptible to urinary tract infections (UTIs) than males (16, 15%) (p <0.05). The age 11-21 years old (23, 21.7%) was the most affected group (p <0.05). All isolates were resistant to penicillin, ampicillin and aztreonam. While, all these isolates were sensitive to imipenem and meropenem. Conclusions: The incidence of uropathogenic E. coli among people is comparable with reports from elsewhere. E . coli isolates are highly susceptible towards imipenem, and meropenem antibiotics, and highly resistant towards β-lactam and cephalosporins antibiotics. Education programs and improving the hygienic measures are necessary to prevent contaminations with E. coli and minimize the use of β-lactam and cephalosporin antibiotics.
21 citations
TL;DR: In this article, a part completion test in the department of pediatrics at Kalinga Institute of Medical Science (KIMS) Bhubaneswar was conducted to evaluate the quality of MCQs, for creating a valid question bank for future use and to identify the low achievers whose problems can be corrected by counselling or modifying learning methods.
Abstract: Background: Multiple choice questions (MCQs) are usually used to assess students in different educational streams. However, the MCQs to be used should be of quality which depends upon its difficulty index (DIF I), discrimination index (DI) and number of Non-functional distracter (NFD). Objective of the study is to evaluate the quality of MCQs, for creating a valid question bank for future use and to identify the low achievers, whose problems can be corrected by counselling or modifying learning methods. This study was done in Kalinga Institute of Medical Science (KIMS) Bhubaneswar. Methods: A part completion test in the department of pediatrics was done. Total 25 MCQs and 75 distracters were analyzed. Item analysis was done for DIF I and DI and presence of number of NFD. Results: Difficulty index of 14 (56%) items was in the acceptable range (p value 30-70%), 8 (32%) items were too easy (p value >70%) and 2 (8%) items were too difficult (p value 0.35), 3 (12%) items was good (d value 0.20-0.34) and 8(32%) items were poor (d value<0.2%). Out of 75 distracters, 40 (53.4%) NFDs were present in 22 items. 3 (12%) items had no NFDs, whereas 8 (32%), 10 (40%), and 4 (16%) items contained 1, 2, and 3 NFD respectively. Conclusion: Item analysis is a simple and feasible method of assessing valid MCQs in order to achieve the ultimate goal of medical education.
19 citations
TL;DR: Colostrum feeding practices were lowers among rural mothers , low educational status, who had delivered at home and reasons behind the discard of colostrum were found to be eleder’s/relative advice, child could not digest and ignorance.
Abstract: Background: Colostrum is the first breast milk produced after birth and is important for promotion of health and prevention of infections of the newborn immediately after birth. Though the breastfeeding practices are well known to mothers but the necessity of colostrum feeding is still poorly understood especially by the mothers in rural areas due to various factors. The objective of the study was to find out the prevalence of colostrum feeding practices and its determinants among the urban and rural mothers of Assam, India. Methods: A cross sectional study was conducted from February-July 2014. The study was conducted by interviewing of 400 mothers having children of 0-23 months of age in both in rural and urban areas. Results: 21% of mothers in urban areas had discarded colostrum whereas in rural areas it was 29.5% .The association between colostrum feeding practices and age of the mothers (P<0.05), religion (P<0.05), type of families (P<0.05), educational status of the mothers (P<0.05), socioeconomic status (P<0.05), place of delivery (P<0.05), mode of delivery (P<0.05) were found to be significant. Conclusions: Colostrum feeding practices were lowers among rural mothers , low educational status, who had delivered at home and reasons behind the discard of colostrum were found to be eleder’s/relative advice, child could not digest and ignorance . Educating the mothers and the communities about the value of colostrum would help in ensuring that colostrum is not wasted but fed to the child.
17 citations
TL;DR: Assessment of antihypertensive drug prescription patterns and adherence to JNC-8 hypertension (HT) treatment recommendations among hypertensive patients attending a tertiary care teaching hospital demonstrated that physicians are not completely adhering to standard guidelines while treating hypertension with comorbid conditions.
