Title: Nurses’ Perception and Practice of Evidence-Based Practice in Federal Teaching Hospital Abakaliki
Authors: Ominyi, Jude Nweze & Nwodom, Maureen Ukamaka
Evidence-based practice is a problem solving approach to the delivery of health care that integrates the best evidence from studies and patient care data with clinicians’ expertise and patient preference and values according to (Fineout-Overholt, 2010). Health Care that is evidence-based and conducted in caring context leads to better clinical decision and patient outcomes. Gaining knowledge and skills in evidence the tools needed to take ownership in their practices and transforms healthcare. The study was a sample descriptive survey to assess nurses’ perception and practice of evidence-based nursing care in Federal Teaching Hospital II Abakaliki, Ebonyi State. 96 nurses including males and females who work in the hospital were randomly selected.
The findings of this study on the knowledge of the nurses on evidence-based nursing practice reveal that (90.6%) had heard of evidence-based nursing practice and (60.4%) heard it though formal education, the result clearly shown that majority of the nurses were knowledgeable about evidence-based nursing practice. The above result supported by Honor Society of nursing (2008) who reported that majority of the respondents were also at variance with Royal and Blythe (2008) who discovered that less than 3% of respondents reported being familiar with the concept of evidence-based practice.
The result also reveals that nurses’ attitude was positive and favorable. This result corresponds with Omery and Williams (2002) who discovered that nurses’ attitude about research was stronger motivator than education. Olade (2004) in supporting this result also find out that nurses expressed more favourable attitude towards research utilization.The finding shows significant relationship between nurses’ knowledge and attitude towards evidence-based practice in Federal Teaching Hospital Abakaliki (FETHA II).
The result in table 9 revealed that there were barriers to implementation of evidence-based practice in Federal Teaching Hospital Abakaliki (FETHA II). The identified barriers were inadequate facilities for implementation; nurses were not capable of evaluating the quality of research, insufficient time, inadequate resources, lack of continuing education, and lack of co-operation by doctors and non-availability of relevant research. The study identified more employees/sufficient staffing, enhancing administrative supports and encouragement, cooperative and supportive colleagues, improving availability/accessibility of research reports, and improving the understandability of research reports as factors that will facilitate the use of evidence-based nursing practice in Federal Teaching Hospital Abakaliki (FETHA).
Conclusively, based on the results of the findings, it was concluded that nurses in Federal Teaching Hospital Abakaliki were aware of the concept of evidence-based nursing practice and the attitude towards the concept was favourable. Despite the above, the nurses still perceived some barriers and facilitators towards implementation of this concept. Based on the findings of this study, the following recommendations were made: Promoting research utilization through formation of nursing research committee as a potent way to promote evidence-based nursing. Membership of this committee must cut across all address of nurses from different specialist for effectiveness. There is need for supportive environment where innovation is valued and rewarded. Nurses should read nursing journals constantly in order to improve care.
Keywords: Evidence based practice, patients, knowledge, attitude, barrier, and implementation.
Title: Correlation of Demographic Profile and Antibiotic Resistance in Patients with Urinary Tract Infection Attending a Teaching Hospital in Kolkata
Authors: Nilay Chatterjee, Reena Ray(Ghosh), Mitali Chatterjee, Sandip Chattopadhyay
The aim of this study was to determine the bacterial aetiology of Urinary Tract Infection (UTI) with their resistance to commonly used antimicrobial drugs and their correlation with age, sex and marital status of the patient. A total of 303 urine specimens, collected from suspected cases of UTI were processed and 77 significant monomicrobial cultures were obtained. E.coli was the most common uropathogen isolated, which constituted 37.6% of the total samples followed by Klebsiella (16.8%), Enterococcus (15.6%), Staphylococcus aureus (12.98%), Acinetobactor spp. (6.49%), Proteus spp.(5.19%), Streptococcus spp.(3.89%) & Pseudomonas spp.(1.29%). Females (52.48%) were found more vulnerable to UTI compared to males (47.52%).The percentage of resistance seen in different uropathogens to various antimicrobial agents were: 84.4% to Nalidixic Acid(NA), 83.1% to Cefpodoxim(CPD), 77.9% to Cefdinir(CDR), 75.3% to Augmentin(Amoxy-clav,AG), 53.2% to Piperacillin(PC), 48.0 to Ciprofloxacin(RC), 46.7% to Norfloxacin(NX), 36.4% to Furadantin(FD), 18.2% to Netilmycin(NT) and 15.6% to Polymyxin-B(PB). The percentage of antimicrobial resistance among different uropathogens varied between 84.4% and 15.6%. Maximum resistance to Nalidixic acid was offered by E. coli irrespective of any age group. E.coli showed resistance to majority of antibiotics (except Nalixdic acid and Norfloxacin) in male. The resistance pattern of E.coli against each antimicrobial agent in relation to marital status showed that majority of the antimicrobial agents (except Furadantin, Polymyxin-B and Augmentin) were not effective in controlling infection in married persons. Thus E. coli was found as the commonest etiological agent of urinary tract infection in both sexes. This study also revealed the strong association between demographic profile of the patient with occurrence of UTI and resistance to antibiotics in uropathogens.
Keywords: Urinary Tract Infection, Escherichia coli, Resistance pattern, Antibiotic sensitivity
Title: Study of Clinical and Sonological Parameters Affecting Outcome of Difficult Laproscpic Cholecystectomy
Authors:Dr. Jitendra T. Sankpal, Dr. Vivek P. Tilwani, Dr.Tushar Valvi, Dr. Vijay S.Nikale, Dr. Pankaj Zawar
Easy availability and portability of ultrasound has made the detection of indications of cholecystectomy more easy and early Laparoscopic cholecystectomy is the gold standard care for the treatment of symptomatic gallbladder disease.In our study total of 356 patients undergone laparoscopic cholecystectomy or laparoscopic converted to open cholecystectomy,mean age group most commonly affecting is 40.98 years,with male to female ratio 1:2.06.Most common symptom found is pain in right hypochondrium,while most common presentation was chronic calculus cholecystitis.In our study 42 cases required conversion to open ie.conversion rate (12.35%),with dense chronic adhesions being the common reason found in (33.3%).Our study found significant association for conversion with previous episodes of acute cholecystitis and pancreatitis ,gall bladder wall thickness .
