Friday, 1 June 2018

Medical Journal- May 2018

Medical Journal: Published volume-4, Issue-5, May 2018 with ad publications

Health and physical development problems in undergraduate students and comparison of opinion between males and females regarding helpfulness of guidance and counselling services to cope with their health and physical development problems

Abstract— Adolescent health and physical development problems are important issue in student life; there are many helpful services to cope with these problems. This study was conducted on 240 students (120 males and 120 females) to know their health and physical development problems and to compare the response of males & females for helpfulness of guidance and counselling services to help them to cope with their health and physical development problems. Study was done at Rajamagala University of Technology Thanyaburi, Pathum Tani Province, Thailand. This study used the Mooney Problem Checklist, College Form which contains 30 statements and the six scales of guidance and counselling service namely Individual and Group Counselling, Consulting, Guidance, Coordination, Assessment, and 3 Personal Growth and Development. Study population was randomly selected 240 undergraduate students from eight difference faculties’ v.i.z. Agricultural Technology, Business Administration, Engineering, Fine and Applied Arts, Home Economics Technology, Liberal Arts, Science and Technology, and Technical Education. This study observed that out of 120 male Thai undergraduate students, 113 (94.2%) male students said that they have troubled with their feet. Otherwise, 119 (99.2%) female students argued that they have not as strong healthy as they should be and they have had poor complexion or skin trouble (N = 120).The result of t-test analysis showed that there was a significant different between Thai male and female students on the helpfulness of individual and group counselling service (N = 120, t (118) =0.903, p = 0.015) consultation service (N = 120, t (118) = 0.983, p<0.001), guidance service (N = 120, t (118) = 0.903, p = 0.015), coordination service (N = 120, t (118) = 0.744, p = 0.017), assessment service (N = 120, t (118) = 0.969, p = 0.002), and personal growth and development service (N = 120, t (118) = 0.902, p = 0.015) provided by the guidance counsellor in helping undergraduate students to cope with their health and physical development problems at a significant level of 0.05.

Keywords: Guidance and Counselling Services, Health and Physical Development Problems, Undergraduate Students.

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A comparative analysis of first trimester medical abortion in cases with previously scarred and non-scarred uterus: A case control study

Abstract—In recent years, termination of pregnancy has also become more common procedure due to intensive development of medicines and increasing demand for such procedures. In previously scarred uterus the use of medical abortion regimen could avoid severe complications such as uterine perforation, cervical laceration and other physical and psychological trauma which are caused by surgical termination of pregnancy. This prospective study was conducted in Department of Obstetrics and Gynaecology, J.L.N. Medical College, Ajmer from December 2015 to November 2017 to compare the efficacy, safety and acceptability of medical abortion in previously scarred and non-scarred uterus. For this study 75 women were included of amenorrhoea < 49 days with previous one or two LSCS (Lower segment cesarean section) and 75 women with no LSCS (primi and multipara with prior normal delivery). Regime which was used in this study was tab. Mifepristone 200 mg followed by Misoprostol 600µgm were given to them. Follow up was done at day 14 using sonography. The overall success rate for complete abortion in group I was 88% and that of group II was 89.3%.Total proportion of incomplete abortion was 9.33% in group I as compared to 8% in group II and continuation of pregnancy occurred 2.67% in both the groups during the entire study period. Thus there was no significant difference in efficacy of medicines in achieving abortion in scared and non-scared uterus. So early medical abortion represents an important method in previous scarred uterus patients having unwanted pregnancy. These regimens offer the prospect of a more private, less intrusive form of abortion that is both safe and effective.

Keywords: Medical abortion, Scarred uterus, Non-scarred uterus, Mifepristone, Misoprostol.

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Tribological Examination of Calcium alginate – UHMWPE blends

Abstract Continuing our previous researches on UHMWPE (Ultra-High- Molecular-Weight Polyethylene) based implant material and its fusion with Ca-alginate, we describe new methods for preparing Ca-alginate blended UHMWPE samples and how we extended the testing of the prepared samples. If sufficient content of Ca-alginate can be achieved and the Calcium-alginate blended UHMWPE can be made, it might lead to an implant material which can promote bone formation. Earlier result shows that the Calcium–alginate contentwill be formed in the structure of UHMWPE. Using our new modified methods we can make polyethylene samples with sufficiently tough alginate content which can withstand washing and sterilization as that is shown in the paper. Since we had modified the UHMWPE specimens with Ca-alginates we carried out different types of wear testing on the prepared samples.

Keywords UHMWPE, Na-alginate, Ca-alginate.