Abstract: Background: The new guidelines issued by the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure (JNC-8) emphasize that aggressive blood pressure (BP) control is essential to reducing morbidity and mortality. Patient non-adherence is a serious obstacle to the effective treatment of many acute and chronic disorders. Successful treatment and outcome of a chronic disease such as hypertension depend on many factors, including resources (e.g., funds, space, and people), avoidance of serious adverse events, patient adherence with treatment plans, and the availability of effective therapies. The aim of this study is to assess the antihypertensive drug prescription patterns and adherence to joint national committee (JNC-8) hypertension (HT) treatment recommendations among hypertensive patients attending a tertiary care teaching hospital. Methods: An observational and cross-sectional prospective prescription audit study was carried over a period of 1 year in ambulatory patients attending medicine OPD. A total of 500 prescriptions prescribed to diagnose HT were analyzed. Drug prescription patterns, and their adherence to JNC-8 report was assessed. Results: Out of 500 patients, 299 (59.8%) were male and 201 (40.2%) were female. Mean age of male and female patients were found to be 57.68±15.32 and 61.29±12.65 years respectively. As per present study, most of the physicians prescribed single drug (monotherapy, 34.6%) to control BP followed by two-drug combination (18.4%), three-drug combination (11.8%) and four-drug combination (3%). Two drugs regimen was prescribed in 18.4% of the hypertensive patients. Angiotensin receptor blocker + diuretic combination (4.4%) was mostly used in two drug combination therapy followed by Angiotensin receptor blockers + Diuretics (3.6%) and Calcium channel blocker + ACEIs combination (2.6%). No combination of ACEIs + ARBs was prescribed in any prescription. The overall rate of adherence was 16.5 % (Pre-hypertension); 87.90% (Stage 1 hypertension); and 68.20% (Stage 2 hypertension). Conclusions: In conclusion, present study demonstrated that physicians are not completely adhering to standard guidelines while treating hypertension with comorbid conditions.
17 citations
TL;DR: Jaundice is a complex disease that can cause various manifestations involving satiety, gastrointestinal bleeding, diarrhea, anemia, edema, weight-loss and can be fatal because it can cause psychosis, lethargy, seizures, coma or even death.
Abstract: Jaundice is a complex disease. Jaundice is actually the high bilirubin level in the body. Yellowing of skin, mucous membranes and skin are common presentations of jaundice. Jaundice has various variants including pre-hepatic jaundice (due to hemolysis of red blood cells), hepatic jaundice (due to defect in capture, conjugation and excretion of bilirubin by liver) and post hepatic jaundice (due to the obstruction of extra hepatobiliary system). The causes of various variants of Jaundice is either acquired or congenital. High plasma bilirubin level can cause various manifestations involving satiety, gastrointestinal bleeding, diarrhea, anemia, edema, weight-loss and can be fatal because it can cause psychosis, lethargy, seizures, coma or even death. High bilirubin level can help in the diagnosis of Jaundice. Differential diagnosis of various variants of Jaundice can be carried out on the basis of bilirubin level (conjugated and unconjugated), ultrasonography and other radiological techniques. The proper management of Jaundice is high water intake and low fat diet. The primary effective treatment for pre-hepatic jaundice and neonatal physiological jaundice is phototherapy. Infusion of immunoglobulins is also used for treatment of pre-hepatic jaundice. Proper nutrition, steroids and immunosuppressant are used for treatment of hepatic jaundice. The treatment for post hepatic jaundice is decompression and surgery.
TL;DR: In this article, the authors evaluated the different patterns of thyroid lesions in surgically resected specimens and biopsies received at department of pathology and correlate the various histo-morphological features with respect to clinical findings, USG and thyroid profile findings.
Abstract: Background: To evaluate the different patterns of thyroid lesions in surgically resected specimens and biopsies received at department of pathology and correlate the various histo-morphological features with respect to clinical findings, USG and thyroid profile findings. Methods: Total 100 cases of partial or complete thyroidectomy were studied. A detailed clinical examination with USG examination and assessment of thyroid function test were carried out preoperatively. Results: The highest incidences (51%) of thyroid enlargements were found in age group of 21-40 years with females predominated (77%), ratio being 3.34:1. Out of total 100 cases, 28 were neoplastic and 72 were non-neoplastic. Thyroid function test was carried out of all 100 cases and out of them 81 were euthyroid. Most common clinical symptom in the patients of thyroid lesions was swelling in the neck which was present in all cases. Multinodular goiter was the most common radiological finding seen in 55% cases. Out of 55 cases of MNG one case turned out to be malignant after histopathological examination. USG diagnosed 10 cases were malignant, out of them 1 case turned out to be benign after histopathological examination. Conclusions: Taking into consideration histopathology report as a gold standard, correlation of USG finding with histopathology finding showed 90% sensitivity, 98.8% specificity with 90% positive predictive value.
TL;DR: The high scores in modified Alvarado score is dependable aid in the early diagnosis of acute appendicitis in men and children but it’s not true as far as women are considered.