Title: Clinical Study of Acute Abdomen In 200 Cases
Authors: Dr. Jitendra T. Sankpal, Dr. Vivek P. Tilwani, Dr.Tushar Valvi, Dr. Vijay S.Nikale, Dr. Ashish Hatkar
Present study is a hospital based prospective study done at tertiary care hospital in 200 patients presented with acute abdomen. Abdomen is considered to be magic box as a symptom complex of acute abdomen may confront surgeon paediatrician obstetrician creating a problem of urgent diagnosis and management. In this study (26.5%) involved were of 21-30 years of age group, males is to female ratio is( 2.4:1),Pain in abdomen and vomiting is common presentation, with abdominal tenderness being common sign, stomach is commonly involved organ. Out of 200 patients (71%) patients managed conservatively and only (29%) patient’s required emergency surgery and only 4 patients died i.e. 2% mortality.
Title: Langer Giedion Syndrome with Absence of Bilateral Radial Arteries - A Rare Clinical Association
Authors: Riya George, Rajesh Rai, Fehmida Najmuddin, Keya Lahiri
Langer Giedion syndrome, also known as Trichorhinophalangeal syndrome type 2 (OMIM 150230) is a rare multisystem disorder characterized by distinctive facial features and cartilaginous exostosis. It is a contiguous gene deletion syndrome located on chromosome 8q24.1-q24.13. The characteristic phenotypic features include sparse hair, multiple cone shaped epiphysis, multiple cartilaginous exostoses, bulbous nasal tip, thickened alar cartilage, upturned nares, prominent philtrum, large protruding ears, mild mental retardation and stunting of growth. The authors present a 6 year old boy with classical features of Langer Giedion syndrome with absence of radial artery bilaterally as a rare clinical association which has never been described previously.
Keywords: Trichorhinophalangeal syndrome type II, exostoses, microdeletion, dysmorphic features, bilateral absence of radial arteries
Title: A Survey of the Current Management of Hepatitis B Virus Infection in Pregnancy among Obstetrics and Gynaecological Medical Trainees in Nigeria
Authors: Paul Olisaemeka Ezeonu, Robinson Chukwudi Onoh, Lucky Osaheni Lawani, Chukwuemeka Anthony Iyoke, Emeka Chinedu Nkwo, Peter Onubiwe Nkwo
Context: Hepatitis B virus infection is a major public health problem and can be transmitted from mother to child in pregnancy. Vertical transmission could be reduced by maternal antiviral therapy and adequate immunisation of the baby.
Objective: To survey the current management of hepatitis B virus infection in pregnancy by Nigerian medical doctors from obstetrics and gynaecology department.
Methods: A semi-structured questionnaire was designed for cross-sectional survey of doctors attending update course in 2011 for part I & II fellowship examinations. The questionnaires were filled and then analysed using 2008 Epi Info™ software.
Results: A total of 96 (83.5%) of the semi-structured questionnaire were correctly filled and analysed out of the 115 questionnaire distributed. The mean duration of obstetrics and gynaecological practice of respondents in this study was 4.6±3.3 years. Of 29 different hospitals represented in this study, most doctors work at the University Teaching Hospital 66(68.5%) and Federal Medical Centre 17 (17.7%). Forty (41.7%) of the doctors asserted that hepatitis B surface antigens was routinely done in their centre while majority 56 (58.3) confirmed that it was not routinely done in their institution. Most of the hospital for residency training do not have protocol for management of reactive hepatitis B surface antigen in pregnancy as indicated by 71(74.0) doctors.
Conclusion: Routine screening for HBV in pregnancy is not done by all doctors in obstetrics and as such is not practiced in all tertiary hospitals in Nigeria and the protocols for management of reactive HBs Ag is not standardized in all hospitals. There is marked variation in the perception of current management of hepatitis B virus infection in Nigeria. Provision of a national guideline, adequate laboratory services and equipping the health institutions will be beneficial in the management of HBV in pregnancy.
Title: Gelatin Sponge Induced Adhesive Intestinal Obstruction Following A Gynaecologic Operation
(Case Report and Review of Literature)
Authors: Ketan Vagholkar
Early postoperative adhesive intestinal obstruction in the first week following a gynaecologic operation is an uncommon problem. Haemostatic sponges can give rise to this condition. Extensive dissection leads to bleeding and extensive deperitonealised surfaces predisposing to adhesion formation. Acute adhesive intestinal obstruction caused by inflammatory adhesions induced by haemostatic gelatin sponge necessitating exploratory laparotomy is presented. The pathophysiologic mechanisms of haemostatic gelatin sponges are discussed. Gelatin sponges can induce dense adhesions. It is best to avoid their use in gynaecologic pelvic surgery.
Keywords: Gelatin, sponge, adhesive, intestinal obstruction, gynaecologic, surgery
Title: Effective Training – Road to Quality Health Care
Authors: Mohan Lal, Kirti
Human resources are the most valuable assets of any organization although other resources are also important, but nothing can be done without human resources i.e., mean manpower. Training for both professional and Para -professional staff is indispensable, but trained paramedical staff can provide better primary health care in rural and tribal population if the training is of high quality and according to the requirement of the need for the general population. The entire training program must be submitted with training needs assessment, but now a day training program is mostly related to the new program and project, so this aspect of the training is ignored in the training process. In training, role of the participants should be active and not passive. Effective training occurs, if classroom training is followed by a practical orientation on the job or health organization. Induction training is provided to the new entrants, while other type of training is needed to time for the employees. Assessment of training is of two types one is immediately by post training test to test the knowledge; the other should be in objectives in behavioral and skill terms. To enhance the quality of staff activities, training is very much required.
Key words: - Attitude, Effective, Job, quality, staff.