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Microbiological survey of the bathing water of moroccan beaches from Mehdia to Skhirat

Abstract—The Moroccan coastline occupies a privileged place at the level of the entire coastline of the African continent. The quality of bathing water is a criterion increasingly demanded by the general public for the choice of its holiday resorts. Main objective of this present study is to find out the status of to find status of bathing water through physicochemical and microbiological examination.

Sampling was done from 8 beaches of Kenitra Mehdia, Nations, Rabat-Sale, Harhoura, Temara, Golden Sand, Val D'or and the beach of Skhirate Amphitrite. Bacteriological evaluations were done & presence of feacal Coliforms and/or Streptococci was considered as indicative of faecal pollution. Enumeration of faecal Coliforms and faecal Streptococci was done by filter membrane method on nutrient media Tergitol7 Agar, Litskey, Slanetz & Bartley. In addition to microbiological sampling of water, temperature and pH of the water were measured "in situ". Data related to the tide (high or low) and populations were collected.

Regarding bacterial load of beaches in present study it was found that at Mehdia beach, Nations beach, Rabat-Sale beach, Temara beach, Harhoura beach, Sable D’or beach and at Skhirat beach the contamination standard is exceeded in 30% of samples for CF and 20% for SF, 10% for CF and 0% for SF, 100% of the samples for CF and 70% for SF, 50% for CF and in none (0%) for SF, 20% for CF and 10% for SF, 30% for CF and 10% for SF and 40% for CF and 10% for SF respectively. But at Val D'or beach in none of sample exceed the guide value (VG) for faecal Coliform and fecal Streptococci. So the beaches of the Nations, Harhoura and Val D'or are classified A. The beaches of Mehdia, Temara, Golden Sand and Skhirat with medium quality waters are classified B. Only the beach of Rabat-Sale was found polluted and classified in category C.

Keywords: Coastline Pollution, Microbiology, Coliforms, Streptococci, Morocco.

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Tuesday, 15 May 2018

Medical Journal- April 2018

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

Design and Architecture of Intelligent Medical Machines: A Research Paper

Abstract— Commonalities between the engineering rigor and the medical approach were explored to solve problems and present generic platforms to fuse the engineering rigor into the current medical approach to resolve the concerns of medical machine designers. The design methodology stresses the ability to fragment medical problems and their procedures into a series or a combination of minor or even microscopic problems (and their procedures) which are resolved by enforcing one or more actions by intelligent agents (or noun objects) to solve the localized problem. A certain amount of knowledge in the solution process is fed back to customize the specific solution for the specific patient. A series of minuscule of such knowledge modules are appropriately integrated to solve the entire medical problem for the patient. This minuscule’s of knowledge become programmable instruction for a medical machine with access to World Wide Web and knowledge bases that can verify and enhance the solution strategy for the fragmented problems.

The role of knowledge and its programmability become crucial to finding an optimal and efficient solution to solve routine, mid-sized or large medical problems of the patients during routine doctor’s visits. It is our contention that the suggested approaches in blending the industry wide practices in the design and manufacture of digital devices and systems can reduce the cost of providing medical services substantially. With reasonable care in selecting the intelligent agents (doctors, staff, instruments, laboratories, and/or medicines), their respective actions and functions in efficient and effective combinations at appropriate instants of time can be a significant step forward in cost reduction and (near) flawless administration of medical procedures.

The paper spans numerous disciplines ranging from mathematics, computer and knowledge science, the science of management including program evaluation and review technique (PERT) and optimization of strategies. The role of these disciplines is incisive and restricted the practice of medicine and the many roles that computer systems that are essential building blocks of medical machines.

Keywords: Medical Machines, Evolution of Medical Processor Units, Intelligent Medical Processor Units.

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Assessment of Stress, Attention and Memory in High School Students in Latacunga, Ecuador: A cross-sectional survey

Abstract—Stress is the side effect of development. Nowadays school going children also had stress and it’s after effects. So this research was carried out in order to evaluate indicators of stress level (stress test), attention (Toulouse-Pièron test), immediate memory (word list test) and working memory (reverse order digit test), to a group of 40 students of the school whose age was between 15 and 17 year. Survey done on first of April in the International Baccalaureate level of the Latacunga city, Cotopaxi province, Republic of Ecuador. The perceptual and attention testing Toluuse-Pièron for additions and omissions plus errors did not throw significant differences between gender; but they behaved over 20 % of the hits, which showed a lack of deep concentration and attention over time. The stress test showed that females were more stressed in relation to males; however, for the word test and the reverse-order digits, no significant differences between the genders were found. A nonlinear (polynomial) relationship was found between the stress of the students and the memory. So it can be concluded that females were significantly more stressed than males whereas regarding memory there was no significant difference in both the sexes. It was also revealed that there was no linear relation between stress and memory.