Abstract: Background: Acute appendicitis, the most common surgically correctable cause of abdominal pain, the diagnosis of which remains difficult in many instances and is essentially clinical. However a decision to operate based on clinical suspicion alone can lead to removal of normal appendix in 15-30% cases. Several diagnostic scoring systems have been devised as an aid to early diagnosis of acute appendicitis and to reduce the incidence of negative appendicectomy. One such scoring system was described by Alvarado and later modified by Kalan et al. The present study is attempted to evaluate the efficiency of modified Alvarado score in pre-operative diagnosis of acute appendicitis. Methods: One hundred twenty consecutive patients suspected of acute appendicitis that were admitted, investigated and treated were taken for the study. After detailed examination and investigations a modified Alvarado score was applied to these patients. They were assigned in three groups and were treated accordingly. Results: The result of the study showed that high scores in men and children (7-9) had a sensitivity of 92.3% and 83.3% respectively, whereas in females it had a sensitivity of 72.7%. The score (5-6) in males and females had a sensitivity of 57% and 50% respectively. Conclusions: The high scores in modified Alvarado score is dependable aid in the early diagnosis of acute appendicitis in men and children but it’s not true as far as women are considered. Ultrasonography of abdomen is a useful tool in avoiding negative appendicectomy rates particularly in females.
TL;DR: Hemoglobin level, polymorphs, lymphocytes, monocytes and RBC count were statistically reduce while other parameters were non-significant as compared to control healthy subjects while deranged haematological parameters were found in all four stages of breast cancer.
Abstract: Background: Breast cancer is one of the most common malignancies found among women in India. Haematological parameters have been shown to predict severity, mortality and treatment follow-up in breast cancer patients. The aim of the study was to compare haematological parameters along with effect of chemotherapy and radiotherapy in different stages of breast cancer patients. Methods: Total 235 human subjects were taken in the study. Out of which 100 normal ages matched healthy subjects were considered as controls and 135 breast cancer patients subjects as cases which were further divided into their respective stages according to TNM classification. Results: Estimation of haematological parameters was done by Sysmex Automated Hematology Analyzer Kx-21. The statistical differences between cases and control were determined by using student independent sample t-test. Conclusions: We found hemoglobin level, polymorphs, lymphocytes, monocytes and RBC count were statistically reduce (p<0.05) while other parameters were non-significant as compared to control healthy subjects. We also found deranged haematological parameters in all four stages of breast cancer. The data also indicated that patients which were on combined therapies i.e. radio and chemo have more deranged and decreased levels of haematological parameters as compared to individual therapies.
TL;DR: In this article speech-in-noise tests were critically appraised for their conceptual model, measurement model, normatives, reliability, validity, responsiveness, item/instrument bias, respondent burden and administrative burden.
Abstract: Speech in noise tests that measure the perception of speech in presence of noise are now an important part of audiologic tests battery and hearing research as well. There are various tests available to estimate the perception of speech in presence of noise, for example, connected sentence test, hearing in noise test, words in noise, quick speech-in-noise test, bamford-kowal-bench speech-in-noise test, and listening in spatialized noise-sentences. All these tests are different in terms of target age, measure, procedure, speech material, noise, normative, etc. Because of the variety of tests available to estimate speech-in-noise abilities, audiologists often select tests based on their availability, ease to administer the test, time required in running the test, age of the patient, hearing status, type of hearing disorder and type of amplification device if using. A critical appraisal of these speech-in-noise tests is required for the evidence based selection and to be used in audiology clinics. In this article speech-in-noise tests were critically appraised for their conceptual model, measurement model, normatives, reliability, validity, responsiveness, item/instrument bias, respondent burden and administrative burden. Selection of a standard speech-in-noise test based on this critical appraisal will also allow an easy comparison of speech-in-noise ability of any hearing impaired individual or group across audiology clinics and research centers. This article also describes the survey which was done to grade the speech in noise tests on the various appraisal characteristics.
TL;DR: Nurse is required to be able to perform their therapeutic communication skill effectively so that the anxiety level of family members is decreasing, and it was indicated that the more effective the communication performed by nurses, the less the anxietylevel of familyMembers.
Abstract: Background: Critical condition of patient is trigger to the increasing of anxiety of family members. This situation is vulnerable of ineffective nursing care services provide by nurses in emergency room. Communication is one of abilities which nurse have to performed, and is recognized not that simple in its implementation. This study aimed was to identify whether or not there is a relationship between communications performed by the nurses and the level of anxiety of family members of patient in Emergency Room dr. Dradjat Prawiranegara hospital, Serang Banten, Indonesia. Methods: This study was cross-sectional study with non-parametric analysis data used was Spearman’s Rho. Data were collected through direct observation by 4 numerators and observational sheet of nurse’s communication. Level of anxiety of family members was measuring by using State Trait Anxiety Inventory Y-1. Data were collected from 47 family members and 47 nurses who were selected by using accidental sampling technique. Results: The study revealed that nurses performed eye contact, well informed consent, quick respond to the needs of patient and family members, clear voice, understandable language, introducing them self, active listening and emphatic, calm and friendly. Regarding anxiety of family members, 42.6% of them were showing moderate level of anxiety, whereas 34.0% of them were showing low level of anxiety. In bivariate analysis by using Spearman’s Rho showed that p value was 0.000 and coefficient correlation -0.765. It was indicated that there was significantly relationship between communication of emergency nurses and the level of anxiety of family members. It was indicated that the more effective the communication performed by nurses, the less the anxiety level of family members. Conclusions: Nurse is required to be able to perform their therapeutic communication skill effectively so that the anxiety level of family members is decreasing. As a result, the stable emotion of family members affect to the appropriate decision making of medical treatment.