Title: Non-Venereal Female Genital Dermatoses – A Clinical Study
Authors: Muktamani G, Shivakumar V, Rajendra Okade
Background: Non- Venereal genital dermatoses is always confused with venereal dermatoses because of its similar presentation and it causes a diagnostic delimma to the treating physician as well as considerable concern to the patients. Non- venereal dermatoses need not be restricted to the genitalia alone, it can affect other mucous membreane and skin. So, a proper knowledge of various dermatoses and its varied presentation with proper knowledge of the anatomical structure is required for its correct diagnosis.
Methods: It was a descriptive study which included a series of 150 patients presenting to the Dermatology department over a period of 15 months from DEC 2011 to March 2013. Some venereal conditions which were transmitted through non- venereal route were also included. Cases having any venereal diseases were excluded from the study.
Results: The frequency of non-venereal dermatoses among female patients attending OPD is very common. The age ranged from 3months to 65 years with majority of age group between 21-40 years (61%) which is reproductive age group. The non – venereal genital lesions were grouped into 4 groups according to the involvement of site with labia majora 96(64%), most common dermatoses being folliculitis 25(16%), oro-genital12 (8%) and skin involment 43(28%). Oro-genital involvement predominantly included vitiligo in 5 cases followed by candidiasis in 2 cases, SJS in 2 cases and PV in 2 cases and lichen planus in 1 cases. Among skin disorders with the oro - genital involvement i.e.11(7%), 5(3%)cases of vitiligo, 2 cases of SJS and 2 cases of PV and 1 cases of LP. A total of 26 non – venereal genital dermatoses were encountered with folliculitis 25(16%) being the most common dermatoses followed closely by LSC 22(14%) and vitiligo 21(14%). A total of 43 cases (28%) with systemic involvement was recorded with most common association being DM-2, 13(8%) followed by HTN 9(6%) and thyroid 7(4%). Among 150 patients, 115 patients were in postpubertal, 17 patients were in postmenopausal and 7 patients in prepubertal age group.
Key word: Genital, Non- Venereal, Dermatoses.
Title: Comparison of the Performance of QF-PCR with qPCR as a Rapid Molecular-Based Method for Sex Chromosome Aneuploidies Detection
Authors: Reham Moftah, Raymonda Varon, Christiane Bommer, Véronique Dutrannoy, Mohsen Karbasiyan, Salah Marzouk, Dalal El-Kaffash, Heidemarie Neitzel
Objective: The high prevalence and variable phenotype of sex chromosome aneuploidies, necessitated the development of a robust method allowing their rapid prenatal diagnosis. Quantitative Fluorescent Polymerase Chain Reaction (QF-PCR) has emerged as a rapid and cost-efficient prenatal diagnostic test for autosomal & sex chromosome aneuploidies. Quantitative real-time PCR (qPCR), an accurate and precise tool for determination of template copy number, represents a potential cost-effective option for sex chromosome copy number detection in laboratories lacking sequencing facilities.
Methods: The performance of QF-PCR and qPCR-ΔΔCT methods for the detection of sex chromosome copy numbers, was evaluated in a retrospective cohort of 56 archival samples; 43 control samples from normal male [n = 19] and female [n = 24] foetuses and 13 sex chromosome aneuploidies. All samples were blindly tested and the results of QF-PCR and qPCR were compared with the original Karyotyping results.
Results: qPCR showed 100% sensitivity. Usingour QF-PCR sex chromosome primer mix, a case of Turner syndrome was misdiagnosed as normal female. Both methods showed 100% specificity.
Conclusion: qPCR is a promising, low cost, rapid tool for sex chromosome copy number detection for further evaluation on a large scale to validate its performance.The introduction of an X/autosome paralagous marker and SRY primers to our QF-PCR sex chromosome primer mix will be considered for future studies.
Keywords: Prenatal, QF-PCR, qPCR, sex-chromosome aneuploidy
Title: Assessment of Carotid Lesions in Nonalcoholic Fatty Liver Disease Patients
Authors: Sathish Kumar A, Sridhar K, Srinivas MG, Ajith Roni D, Srikanth Reddy Y, Lalit Nihal, Pavan Kumar Reddy Y, Panil Kumar K, Ram Mohan, Pradeep PV, Janaki Ram N, Mahaboob V Shaik, Thankappan KR
Objective: Assessment of carotid lesions in Nonalcoholic Fatty Liver Disease patients. To know the association of c-IMT with cardiovascular risk factors in NAFLD patients.
Background: Nonalcoholic fatty liver disease (NAFLD) affects 10-24% of general population across various countries and in India it varies between 9-32%. Long-term studies revealed that NAFLD patients had an increased mortality rate, with cardiovascular disease being one of the leading causes of death. To this purpose, we evaluated the risk of cardiovascular disease in NAFLD patients using Carotid ultrasound.
Methods: 50 patients with NAFLD based on USG abdomen were enrolled. Patients were excluded if they were alcoholics or having HBV, HCV, HIV, auto immune, Wilson or having chronic liver disease or pregnant. We measured visceral fat thickness (VFT), subcutaneous fat thickness (SFT), carotid intima media thickness (c-IMT.) and carotid plaque prevalence.
Results: A total of 5276 patients were attended to medical gastroenterology OPD during the period of April 2010 to Nov 2011. USG abdomen was done in 826 patients for various reasons, among them 306 (37%) were diagnosed to have fatty liver and 111 (13.5%) out of them were having NAFLD. The Mean age of NAFLD patients was 54.32±9.60 yrs. The mean values of SFT 20.81±4.71 mm, VFT 53.14±17.42 mm and c-IMT 0.86±0.13 mm were higher in NAFLD patients than controls 16.07±3.29, (p=0.000), 40.64±11.46 mm (p= 0.000) and 0.81±0.08 mm, (p <0.05) respectively. Plaques prevalence was also more in NAFLD patients 18/50 (36%) than controls 6/50 (12%) (p-0.009). Among NAFLD patients, the c-IMT was significantly higher in patients with risk factors for cardiovascular disease than those who were not having.
Conclusion: The prevalence of NAFLD in our study was 13.5%. C-IMT was significantly higher in the NAFLD group than controls. The relative risk of plaques prevalence was 1.375. Screening of c-IMT might be valuable in NAFLD patients, for detecting subclinical atherosclerosis.
