Saturday, 31 December 2016

IMJ Health : December 2016

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

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

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

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

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

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

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

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

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

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

Key words: ASHA, Knowledge Status of ASHA.

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

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

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

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

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

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

Key words: Basicervical fracture, DHS, Derotation screw.

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Tuesday, 6 December 2016

Medical Journal: November 2016 Issue

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Factors associated with Physical Quality of Life in Diabetes Mallitus

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

Keywords Diabetes Mellitus, Physical Quality of Life.

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