Keywords: Stress, Attention, Memory, Concentration.

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Comparative Study on Macroscopic Morphology of Human Placenta in Preterm, Term & Post Term Pregnancy

Abstract— Pregnancy is highly precious for every couple but presence of risk factors that cause prematurity, post maturity and various other conditions that complicate the pregnancy have adverse effects. Gross examination of the placenta may provide useful information about the etiology of newborn and maternal complications. Hence it is important to study relationships between placental abnormalities, gestational age and occurrence of adverse outcome. So, this study aims to compare the macroscopic morphology of human placenta in preterm, term and post-term pregnancy. A hospital based comparative observational study conducted on placentae of 40 pre-term, 40 term and 40 post-term. Shape, weight, diameter, thickness, mode of insertion of umbilical cord, number of cotyledons and arrangement of chorionic vessels was observed of each placenta included in the study. These variables of palcentae were compared as per pre-term, term and post-term. Significance of difference was determined by Chi-square test. This study revealed that most of the placentae were discoidal in shape. And the weight as well as diameter of the term placentae were significantly more from preterm placentae. Likewise weight and diameter both of the post term placentae were significantly more form term placentae. Regarding thickness of placentae, term placentae thickness were more from preterm placentae and post-term placentae were more from term placentae but it was found significant in term to preterm not in term to post-term. So it can be concluded from this study that as gestational period increases weight, diameter and thickness of placenta increases. Observing the facts, more studies are suggested to explore the other variables related to placenta and its relation to pregnancy outcomes.

Keywords: Placenta, Macroscopic anatomy of Placenta, Pregnancy Outcomes.

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VACTERL association: A Case Report of a congenital malformations

AbstractVACTERL / VATER association is defined by the presence of at least three of the following congenital malformations: vertebral defects, anal atresia, cardiac defects, trachea-esophageal fistula, renal anomalies and limb abnormalities. It is diagnosed clinically by the above features with presence of core component features like trachea-esophageal fistula or ano-rectal malformations. Etiology is largely unknown. Management centers on surgical correction of the specific congenital malformations in the immediate postnatal period followed by long term treatment of the sequelae. Prognosis is good if surgical correction is achieved but majority continue to be affected by their malformations throughout life.

Keywords: VACTERL Association, Congenital Malformations.

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Correlations of Serum Level of 25(OH)D and Bone Mineral Density (BMD) among chronic patients of Spinal Cord Injury (SCI)

Abstract—Chronic patients of spinal cord injury has been detected severe reduction of bone density. Patients with SCI show mostly osteopenia or osteoporosis of the hip and spine. Vitamin D deficiency may contribute to development of osteoporosis in SCI. So a study was conducted on 100 chronic SCI patients to find out status of correlation of Vitamine D and bone mineral density (BMD). Blood samples were collected and investigated routine biochemistry with serum 25(OH)D. DXA scan of hip and spine was also done. This study observed that 55% patients had suboptimal vitamin D. Positive correlation was found between vitamin D & bone mineral density. It is concluded from this study that monitoring of Serum 25(OH)D levels and annual surveillance of bone mineral density is crucial among persons with chronic SCI to reduce progression of osteoporosis and minimize the risk for further fractures.

Keywords: 25(OH)D: 25 Hydroxy Vitamin D, DXA: Dual Energy X-Ray Absorptiometry, BMD: Bone Mineral Density.

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Assessment of Knowledge and Practices regarding personal hygiene among students of Government schools of Jaipur city: A cross-sectional survey

Abstract— Hygiene practices are very important, poor hygiene results into various communicable diseases. These hygiene practices can have cultivated in Childhood. School children are particularly vulnerable to neglect the basic personal hygiene. So this study was conducted on 1385 school children to assess the status of knowledge and practices of their hygiene with the source of their knowledge. This study was conducted on 1385 students of 6 selected schools of Jaipur city. It was observed that it was observed that 98.4% had knowledge about body and clothes hygiene, 95.2% had knowledge about teeth brushing, 92.5% had knowledge about regular clothes washing, 89.2% had knowledge about soap use in personal hygiene, 50.3% had knowledge about use of toilet paper, 78.8% had knowledge about use of nail cutter and 37.1% knowledge about sanitary pad. And 97.3% practice for bath & brush teeth every day, 95.1% practiced for hand wash before meal, 74.3% practiced for hand wash before cooking, 66.6% practiced for hand wash after cooking, 90.2% practiced for hand wash after using toilet, 87.8% practiced for hand wash after handling garbage, 75.7% practiced for hand wash after handling animal, 73.6% practiced for cutting nails in < 7 days, 80.8% take hair cut out in < 1 month, 70.1% use soap as hygiene product, 42.7% use facial tissue as hygiene product and 50.1% use cotton swab as hygiene product.

