Introduction: The study was conducted to evaluate the relationship between mother’s employment status and prevalence of risk behavior among adolescent students in Lalitpur district of Nepal. Method: This comparative study was conducted in year 2013 with selected 110 secondary level students of purposively selected 4 public schools of Lalitpur district, Nepal. A total 110 mothers [55 employed and 55 unemployed] of selected adolescents were considered under the study. Information was collected by using pre tested structured interview schedule and collected data were analyzed by using SPSS version 19. Results: Adolescent students had poor knowledge on STDs and prevalence of risk behavior is found among adolescents of both working and non working with no association between development of risk behavior and employment status of mothers. Conclusion: Maternal employment status is not the exclusive reason behind the development of unhealthy practices and development of risk behavior among adolescents. The study suggests the need of awareness about the changing nature of adolescent to provide psychological and emotional support to children.

Keywords : Adolescents; employed; mothers; risk behavior; unemployed

Author : Bina Adhikari, Bishwas Adhikari

Title : Effect of mothers employment status on prevalence of risk behavior among adolescent students in Lalitpur Nepal

Volume/Issue : 2014;2(3)

Page No : 724-728

Background: Misuse of antibiotics in the treatment of infections leads to nosocomial infection as well as community infections. The objective of the study was to know the aerobic bacteriological profile of clinical specimen and antimicrobial sensitivity pattern of bacteria isolated from various clinical specimens which provides a basic profile of bacteria and their sesitivity pattern. Materials and Methods: Study design included 200 samples which were processed (excluding blood samples) they were pus, urine, sputum throat swab, stool etc. All the isolates were identified by their colony morphology on nutrient agar, macconkey agar and blood agar. The organism was identified by direct gram stain, gram stain. It was phenotypically identified by conventional biotyping. Antimicrobial sensitivity pattern was done by disc diffusion method according to CLSI guidelines. Results: 200 samples that were cultured from various departmental OPD’s of which 95(47.5%) were positive for culture. The samples that were processed were Pus (90 no), Urine (19 no), sputum (43 no), throat swab (24 no), stool (13 no), gastric aspirate (11 no). Age group 1 to 10 yrs (40 no) followed by 21-30 yrs(41 no), preponderance is in females than males. Commom organisms isolated are Staph aureus & Klebsiella spp. Antibiotic sensitivity pattern was processed by CLSI guidelines among gram positive organism (staph aureus) showed sensitivity to vancomycin 48%, CO (41%) Tetracycline (22%) followed by Klebsiella spp (GNB 37 no), I (13.5%), Gatf (8%) CP (8%) CFS (5.-5 %) AL (5.5%) followed by Pseudomonas aeruginosa (19n): I- 53% sensitivity to CAZ 42% G (31.6%) Tob cb, gat (10.5%) followed by CONS – (6 no)- AMC (16.6%) CP 33% Va- 33% followed by Streptocococcus pyogenes (4no), Bacitracin (50%), Va (25%) & CP – (25%). Conclusion: This study gives us the baseline data for prescription for the patients, more research is needed to find association of culture and sensitivity reports with the antibiotics used in the hospital and the practical utility of such data for the hospital and even other hospitals in the community. Gram positive organism are more sensitive to Vancomycin & GNO to Impenem.

Keywords : Antibiotics, antimicrobial, hospital, infection, prevention, sensitivity

Author : Vinay Hajare, Mahalakshmi V, Tapan Mandal, Achut Rao, Sreekantha

Title : Aerobic bacteriological profile in various clinical specimens and their antibiotic sensitivity pattern in a teaching hospital (NMC & RC)- Raichur

Volume/Issue : 2014;2(3)

Page No : 729-733

Background: Indiscriminate use of antibiotics has led to a state where multi drug resistant bacteria have become increasingly prevalent. The knowledge of antibiotic resistance patterns is necessary to stop the continued emergence of resistance. Objective: This study thus aims to provide the antibiotic resistance patterns of the gram negative clinical isolates. Method: Five hundred and seventy nine gram negative isolates from various clinical samples such as pus, urine, sputum, blood etc., were tested for their antibiotic sensitivity profiles. The clinical data was obtained from the respective units and wards of the patients. Results: Majority of the gram negative organisms isolated were found to be sensitive to Imipenem [9.28% resistant], Amikacin [20.84% resistant] and Piperacillin + Tazobactam [24.69% resistant]. Most of the gram negative organisms were resistant to the routinely used drugs, Norfloxacin [96.49%], Nitrofurantoin [94.92%], Carbenicillin [85.98%] and Amoxiclav [78.28%]. Conclusion: The results of the study conducted demonstrate the distribution and susceptibility pattern of the commonly used antimicrobial agents. The importance of strict antibiotic policies, evidence-based empirical therapies and rigorous surveillance programs to prevent the further spread of resistant bacteria cannot be overstated.