TL;DR: This study signifies that patients require support and guidance for practicing better disease management and clinical activities such as patient counselling, Home Medication Review, Pharmaceutical care program help to increase the patients practice in disease management.
Abstract: Background: Hypertension is not a disease but it is an important risk factor for cardiovascular complications. Approximately 77.9 million American adults (1 in 3 people) and one billion people worldwide have high blood pressure. Hypertension can be described as the ‘sleeping snake’ which bites when it wakes up. There is need to investigate KAP among the general population which helps in the future development programmes for effective health education The main aim of this study was to assess the patients Knowledge, Attitude and Practice regarding hypertension. Methods: This is a prospective observational study conducted in the In-patient Departments of Gandhi hospital, Secunderabad for a period of 6 months (August 2015 - January 2016) which was approved by institutional ethics committee. A total of 160 hypertensive patients with or without comorbid condition were included. . Adults of age less than 30 years, paediatrics, Pregnant and lactating women were excluded. Patients were selected by simple random sampling method. A suitably designed and validated KAP questionnaire was administered to hypertensive patients. This questionnaire was filled in at face to face interview along with inform consent Statistical analysis was performed using Graph pad prism software version 5. Data was analysed using unpaired t-test. Results: We observed a good score towards knowledge, attitude and poor score towards practice. Conclusions: Our study signifies that patients require support and guidance for practicing better disease management. Clinical activities such as patient counselling, Home Medication Review, Pharmaceutical care program help to increase the patients practice in disease management.
TL;DR: Organizational barriers and personal barriers have an important role in doing the research in the Medical Sciences University of Ardabil; these barriers can be passed through.
Abstract: Background : Due to its role in identifying educational, research, health problems and providing a solution to prevail upon the problems related to public health, the research in the Medical Sciences University has a special importance. The present research aims to determine the restraining factors of doing research from the viewpoint of professors and students of the Medical Sciences University of Ardabil; it was conducted in 2014. Methods: In this descriptive cross-sectional study, 250 individuals from between the professors (50 individuals) and students (200 individuals) of the various academic disciplines of medical sciences were selected by way of completely random sampling. The data collection tool was a researcher-made questionnaire containing 3 parts: demographic information, individual barriers (10 questions) and organizational and environmental barriers (25 questions) based on the binary scale (Yes or No). By using the descriptive statistics and student t-test, data were analyzed with the significance level of 0.05, in the software SPSS19. Results: In the area of organizational factors, the most important restraining factor of the research activities of students was the lack of access to information sources (73.2%) and in the area of individual factors the main obstacle was lack of domination in English (68.6%). Also, the administrative restrictive regulations (73.3%) as the most important organizational restraining factor and lack of time due to job preoccupation (68.9%) as the main individual barrier were recognized for doing research in view of professors. There is not any statistical significant difference between the view of students under study in all the influential individual barriers other than the being unimportant of research from my view and having the negative attitude towards the research works in the view of professors. Also, there is a significant difference between students’ view in all effective organizational barriers other than lack of research in the chapter heading of courses of most of fields and the professors’ view. In total the score of organizational barriers was more than that of the individual barriers. Conclusions: Organizational barriers and personal barriers have an important role in doing the research in the Medical Sciences University of Ardabil; these barriers can be passed through. The availability of consulting forces and sufficient and necessary counseling, teaching know-how and attitude correction, compensating the lack of facilities and equipment, creating the motivation by the authorities and educating and empowering as executive working procedures are recommended for overcoming the research barriers in the universities.
TL;DR: Serum LDH showed significant association with severity of disease and maternal and fetal complications in patients with preclampsia-eclamapsia and its severity was assessed.