Key Words: Nonalcoholic fatty liver disease, visceral fat thickness, subcutaneous fat thickness, carotid intima media thickness
Title: Assessment of the impacts of 830 nm Low Power Laser on Triiodothyronine (T3), Thyroxine (T4) and the Thyroid Stimulating Hormone (TSH) in the Rabbits
Author: AL- Timimi Zahra’a
This study has designed to research whether there an impact on the thyroid hormone in female rabbits irradiated by low power laser therapy (LPLT) in the thyroid gland region. Thirty female rabbits utilized in this investigation. Ten rabbits used for inspecting the thyroid gland location and dissected to make certain that low power laser source shall be directed to this gland. Twenty female rabbits divided into two equal groups: 10 used as control and the others have exposed to LPLT for three sequential days for five minutes on either side.
LPLT irradiation procedures consisted of an infrared diode laser emitting at 830 nm in continuous mode, point manner on the thyroid gland role. Blood collected for secretion assay from the ear vein at 1st, 4th, 7th, 10th, 13th, 16th, 19th, 22th, 25th and 30th days after the last treatment of LPLT.
The results discovered a gradual decrease in Triiodothyronine (T3) and Tetraiodothyronine (T4) levels. A concomitant increase in Thyroid-Stimulating Hormone (TSH) level, then the normalization of hormone level has taken place to be normal after thirty days. It has concluded that LPLT of the thyroid gland can produce an effect on the thyroid hormone levels. A supplementary work is required on this topic to examine the specific role of LPLT on the glands.
Keywords-Thyroid Gland, Triiodothyronine, Thyroid-Stimulating Hormone, Triiodothyronine,Low Power Laser Therapy.
Title: Adenomatoid Tumour of the Uterus: A Rare Case Report
Authors: Shraddha N K, Sunitha T H, Saraswathi Patil, Rathnamala M Desai, Dr. Hephzibah Rani S
Adenomatoid tumours are rare benign tumours originating in the mesothelium. Uterine adenomatoid tumours are benign tumours of the uterine serosa and myometrium that originate from the mesothelium. They are mostly under diagnosed as they resemble leiomyoma of the uterus. They may resemble pre-existing vessels and lymphatic ducts as well as metastatic adenocarcinomas. We report a rare case a of adenomatoid tumour of the uterus in a 50 years old lady that was found accidently during the treatment of adenomyosis. Although adenomatoid tumour may cause a diagnostic problem, in our case histological study has confirmed the diagnosis.
Keywords: Adenomatoid tumour, Uterus, Mesothelium
Title: Cerebrovascular Episode after an Acute Alcoholic Binge
Authors: Sourya Acharya, Samarth Shukla, Prasad Gurjar, Rasika Thakre
A 40 year old male patient presented to us with stuporous condition. He was accompanied by relatives. According to history he was a chronic alcoholic and had an episode of binge drinking on the previous night. There was no history of vomiting, convulsion, fever. He was a nondiabetic and non hypertensive.
Discussion: The role of alcohol consumption as an independent risk factor for ischemic brain infarction has remained unclear. Both mortality and morbidity from ischemic brain infarction seem to be increased among heavy alcohol drinkers. A synergistic effect of alcohol consumption and hypertension on the risk of ischemic stroke has been observed.[1,2] Studies claim that there are convincing evidence to support such an effect. [3,4] A case-control study showed that heavy alcohol ingestion within the 24 hours preceding the onset of stroke was a risk factor for ischemic brain infarction.  Cardioembolic stroke in particular could well be precipitated by binge drinking, because alcoholic intoxication may precipitate untoward effects on circulation and cardiac rhythm.
Title: A Child without A Smile : Moebius Syndrome – A Case Report
Authors: Ashish Kumar Roy, Prerna Roy, Tulsi Prasad Das
Background: Moebius syndrome is a rare congenital neurological disorder. It is characterised by Facial Palsy accompanied by unilateral or bilateral Abducens nerve palsy. It may be accompanied by weakness of III, IV or XII cranial nerves andoro-facial/ limb deformities.
Case Characteristics: A 9 months old girl child presented with absence of a smile and a drropy right eyelid. On examination, she had bilateral facial weakness, right sided abducens nerve palsy and right sided ptosis.
Outcome: The child had no other congenital deformity. Her developmental milestones were normal as per age.
Message: Moebius syndrome, because of the facial paralysis, usually masquerades as developmental delay. But the patients usually have normal development and normal intelligence
Title: A Coat Button Lesion in Duodenum
Authors: Shah NA, Riyaz-u-Saif, Shagufta Parveen, Mohsin-ul-Rasool, Mushtaq Saif
Most duodenal neuroendocrine tumors (NETs) are detected incidentally and therefore are recognized at an early stage. Duodenal NETs are well differentiated, less than 10 mm and limited to the mucosa/submucosa. The management of duodenal NETs 1-2 cms needs an interdisciplinary discussion before management and those more than 2 cms need surgery. Endoscopic ultrasound is the method of choice to determine tumor size and depth of infiltration. Surgery is recommended for any localized ileal NET. Advanced small intestinal NETs with a carcinoid syndrome are treated with long-acting somatostatin analogs. This treatment significantly improves survival in patients with metastatic NETs. For optimal NET management, tumor biology, type, localization and stage of the neoplasm, as well as the patient’s individual circumstances have to be taken into account.
Title: Acute Acalculous Cholecystitis in Plasmodium Falciparum Malaria
Authors: Meenaxi Sharda, Shivraj meena, Deepti Nagar, Anil Soni
Malaria is one of the major health problems in India. Gastrointestinal manifestations are quite common in malaria. AAC is a rare manifestation seen in P. Falciparum malaria. We report a case of AAC in P. Falciparum malaria in a 13 year old girl. Acute acalculous cholecystitis (AAC) has been described in association with various infectious agents. AAC can be due to bile stasis or gall bladder ischemia. But it remains to be determined whether AAC in P. Falciparum patients is directly related to malaria or to a secondary gallbladder bacterial infection.