Keywords: Hygiene, Knowledge, Practices, School Children.

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Clinical assessment of Fetal weight estimation using Johnson's formula & Ultrasonographic assessment using Hadlock's formula at or near term: A comparative observational study

Abstract—Fetal weight in conjuction with gestational age is an important indicator of pregnancy outcome. So this study was conducted to find out the better method among using Johnson's formula or using Hadlock's formula to estimate fetal weight antenatally at or near term. This prospective study conducted on 100 pregnant women selected by simple random sampling with single term pregnancy with no fetal anomalies, delivered within one week of ultrasonography as well as measuring the symphysiofundal height and accuracy of Johnson's and Hadlock's formula compared. Fetal Weight is overestimated in all groups by Johnson's formula whereas in Hadlock’s formula there is underestimation of birth weight <2500 gms and >3500 gms babies and overestimation between 2500-3500 gms babies. The correct weight was estimated with an error of 100gms in 30% of cases by Johnson’s formula and in 68% of cases by ultrasound Hadlock's method. Although Hadlock's formula was found relatively more accurate than Johnson's formula in predicting birth weight but Johnson's formula is a quick, easy, accurate, reliable and cost effective method for estimating the fetal weight in remote areas where ultrasound is not available if assessed by experienced obstetricians. Despite the superiority of ultrasonography the simple clinical method of predicting fetal weight is of great value especially in developing countries.

Keywords: Fetal Weight, Johnson's Formula, Hadlock's Formula.

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Comparison of diagnostic efficacy of USG, Tuberculin test, Nucleic acid amplification test (PCR) & histopathology for diagnosis of genital tuberculosis in infertile women, assuming culture as gold standard

Abstract— Female genital tuberculosis is one of the major etiological factors of female infertility. Diagnosis of genital tuberculosis is very important in such cases. So this comparative observational type of study was carried out on infertile women to compare the diagnostic effectively of ultrasonograpgy (USG), genital tuberculosis, Tuberculin test, Nucleic acid amplification test (PCR), histopathology and hysteroscopy & laparoscopy (DHL) assuming culture as gold standard. It was observed that the 28% of infertile cases were found positive for genital tuberculosis on culture. Sensitivity of PCR 64.28%, DHL 92.85%, USG 42.85%, Histopathology 60.71% and Tuberculin Test 64.28%. So sensitivity was found with significant variation ranging from 42.85% with ultrasonography (USG) to 92.85% with DHL. Specificity of PCR 52.77%, DHL 55.55%, USG 98.61%, Histopathology 91.66% and Tuberculin Test 36.11%. So specificity was also found with significant variation being found maximum with USG (98.61%) and minimum with tuberculin test (36.11%). Positive predictive value (PPV) was found maximum (92.3%) with USG and minimum (28.12%) with tuberculin test and negative predictive value (NPV) was found maximum (95.23%) with DHL and minimum (72.22%) with tuberculin test. Diagnostic effectively of diagnosing GTB with various studied modalities vary with significant variation.

Keywords: Infertility, diagnostic efficacy, genital tuberculosis, Tuberculin test, Nucleic acid amplification test (PCR).

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Burden of infertility and its associated factors: A cross sectional descriptive analysis of infertility cases reported at a tertiary level hospital of Rajasthan

Abstract—In many cultures in India, womanhood is defined through motherhood and infertile women usually carry the blame for the couple inability to conceive. A childless woman is stigmatized and sometimes not allowed to participate in various auspicious ceremonies, particularly those involving childbirth. The present study was undertaken in S.M.S. Medical College, Jaipur, Rajasthan to find out the factors contributing to infertility and the health seeking behavior of infertile women. A hospital based observational study was carried out in year 2017 on eligible women attending OPD of Obstetrics and Gynecology at Mahila Chikitsalaya, S.M.S. Medical College Jaipur. A total 1000 eligible women were recruited using systematic random sampling and interviewed using a predesigned and pretested questionnaire. A total of 119 women (11.9%) were found to be infertile. Age of women, caste, residence, education status of women, occupation, family size and socio-economic status were found to be significantly associated with infertility (P<0.05). Lower age of women, OBC caste, urban residence, less family size, lesser education status of women, housewives and middle socio-economic status were found to have significantly more infertile females than their counterparts. Age of women, type of family and religion were not found to be associated with infertility (P >0.05). Improving awareness about infertility and its management could help reduce the burden and its social implications.

Keywords: Infertility, Infertile Women.

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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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