Abstract: Background: Pregnancy induced hypertension (PIH) is a global problem with a 5-15% incidence rate in India and complicating 10-17% of all pregnancies. The complications of PIH are responsible for significant maternal and perinatal morbidity and are the third leading cause of pregnancy related death. Lactate dehydrogenase (LDH) serves as indicators suggestive of disturbance of cellular integrity induced by pathological conditions and is used to detect cell damage or cell death. The main objective was to assess significance of the value of serum LDH as a marker of PIH and its severity. Methods: Serum LDH was analyzed by modified UV Kinetic IFCC method. This study was conducted from February 2014 to June 2015 and all the patients admitted in the department of obstetrics and gynecology and biochemistry, at the GMERS medical college, Dharpur, Patan, Gujarat, India. Results: Total 110 cases were studied during the study period, 40 were normal pregnant women and remaining 70 were PIH cases. Out of the 70 PIH cases, 15 (21.5%) were mild preecclampsia, 35 (50.0%) were severe preeclampsia and 20 (28.5%) were eclampsia. Maternal mortality occurred in 06 cases (8.5%). Perinatal mortality was seen in 28 (40.0%), Out of these, 20 (71.4%) were stillbirth and 08 (28.6%) were neonatal deaths. There is significant rise in the LDH levels with the increasing severity of the disease (172.37±28.09) normotensive, (356.33±24.47) mild preeclampsia, (609.91±136.92) severe preeclampsia and (854.05±247.45), eclampsia (P 800 IU/l. Conclusions: Serum LDH showed significant association with severity of disease and maternal and fetal complications in patients with preclampsia-eclamapsia.
TL;DR: Different roles of OC are tried to explain, however further studies are required to elucidate the metabolic and hormonal role of OC in human body.
Abstract: Osteocalcin (OC) is produced by osteoblasts during bone formation. OC is excreted into urine by glomerular filtration and can be found as fragments in urine. The presence of three vitamin K-dependent γ-carboxyglutamic acid residues is critical for osteocalcin’s structure, which appears to regulate the maturation of bone mineral. Recent bone biology research have highlighted the importance of bone not only as a structural scaffold to support the human body, but also as a regulator of a metabolic processes that are independent of mineral metabolism. Circulating osteocalcin is present either as carboxylated or as undercarboxylated forms. Increased serum level of osteocalcin is linked with increased bone mineral density. The importance of the bone–kidney relation in physiologic regulation of mineral ion has also been extensively studied and documented. Several workers have uncovered the role of insulin as an additional factor involved in the skeletal remodelling process. Evidences are available which shows that osteoblastic insulin signalling is important for glucose metabolism. The measurement of OC in urine samples could be used as an index of bone turnover in monitoring bone metabolism. In this review, we have tried to explain different roles of OC, however further studies are required to elucidate the metabolic and hormonal role of OC in human body.
TL;DR: Justification of hysterectomy is proved when the HPE report is compatible with the preoperative diagnosis; hence HPE of all hystEREctomy specimens should be done and analyzed.
Abstract: Background: This was a retrospective study in which the histopathological examination (HPE) of the specimens of all the hysterectomies done for the non-oncological causes in the Mayo Institute of Medical Sciences (MIMS), Barabanki, India from January 2015 to July 2016 were analyzed. The aim of the study was to assess the range of pathological lesions in the hysterectomy specimens and correlation of the preoperative diagnosis with the histopathological diagnosis. Methods: This was a retrospective study which included all the patients who underwent hysterectomy for the non – oncological gynecological causes in Mayo Institute of Medical Sciences, Barabanki, Uttar Pradesh, India over a span of 19 months, from January 2015 to July 2016. Results: A total of 152 hysterectomies were done for the non-oncological causes in the department of obstetrics and gynecology, MIMS, during the study period. Among these, 95 (62.5%) were done by the abdominal route and 57 (37.5%) were done by vaginal route. Mean age of the patients were 50.86±6.9 years, the mean age for vaginal hysterectomy being higher as compared to the abdominal hysterectomy. Uterovaginal prolapse (37.5%) was the most common preoperative indication, while the fibroid uterus (25.65%) was the commonest indication for the abdominal hysterectomy. Other common indications were dysfunctional uterine bleeding (DUB, 9.87%) and ovarian mass (7.89%). Fibroid uterus in the myometrium, chronic cervicitis in the cervix and functional cysts in the ovaries were the commonest histopathology noted. Adenomyosis was the most missed pathology preoperatively. Patients operated with a preoperative diagnosis of DUB had least HPE correlation. Unremarkable HPE was found in 12.5% cases, all were operated for uterovaginal prolapse Conclusions: Justification of hysterectomy is proved when the HPE report is compatible with the preoperative diagnosis; hence HPE of all hysterectomy specimens should be done and analyzed.
TL;DR: Altered serum levels of copper (Cu), zinc (Zn), iron (Fe), ferritin, calcium (Ca) and magnesium (Mg), in PIH and normotensive primipara mothers was conducted to consider a role in the etiopathogenesis and severity of PIH.