Keywords: Acalculous Cholecystitis, malaria, plasmodium falciparum
Title: Apert’s Syndrome:- A Case Report And Review of Literature
Authors: Dr. Bijendar Kumar Meena, Dr.Amit Bansal, Dr.Sweta Meena, Dr.Shailesh Agrawal
Apert's syndrome makes up approximately 4% of all cases of craniosynostosis. The incidence is reported to be 1/160,000 live births . Radiology has an important role in the evaluation, management and follow up of Apert syndrome patients. Plain radiographs are sufficient for diagnosis but CT has added a new dimension to the evaluation of these disorders. Apert syndrome is a form of acrocephalosyndactyly, a congenital disorder characterized by malformations of the skull, face, hands and feet. It is classified as a branchial arch syndrome, affecting the first branchial (or pharyngeal) arch, the precursor of the maxilla and mandible.
Title: Coinfection of Hepatitis B and C virus among HIV Patients Visiting Specialist Hospital in Ikole Ekiti, Nigeria
Authors:Oluyinka Oladele Opaleye, Adeolu Sunday Oluremi, Adesiyan Adekunle, Mujeeb Shittu, Oladipo Abayomi, Musliyu Oyenike, Adewumi Olutope
Infections from HIV, Hepatitis B and Hepatitis C viruses constitute a major public health challenge in sub-Saharan Africa, and concurrent morbidities from liver diseases among HIV patients have also been observed due to co-infection with hepatitis B (HBV) and C (HCV) viruses. Free testing of HBV and HCV are not provided alongside free HIV treatment in Nigeria. The aim of this study was to determine the prevalence of HBV and HCV infections among HIV-infected individuals, and describe the socio-demographic features and correlates of HIV and HBV/HCV co-infected patients at Ikole Ekiti, Nigeria. This was a cross- sectional study among HIV individuals attending Specialist Hospital, Ikole Ekiti, Nigeria. One hundred and fifty eight (158) HIV infected individuals were first screened and later tested for marker of HBV and HCV using Enzyme-linked Immunosorbent Assay (ELISA) and their demography information were collected. Data were analysed using packages within SPSS software and a p <0.05 was regarded as significant. Prevalence rates of Hepatitis B and C virus infections obtained were 5.7% and 1.9%, respectively. Two (1.3%) had triple infection of HIV/HBV/HCV. The CD4 count of the sample tested ranged from 2 to 2140 cell/mm3 with a mean value of 210cell/mm3. About 62.5% of them had CD4 T cell count less than 200 cells/mm3. The mean ALT and AST are 23.8 IU/L and 25.9 IU/L respectively. In conclusion, Co-infection with hepatitis B and C virus is common among HIV-infected individuals and this confirm the necessity for routine screening for this markers before initiation of highly active antiretroviral therapy. Also, HBV negative individuals should be immunized with HBV vaccine to improve the prognosis of their HIV status.
Keywords: Coinfection, Hepatitis B, Hepatitis C , HIV, ELISA
Title: Urinary Tract Infections in Tertiary Care Hospital in North India: Etiology and Antimicrobial Susceptibility Pattern
Authors: C.P.Baveja, Naz Perween, Prabhav Aggarwal
Background: Urinary tract infection (UTI) is one of the most prevalent bacterial infections. Most are mild in nature but, can be complicated with renal involvement and bacteremia. Inappropriate selection of antimicrobials results in emergence of drug resistance and further complications. Microorganisms causing UTI vary in there susceptibility to antimicrobials from place to place and time to time. Hence, there is always need of local susceptibility pattern to determine the therapy.
Aims: The present study was designed to determine etiological pathogens and antibiotic susceptibility patterns of common bacterial isolates causing UTI.
Methods and Material: Total of 3000 urine samples were included. Isolation and identification was done by semi-quantitative culture technique, Grams’ staining and biochemical tests. Antimicrobial susceptibility testing was done by Stroke’s disc diffusion method.
Results: Out of 3000 samples 306 (10.25%) showed significant bacteriuria. Rate of isolate was higher in females 179 (58.49%). E. coli (70.9%) was most common isolate followed by Klebsiella spp. (17.97%). Highest sensitivity of E. coli was observed with Nitrofurantoin. Higher efficacy of Nitrofurantoin was also observed against Klebsiella spp. Pseudomonas was highly sensitive to Piperacillin + Tazobactam. Ceftriaxone was most effective for Acinetobacter spp.
Conclusions: The pattern of sensitivity of bacteria to antibiotics varies over time and with different geographical regions, thus, antibiotic treatment of infections should be based on local experience of Antibiotic Susceptibility patterns.
Title: Hair Dye Poisoning with Refractory Arrthymia & Interstitial Nephritis- Rare Presentation
Authors: Raghu K, Shreevani P, Praveen Kumar K, Ramya Kumar, Md. Haneef
A 45year old female with no comorbid illness brought to emergency room with alleged history of consumption of 100ml of hair dye at 10am at her residence. She was initially treated at government hospital and brought to our hospital at 1:45pm. On arrival patient E1V1M1 in gasping state, with cervicofascial edema. In view of impending respiratory arrest patient was intubated with 6 size ET tube. After 5min she had Ventricular Tachycardia without pulse defibrillated with 200J, Chest compression given @100/min, after 2min, monitor shows Ventricular Fibrillation, defibrillated with 200J, Chest compression given @100/min Inj Adrenlaine1mg, after 2min monitor shows Ventricular Fibrillation --- debrillated with 200J, Chest compression given @100/min Inj Adrenlaine1mg given. Inj Amiadarone 300mg given after 3rd shock repeated with 150 mg after 2 minutes followed by infusion, in view of sustained Ventricular Fibrillation for 1hour continued treatment as per ACLS protocols. Inj Mgso4 2grams over 30min given in 100ml NS, Inj calcium Chloride 1gram Given, Inj soda bicarbonate 100meq given, during resuscitation.
Title: Effect of Aerobic Exercise during Ramadan Fasting on Lipid Profile
Authors: Mariana M Aziz, Zahra M Serry, Sahier O El-khashab, Magda G Sedhom
Background: The major religious period of the Islamic calendar is Ramadan when many millions of Muslims fast throughout the daylight hours. Research indicated that fasting in Ramadan can cause changes in body component.
Purpose: to investigate the effect of strict prolonged fasting combined with aerobic exercises on body composition, and lipid profile in normal subjects.
Design: a pre-test post-test design.
Methods: 50 subjects of both genders, aging from 35-45 years and BMI from 30 to 34.9 kg/m2 participated in this study. Subjects were assigned into 2 groups; group (A) 25 subjects received moderate intensity aerobic exercise during Ramadan fasting while group (B) 25 subjects were fast only. Body composition (Weight, BMI and W/H ratio) and serum lipid profile (TC, TG, LDL and HDL) were determined at 24h before and the last day of Ramadan month
Results: moderate intensity aerobic exercise and fasting in group A had a considerable effect on body composition and lipid profile. While in group B fasting alone had no considerable effect on W/H ratio and HDL.
Conclusion: Interaction between fasting and aerobic exercise was not considerable, except on W/H ratio and HDL which didn't decreased due to fasting only
Key words: Fasting Ramadan, Aerobic exercises, Lipid profile and body composition.
Title: Nutritional Status according to Mini Nutritional Assessment (MNA) in an Elderly Population in the Northwest Rajasthan
Authors: Shivraj Meena, V B Singh, Neelam Meena, Dayal Sharma, Kusum Singh
Introduction: The early detection of malnutrition and the risk of malnutrition is an important challenge for improving the care of elderly people. There is definite evidence that malnutrition is more common in geriatric population but it is underestimated in diagnostic and therapeutic procedures. MNA is a tool to identify those at risk of malnutrition who can benefit from early intervention.
Objective: The present study was carried out to assess Nutritional Status According to Mini Nutritional Assessment in ≥ 65 years. The study the impact of socioeconomic status, living arrangement, smoking and alcohol on nutritional status.
Material and Methods: It was a cross sectional study of 500 elderly subjects of age≥ 65 years (63% subjects from urban area and 37% subjects from rural area). Nutritional status assessment was done by using 18 items (30 points) Mini nutritional assessment (MNA) scale.
Results: Present study showed that 11.6% elderly were malnourished while 46% were at risk of malnutrition and only 42.4% were well nourished. Malnutrition and risk of malnutrition was more common in rural 104 (52.21%), 47 (25.41%) than urban 126 (40%), 11 (3.49%) respectively. Prevalence of malnutrition was more in lower class (BPL) 28 (36.84%) than upper class (lower middle) 5 (10.20%). Prevalence of malnutrition in smokers, ex-smokers, tobacco-chewers and non-addicts was 20.25%, 13.38%, 0% and 8.30% respectively. Prevalence of malnutrition in alcoholic consuming, occasional and not consuming was 15.90%, 12.50% and 11.13% respectively. Prevalence of malnutrition in With spouse & Children, with children, with souse and alone was 11.68%, 13.63%, 10.20%, and 0% respectively.
Conclusion: Nutritional status declines further as the age advances. Nutritional status of our urban elderly was better than nutritional status of rural elderly. Mini Nutritional Assessment (MNA) is one of the very good nutrition screening/assessment tools. We can identify risk of malnutrition in early stage and do intervention on timely. Nutritional evaluation should be a part of clinical assessment of elderly.
Key words: malnutrition, elderly, Mini nutritional assessment, MNA.
Title: Effects of Yogasanas in the Management of Pain during Menstruation
Authors: Vungarala Satyanand, Kaliki Hymavathi, Elakkiya.Panneerselvam, Shaik Mahaboobvali, Shaik Ahammad Basha, Chemuru Shoba
Menstrual irregularities are main problems in females due to many reasons. The aim of the study is to evaluate effects of yogasanas in the management of pain during menstruation.100 patients were selected as subjects, among them 50 participants in the case group were asked to attend 45 minutes yoga class every day with medications for a period of 3 months. The control group 50 subjects did not receive any yoga intervention only medications and were asked to complete questionnaires. Visual analog scale (VAS) was used to measure the pain severity for both the groups. The results of this study showed that yoga and relaxative techniques are better and beneficial therapy in the management of irregular menstruation and reducing the pain during menstruation. These techniques may be used as supportive along with conventional medications.
Key words: Yogasanas, pain during menstruation
Title: Anxiety levels in First year MBBS Students
Author: Amit Vasant Desphpande
Medical students encounter multiple stresses and emotional challenges from their beginning to a young knowledgeable physician. As far as academic stressors are concerned, academic performance especially in the First Professional, examination criteria dissatisfaction and being overburdened with test schedule were significantly associated with anxiety, which is the case in a number of other studies as well, suggesting academic stressors as being a source of psychological distress among medical students. So the objective of the study was to assess the levels of anxiety among medical students in our region. The study was done on 150 medical students of first year of Mamta Medical College, Khammam. Students were divided into two groups – hostellers and day scholars. Anxiety level was assessed by Hamilton anxiety scale using questionnaire. Student t test and Pearson correlation were used for comparison. The prevalence of anxiety was 31.3% among males and 62.8% among females. The difference in mean values for anxiety score in male hostellers and male day scholars was not significant, whereas, the difference in mean value for anxiety score in female hostellers and female day scholars was highly significant. So anxiety if untreated, can lead to mental distress and have a negative impact on their cognitive functioning and learning behavior.
Keywords– Anxiety, Stress, Hamilton anxiety scale, Depression
Title: FNAC Diagnosis of Scar Endometriosis: A Case Report with Review of Literature
Authors: Dr. Akanksha V.Gaajre, Dr. Yasmeen Khatib, Dr. Richa D Patel, Dr.Asha Premlata
Endometriosis is the presence of functioning endometrium outside the uterus.Extra pelvic endometriosis is less common and more difficult to diagnose due to extreme variability in presentation.The diagnosis can be suspected clinically when there is systemic endometriosis or cyclical pain. Otherwise it is difficult to differentiate it from other abdominal tumors and non-neoplastic conditions.We report a case of 32 year old woman who presented with a tender anterior abdominal wall nodule at previous caesarean section scar. Initial clinical diagnosis was of a suture granuloma. Medical treatment was not helpful. On fine needle aspiration cytology (FNAC) a diagnosis of scar endometriosis was given which was confirmed on histopathology.