Abstract: Background: Exact pathophysiology of pregnancy induced hypertension (PIH) is still unknown but there is a definite relationship between trace elements and preeclampsia. Several studies in this context have conflicting reports. So, a comparative study of serum levels of copper (Cu), zinc (Zn), iron (Fe), ferritin, calcium (Ca) and magnesium (Mg), in PIH and normotensive primipara mothers was conducted. Methods: Study was conducted in Department of Biochemistry & Department of Gynaecology and Obstetrics, R. G. Kar Medical College & Hospital, Kolkata over 1 year from September 2013 to August 2014 on fifty PIH patients as cases and fifty normotensive primipara mother without proteinuria as controls, both having ages ranging between 15-35 years in 2nd and 3rd trimesters. Results: Serum Ca, Mg, Cu and Zn levels were found to be significantly reduced (<0.05) in the PIH group compared to the normal pregnant group. Serum ferritin was markedly increased in the cases (mean 90.41±47.39, p<0.00001). No significant correlation was found in serum Fe levels. Conclusions: Alteration of serum Cu, Zn, Ca, Mg and ferritin levels can be considered to have a role in the etiopathogenesis and severity of PIH.
TL;DR: The results indicated that both quercetin and moringinine are strong antitumor agents against the two human cell lines, the extract and its three active ingredients improved the induced liver toxicity.
Abstract: Background: The three well-characterized phytochemicals in Moringa oleifera leaves are moringinine, quercetin, and chlorogenic acid. Moringa oleifera is postulated to have the highest antioxidant content in food and also has a remarkable range of medicinal uses and high nutritional value. Methods: Evaluation of the antiproliferative effect of moringinine, quercetin and chlorogenic acid as well Moringa oleifera leaves extract on two human cell lines, breast cancer cell line (MCF7) and liver carcinoma cell line (HepG2) using the sulforhodamine B (SRB) assay. The efficacy on liver toxicity induced in rat by alloxan was carried out. Results: Our results indicated that both quercetin and moringinine are strong antitumor agents against the two human cell lines, the extract and its three active ingredients improved the induced liver toxicity. Conclusions: Quercetin and moringinine are responsible to a great extent for the antitumor activity of the whole extract. Chlorogenic acid is a potent hepatoprotective in alloxan induced liver toxicity.
TL;DR: The study shows that OTs were having bacterial CFU rate of air varying from 6-72 CFU/m 3 and colonized by contaminants like Bacillus sp and pathogens like Klebsiella sp, which indicates the needs for periodic surveillance aimed at early detection of bacterial contamination levels and prevention of hospital acquired infections.
Abstract: Background: Hospital-associated infections are the major cause of patient morbidity and mortality. Environmental monitoring by the microbiological testing of surfaces and equipments is useful to detect changing trends of types and counts of microbial flora. The aims of the study were to count CFU (colony forming unit) rate of indoor air, to identify bacterial colonization of surface and equipments isolated from Operation theatres, ICUs and Labor room of a teaching hospital in Telangana, India. Methods: Air sampling of 10 OT’s, 4 ICU’s and 1 LR were done by settle plate method. Swabs were taken from different sites and equipments and bacterial species were isolated and identified from them. Results: Gynaecology OT-2 and 3 showed less bacterial CFU rate of air (6 CFU/m 3 ) followed by Opthamology OT (16 CFU/m 3 ) and highest in Orthopaedics minor OT (72 CFU/m 3 ) and Dental OT (42 CFU/m 3 with 1 fungal CFU/m 3 ). Pediatric ICU showed less bacterial CFU rate (28 CFU/m 3 ) followed by Surgery ICU (40 CFU/m 3 ) and highest in Medical ICU (100 CFU/m 3 and 5 fungal CFU/m 3 ). Labor room showed 65 CFU/m3. Bacterial species were isolated from 48 (43%) out of total 111 swab samples taken from all OTs and ICUs. The most common isolate was Bacillus species 36 (75%) followed by micrococcus (54%). Pathogenic organisms isolated were 12 Gram negative bacilli and 6 gram positive cocci, the common isolate was Klebsiella spp (7 of 12). Conclusions: The study shows that OTs were having bacterial CFU rate of air varying from 6-72 CFU/m 3 and colonized by contaminants like Bacillus sp and pathogens like Klebsiella sp . ICUs were having bacterial CFU rate of air varying from 28-100 CFU/m 3 and colonized with contaminant like Bacillus sp., as well as potential pathogens like Klebsiella, Pseudomonas etc. Fungal CFU were also seen both in OTs and ICUs. High level of microbial contamination indicates the needs for periodic surveillance aimed at early detection of bacterial contamination levels and prevention of hospital acquired infections.
TL;DR: The study concluded that Majmaah University students’ awareness of carcinoma breast is low and there is no significant difference in the level of awareness between students of medical colleges and those of non-medical colleges.