Key Words- endometriosis, FNAC, scar,
Title: Hysterectomy Enhances the Risk of Coronary Artery Disease in Type 2 Diabetic Women in Premenopausal Age Group
Author: Dr Basab Ghosh
Aim: In this study we aim 1) to assess the associated risk for Coronary Artery Disease (CAD) in premenopausal and postmenopausal stage in women and 2) to determine the impact of hysterectomy in women with type 2 diabetes mellitus in premenoupausal age, on the risk of CAD.
Methods: A total of 181 type 2 diabetic women who underwent exercise treadmill ECG testing in the hospital during a 30 months period was studied. Based on an arbitrary cut off age of 48 yrs subjects were assigned in group 1: age < 48 yrs (premenopausal) and group 2: age ³ 48 years (postmenopausal). Based on exercise treadmill ECG results, they were subgrouped as without CAD (treadmill ECG test negative) and with CAD (treadmill ECG test positive).
Results: Age, duration of diabetes, hypertension and CAD were significantly more in postmenopausal group (p<0.05). Age, HDL-cholesterol and hysterectomy were significantly (p< 0.05) associated with premenopausal CAD. In postmenopausal CAD subgroup age, duration of diabetes, hypertension, HDL-cholesterol, sedentary physical activity and hysterectomy were significantly higher (p<0.05). In the multivariate analysis, hysterectomy was strongly associated (OR = 7.73, p = 0.016) with premenopausal CAD. Conclusion: The study projects hysterectomy as a high risk factor for the CAD in premenopausal type 2 diabetics.
Keywords: Type 2 diabetes, age, hysterectomy, coronary artery disease.
Title: Designing the Occlusion for a Single Tooth Implant in a Compromised Occlusion
Authors: Khurshid Mattoo, Rishabh Garg, Vishal Bansal
Single implant restorations are fast becoming the treatment of choice for many partial edentulous situations because of inherent advantages they possess. Indicated for many clinical conditions that range from ideal to imperfect, single tooth implant restorations provide competent functional option to natural teeth. Although there are various determinants for single implant prosthetic option, one factor that decides its ultimate success is the patient’s occlusion. As there is no occlusion that is ideal therefore this article in the form of a clinical case report discusses designing of single implant restorations in compromised occlusion.
Keywords- occlusion, abutment, fixture, Osseointegration, crown
Title: Sliding Cast Post Core System – Prosthodontic Solution for Divergent Root Canal Configuration
Authors: Khurshid Mattoo, Rishabh Garg, Vipin Arora
Advanced endodontics have made it possible that if margin of future crown can be placed supragingivally then irrespective of coronal destruction one can restore the natural tooth. This has challenged the prosthodontic fraternity to come up with new and innovative designs to restore the posterior natural endodontically treated teeth. Degree of difficulty in treating posterior teeth with post core is their root configuration and relation that is never parallel especially in maxillary molars. With palatal root being the widest of all roots, the mechanical advantage that it offers cannot be overlooked and therefore involvement of palatal root for any post core system is mandatory. This article describes a technique of fabricating a cast post core for multiple divergent maxillary root canals using the principle of sliding one component over the other.
Keywords-cast core, dowel crown, endodontics, metal ceramic, crown and bridge
Title: Malarial Hepatits in Non Endemic Area
Authors: Dr Riyaz U Saif , Dr Gul javid , Dr Syed Mushtaq Saif, Dr Nisar A Shah, Dr Mohsin ul Rasool, Dr Arsheed Iqbal, Dr Mohd Ismail
Kashmir valley is a non endemic area for malaria due to its high altitude. However, globalization and increased human travel has led to an increased incidence of malaria here. Further malaria can have varied presentation; therefore, a high index of suspicion is necessary especially in non endemic area. We present our experience of six patients with documented malarial infection who presented with typical clinical features of hepatitis and hence a diagnostic challenge since malaria is regarded rare in Kashmir and index of suspicion is low.
Keywords:- Malaria ,malarial hepatitis, renal failure, plasmodium falciparum
Title: An Insight into Saliva as a Biomarker for Periodontal Disease
Authors: Dr. Arvind Garg, Dr. Suruchi Hans, Dr. Shweta Bansal, Dr. Arun Garg, Dr. Asmita Sethi
periodontal disease is a immune-inflammatory disease with varying degree of disease severity. It has been a challenge to determine biomarkers for screening and predicting the early onset of periodontal disease, evaluating the disease activity and the efficacy of therapy. Traditional clinical criteria are often insufficient for determining sites of active disease, for monitoring the response to therapy, or for measuring the degree of susceptibility to future disease progression. . In the recent past, research on saliva have been directed towards better understanding of the potential of saliva as an aid in the diagnosis of several diseases where presence/absence or a change of one or more of its constituents can act as a marker. Saliva is a fluid that can be easily collected non-invasively, contain locally derived and systemically derived markers of periodontal disease hence may offer the basis for patient specific diagnosis for periodontal disease. This review highlights the various potentials of saliva as a diagnostic biomarker for periodontal diseases.
Keywords: Biomarker, diagnostic fluid, periodontal disease, saliva
Title: Embryonal Rhabdomyosarcoma of Orbit-A Case Report
Authors: Dr.Preeti Rawat, Dr.Sachin Tammannavar, Dr.Akshay Harne, Dr.Divya Patel, Dr. Narmada Prasad Tiwari
Rhabdomyosarcoma is a highly malignant neoplasm of pleuripotent embryonic mesoderm, which commonly differentiates to form cells similar to rhabdomyoblasts of the foetus. Because of the presence of elongated cells that contain abundance of eosinophilic glycogen rich cytoplasm, it is generally referred to as embryonal form of rhabdomyosarcoma. Rhabdomyosarcoma is one of the most common primary malignant orbital neoplasms of child hood. It usually produces a precipitously progressing unilateral proptosis of sudden onset. We report a case of embryonal rhabdomyosarcoma of orbit presenting as large mass on medial side of right upper lid since 1 month in a 15 year old female patient.
Title: Identification of Fungal Species in Proved Cases of Fungal Corneal Ulcer
Authors: Madhusudhan C.N, Tanushree V, H.T.Venkategowda, Sudharani B.K
Background: Mycotic keratitis is a fungal infection of the cornea. This infection is difficult to treat and it can lead to severe visual impairment or blindness. It is worldwide in distribution, but is more common in the tropics and subtropical regions. Trauma is the major predisposing factor, followed by ocular and systemic defects, prior application of corticosteroids. The objective of this study was to determine causative agents of mycotic keratitis.
Methods: A retrospective review of medical and microbiology records was conducted for 25 corneal ulcer patients with suspected fungal etiology who were subjected to direct examination by 10% KOH mount, Gram stain and culture.
Results: This study included 25 subjects with corneal ulcers, males were more commonly affected and were mostly in the age group of 45-60 years. Aspergillus was the most common fungus isolated followed by fusarium. The most common predisposing factors were injury to the eye.
Conclusion: In this study we found that fungal corneal ulcer is more predominant in males and trauma with vegetative matter is the predisposing factor and we found Aspergillus species is more common.
Key words: corneal infections, fungal keratitis, fungal culture, Fusarium spp, Aspergillus spp
Title: A Rare Case of Non-Functioning Pancreatic Neuroendocrine Tumour and Its Surgical Management
Authors: Dr. Manuneethimaran Thiyagarajan, Dr. Rubina Singh, Dr. Pragnya Chirugupati, Prof. A. Vikram, Prof. Sandhya
Pancreatic neuroendocrine tumors (PNET) consist of a rare group of neoplasms that arise from the pancreatic endocrine cells which are scattered among exocrine tissue of pancreas. They account for 2-4% of pancreatic neoplasms. The incidence is 1/100000. People frequently harbour a symptomatic PNET, and are found only on autopsy studies. They are usual sporadic but more than 10% are associated with genetic syndromes hese tumours can either be functional or non-functional attributing to the secretion of specific hormones. In this case report we are discussing about Pancreatic neuroendocrine tumour which was managed surgicaly
Title: Antiangiogenetic Effect of Neem Root Extract on the Fin of Zebrafish (Fin Regeneration Method)
Authors: L. P. B. Lavanya Uppuluri, Ms. V. N. Garge, Dr.V.J.Kadam
Cancer is a serious cause of death globally. Cancerous cells cannot be distinguished easily from the normal cells. Rapid development of cancerous cells depends on the process of Angiogenesis. Inhibition of the angiogenesis is a novel strategy in cancer treatment. Currently, herbal medicines are also being used, along with chemotherapy to reduce the side effects. For the present study, Neem was selected as it is a versatile tree in India. From the ancient times it has been considered as a mighty tree which gives good health. Roots of that tree were taken to study anti-angiogenesis activity on Zebra fish. The different parts of Neem tree were proven for their cytotoxic activity; hence water soluble fractions of crude methanolic extract of neem roots were taken as a test drug. Fin Regeneration in Zebra fish was selected as an experimental model. Fish were divided into groups, each with six fish. Fins were amputated, allowed to grow for 15 days. They were treated with Different concentrations of the test drug and standard drug. Length of the regenerated fin was measured frequently using digital microscope, and different software. Dose response was calculated for the test drug in comparison with standard drug and control groups. A graph of dose response vs. concentration was plotted accordingly. The test drug has shown desirable effect in angiogenesis inhibition.
Keywords-Neem root. Water soluble extractives, Zebrafish, Angiogenesis, fin regeneration, cancer.
Title: Frontoethmmoidal Encephalocoele Case Report (Two Cases In Last Five Years)
Authors: Dr. Dinesh Sodhi, Dr. Krishna Veer Singh Choudhary, Dr. Neelima Arora
Anterior encephalocoele are very rare congenital malformation of CNS. The preoperative diagnosis requires clinical examination and imaging modalities like CT scan and MRI brain with face.
The principle of surgical management is dissection of sac and adequate closure of the defect at neck. We have operated two cases of Anterior Encephalocoele in last five years.
Keywords: Congenital Anomaly, Fronto ethmoidal, Encephalocoele.
Title: Gene Chips in Microbiology-its Various Diagnostic Applications
Authors: B.V Shamsundar
The laboratory introduction of in vitro nucleic acid amplification techniques, led by real-time PCR, into the clinical microbiology laboratory has transformed the laboratory detection of viruses and select bacterial pathogens. However, the progression of the molecular diagnostic revolution currently relies on the ability to efficiently and accurately offer multiplex detection and characterization for a variety of infectious disease pathogens. Multiple microarray platforms exist, including printed double-stranded DNA and oligonucleotide arrays, in situ-synthesized arrays, high-density bead arrays, electronic microarrays, and suspension bead arrays. This review highlights uses of microarray technology that impact diagnostic microbiology, including the detection and identification of pathogens, determination of antimicrobial resistance, epidemiological strain typing, analysis of microbial infections using host genomic expression and polymorphism profiles and various other applications.
Other application of microarray include differentiations of mycobacterial species and detection of tuberculosis drug resistence, detection of virulence factors of microbial pathogens, detection of pathogens in food and water sample, typing of antimicrobial resistence genes, and identification of fungal pathogens.
This article has also reviewed the roll of microarray in the diagnosis of parasitic infection(identification of parasitic genes),industrial application of microarray(gene expression profiling to determine the effect of antibiotics,agrochemicals, pharmaceutical products on different organisms ) and the roll of array in the detection of graft rejection.
Keywords: gene chips,oligonucleotide microarray, Virochips.
Title: Exodontia – A Review of Various Techniques
Authors: R. Skanda, Dr. Pradeep
This review encompasses the various principles and techniques used in exodontia and also their advantages and disadvantages.
Keywords – tooth, extraction , physics forceps, periosteal elevators