Abstract: Background: Breast cancer is a common health problem among females in Saudi Arabia. The disease account for 27% of all female malignancies representing 25.1% of all newly diagnosed female cancers. The objectives of the current study were to assess the level of carcinoma breast awareness of female university students, Majmaah University in Saudi Arabia and to compare the level of awareness, breast self-examination and breast cancer screening between medical and non-medical students. Methods: The current study was a cross-sectional, conducted among female students in Majmaah University in Saudi Arabia. The stratified and the systematic sampling were employed to select the colleges and the students respectively. The sample size was calculated as 325. Data was collected by a pre tested questionnaire and analyzed by SPSS. Results: The university students who acquired good knowledge were 111 (34.2%). Students who acquired average and poor knowledge were 42.2% and 23.6% respectively. Medical students who had good knowledge were 37.6% compared to 26.9% of non-medical students. The results showed that 94 (28.9%) of the participants practice breast self-examination and 25 (7.6%) performed a screening test. Conclusions: The study concluded that Majmaah University students’ awareness of carcinoma breast is low. There is no significant difference in the level of awareness between students of medical colleges and those of non-medical colleges. The level of practicing breast self-examination and performing screening test for carcinoma breast among female university students is low. There is a significant difference in performing carcinoma breast screening test between medical and non-medical students.
TL;DR: Depression severity was positively correlated with age of women and duration of infertility, and low socioeconomic status, low educated and rural background was a risk factor for severity of depression for infertile women.
Abstract: Background: Infertility has been a major medical and social preoccupation since the dawn of human existence and women have always been the symbol of fertility. Infertility is a stressful life event and depressive symptoms are normal responses to the life crisis of the infertile women. Aim and objective of the study was to determine the severity of depression in infertile females as compared to control group and to correlate the duration of infertility to depression in infertile females. Methods: The Present study was carried out on 70 patients in both groups. After randomization, assessment of Sociodemographic details was done with the help of semi-structured performa and severity of depression by beck depression rating scale. The proposed study was conducted in phased manner observing ethics of voluntary participation and informed consent of the participants were taken. Results: Both the groups were comparable with respect to age, socioeconomic status, occupation, education, religion, family type and area. No significant differences found between both groups with respect to the sociodemographic profile (p-value >0.05). The mean age of infertile women was 28.72 year and fertile women 27.45 years. We found that maximum female was from a middle class in both groups, 48 (68.57%) in infertile and 50 (71.42%) in the fertile group. Conclusions: Depression was more in infertile women. Depression severity was positively correlated with age of women and duration of infertility. Low socioeconomic status, low educated and rural background was a risk factor for severity of depression for infertile women.
TL;DR: The results from 16 publications showed that survival of breast cancer varies widely depending on number of factors like age, stage at diagnosis, marital status, educational level, hormonal status, clinical extent of disease and treatment.
Abstract: Length of survival of cancer patients is an important indicator for knowing the outcome of treatment in any study. Epidemiological features and biological profile of breast cancer appear to be different in developing countries as compared to Western countries. Knowing the factors that influence survival rates among women with breast cancer may help define early detection actions, and improve treatment and care proposals in all the areas of health. Therefore, this study aims to identify, the publications defining the factors influencing survival for women with breast cancer in India. PUBMED database was searched from January 1990 to April 2016, using the key words Breast cancer, breast cancer outcome and Survival and their corresponding Mesh terms were used in combination with Boolean operators like OR, AND. Five year overall survival rate of breast cancer in India ranged from 40-62%. The results from 16 publications showed that survival of breast cancer varies widely depending on number of factors like age, stage at diagnosis, marital status, educational level, hormonal status, clinical extent of disease and treatment. The publications that make up this review present contributing factors that affect the survival rate of women with breast cancer in India. This information on survival studies can pinpoint the lacunae in treatment modalities and can guide us to do basic and translational research so the preventive strategies can be implemented.
TL;DR: ADRs involving different organ systems were seen in both categories with varied frequency and add to hospitalization expenses, insurance costs and increase in work loss days besides addition to patient suffering and loss of compliance.
Abstract: Background: Tuberculosis is a major public health problem, with one out of three people in the world are infected with Mycobacterium tuberculosis . The prevalence of MDR TB in India is 2-3% among new cases and 12-17% in reinfection cases. One of the reasons for MDR may be noncompliance to treatment due to adverse drug reactions. The present study was conducted to find out ADRs in patients on antitubercular treatment (ATT) under pharmacovigilance programme of India (PvPI). Methods: This was a retrospective observational study. Data was collected through voluntary reporting by health-care professionals (HCP) in standard IPC-PvPI prescribed suspected ADR reporting form and analyzed for 100 patients on ATT. Causality assessment was done using WHO causality assessment scale. Results: The maximum ADRs were reported in adults with a mean age of 40.79±16.79 years. Males (n=66) outnumbered females (n=34). There were 62% MDR-TB on DOTS-plus regimen, followed by 35% on Cat1 ATT for pulmonary and extrapulmonary tuberculosis cases and XDR-TB accounted for 3% of the total cases. The commonest ADRs in patients on MDR treatment were related to CNS 44 (27.5%), followed by Gastrointestinal system 31 (19%), psychiatric 20 (12.5%) otovestibular 13 (8%) and ophthalmic ADRs being the least in frequency 1 (0.6%). In contrast patients on Cat 1 ATT the ADRs involving Gastrointestinal system 44 (44%) followed by CNS 12 (12%), psychiatric 0% and ADRs related to otovestibular manifestations being the least 1 (1%) frequency. Conclusions: ADRs involving different organ systems were seen in both categories with varied frequency. Adverse drug reactions add to hospitalization expenses, insurance costs and increase in work loss days besides addition to patient suffering and loss of compliance. Prior knowledge can help in better prescriptions and prevent valuable resource loss.
TL;DR: Determination of endotracheal tube size by ultrasound is a good predictor of proper sized ETT in paediatric age group when compared with age based formulas.
Abstract: Background: Age-based formulas have been widely used to predict the appropriate size of the endotracheal tube (ETT) for intubation in paediatric age group. These formulas often fail to reliably predict the proper size of ETT. The objective of the study is to determine whether the tracheal internal diameter imaged by ultrasound is a better predictor of ETT size than age based formulas. Methods: The study included a total of 60 patients of ASA 1 and 2 aged between 2 and 15 years of either sex posted for elective surgery under general anaesthesia. After institutional ethical committee approval and written consent from the parents, anaesthesia was induced as per the protocol. The tracheal diameter was measured after induction of anaesthesia, during mask ventilation prior to intubation. A linear high frequency ultrasound probe (GE venue 40) was used to measure the tracheal diameter. The size of ETT was selected according to the measured tracheal diameter. The leak test and adequate oxygenation/ventilation were the objective tests used to validate the appropriateness of the ETT chosen. The ETT sizes determined by age based formulas and by the use of ultrasound were statistically compared with the appropriate ETT size used clinically for intubation. Results: The estimation of endotracheal tube size with the aid of ultrasound was found to be superior when compared with age based formulas. Ultrasound tube size determination correlated well with clinically used ETT size. Conclusions: Determination of endotracheal tube size by ultrasound is a good predictor of proper sized ETT in paediatric age group when compared with age based formulas.
TL;DR: Dyslipidemia is highly prevalent in type 2 diabetes mellitus patients in Punjab and the patients of all age groups are affected similarly, and the complete lipid profile should be evaluated and dyslipidemic should be treated.
Abstract: Background: India leads the world with the largest number of diabetic patients. The risk of mortality is high with cardiovascular disease in patients of diabetes mellitus which in turn is well associated with dyslipidemia. Patients of type 2 diabetes mellitus are usually dyslipidemic, even when under relatively good glycaemic control. Diabetic dyslipidemia usually includes elevated plasma triglycerides (TG), elevated low density lipoprotein cholesterol (LDL-C) and decreased high density lipoprotein cholesterol (HDL-C) levels but its pattern is also influenced by patient ethnicity. The objective of the study was to investigate the pattern of dyslipidemia in patients of type 2 diabetes mellitus attending a tertiary care hospital of Punjab. Methods: A cross sectional study was performed on the consecutive patients of type 2 diabetes mellitus attending the Medicine OPD of Punjab Institute of Medical Sciences, Jalandhar over 6 months period (March 2015 to August 2015). The study included 285 patients of type 2 diabetes mellitus and the variables recorded were demographic characteristics, weight, height and fasting lipid profile parameters i.e. total cholesterol (TC), TG, LDL-C and HDL-C. The collected data was analyzed statistically using SPSS version 20 software. Results: There were 55.1% male and 44.9% female with mean age 52.7 ± 11.43; 42.8% patients were urban and 57.2% rural. The mean body mass index (BMI) was 26.8 ± 5.48 (male: 25.4 ± 4.62 and female: 28 ± 5.31). Dyslipidemia was found in 81.8% patients. The most commonly elevated lipid was LDL-C (59.3%) followed by TG (57.2%) and TC (36.5%). The HDL-C was decreased in 34.4% patients. The distribution of dyslipidemia among the different age groups was almost similar: 82.6% in 60 years, the difference was not statistically significant (p = 0.998). Conclusions: Dyslipidemia is highly prevalent in type 2 diabetes mellitus patients in Punjab. The patients of all age groups are affected similarly. The patients of type 2 diabetes mellitus should be made aware of dyslipidemia and the consequent increased risk for cardiovascular diseases. The complete lipid profile should be evaluated and dyslipidemia should be treated. This would significantly reduce cardiovascular morbidity and mortality among the type 2 diabetes mellitus patients.