Keywords : Antibiogram; Gram Negative Clinical Isolates; Imipenam; Klebsiella; Norfloxacin

Author : Kala Yadhav M L, Ashmitha Raja

Title : Bacteriological profile and antibiogram of the gram negative clinical isolates from a tertiary care centre

Volume/Issue : 2014;2(3)

Page No : 734-739

Background: Drug abuse is common all over the world. Abused drugs are psychoactive and make abusers engage into activities which are unacceptable in the community. For injecting drugs, the apparatus used is often shared and is unsterile. Unsterile injecting apparatus predispose the users to blood borne infections. People who use drugs often indulge in unprotected sex which is a risk factor for acquiring sexually transmitted infections. Methods: A cross-sectional study of people who use drugs (PWUDs) aged 18 years and above, was done in Mwanza urban. People who use drugs who were either too sick or unable to answer questions and those who refused to give consent to the study were excluded. Data collection involved use of a questionnaire (Face to face approach) and collection of blood and urine samples. The blood samples were used to determine the serological status of the participants, while the urine samples were used to detect presence of illegal drugs. Complete data was obtained for seven hundred and seventy out of the 774 PWUDs who were initially recruited into the study. Results: The project has shown that cannabis and alcohol are highly abused 83.0% n= 581 and 74.2% n= 519 respectively followed by khat 38.3 % n= 268. Heroin use was recorded in 34.0% n= 238 and heroin injection was noted in 5.6% n= 43 of the illegal drug users. HIV infection was detected in 8.6% of the drug abusers, while hepatitis B was seen in 3.8%, hepatitis C was detected in 2.9% and syphilis was detected in 2.5% of the participants. Conclusion: HIV infection in people who use drugs was high (8.6%) compared to that seen in the general population (5.1%) and also high rates of positive results for hepatitis C and syphilis were recorded. Among the intravenous drug users 6.3% were HIV positive. Recommendations: Education should be given to the substance abusers on the consequences of taking illegal drugs. Safe sex should be advocated, a methadone clinic and sober houses should be established in Mwanza. The Ministry of Home Affairs should increase efforts to prohibit importation of illegal drugs.

Keywords : Drug abuse, injecting drugs, HIV infection, hepatitis, Mwanza, Tanzania

Author : Jande Mary, Kongola G, Kalluvya S, Kapiga S, Majinge C, Hauli, Agnes Kiyeti, Kidenya B

Title : Association between HIV infection and the over 18 year old people who use drugs in Mwanza urban, Tanzania

Volume/Issue : 2014;2(3)

Page No : 740-749

Objective: To study the prevalence of depression among diabetics and their care givers. Methods: A cross sectional hospital based study was conducted by interviewing the selected diabetic patients and their care givers using internationally accepted Beck’s Hopelessness Scale to determine the prevalence of depression. Results: The prevalence of depressive illness was high (52%) not only among diabetics but also among their care givers (44.5%). Diabetics with complications (neuropathy and retinopathy) and on insulin treatment were more likely to be depressed than those without complications and/or on treatment oral hypoglycaemic agents. Conclusion: The high prevalence in the care giver group warrants screening and concomitant therapy.

Keywords : Caregivers; Depression; Diabetics; Prevalence

Author : Shalini P, George C.E, Norman G, Mukherjee D

Title : Toll of depression among diabetics and their care takers: A descriptive study from Bangalore, India

Volume/Issue : 2014;2(3)

Page No : 750-754

Background: Pulmonary Tuberculosis is a dreaded disease in the developing countries of the world. It is caused by a bacterial infection and it can lead to severe, debilitating disease. It's management includes a variety of Anti-TB Drugs which have various threatening side effects. The use of Kharjuradi Ghrita and Pranayama can not only decrease the complications arising out of the management of TB but also improve the standard of living in a post TB treatment patient. Materials & Methods: This was a randomized control trial. Sixty patients were divided into two groups of thirty each. Group A (n=30), received Kharjuradi Ghrita, 20 ml rasayankale and Group B (n=30) received both Kharjuradi Ghrita and Prayanama once a day. Patients who had completed treatment for pulmonary tuberculosis were only selected and studied over a month. Parameters observed were weight gain, appetite, weakness and incidence of respiratory Infection. Results: Both groups showed significant improvement at the end of one month. (p < 0.05). However the group that received both Kharjuradi Ghrita and Pranayama showed better effects on appetite, strength and weight gain. The recovery was better and complications were minimal.

Keywords : Kharjuradi Ghrita; Prayanama; Rehabilitation; Pulmonary TB

Author : Supriya B. Kurane, Vivek B. Singh, S. D. Waghmare

Title : Rehabilitation of pulmonary tuberculosis patient with Kharjuradi Ghrita and Pranayama : A study

Volume/Issue : 2014;2(3)

Page No : 755-760

Introduction: Patellar fractures constitute about 1% of all skeletal injuries and are seen frequently in the age range of 20 to 50 years. The aim of surgical treatment comprises of maximal possible preservation of patella, stable fixation resulting in the precise anatomical reduction of the articular surface and restoring the knee-extensor mechanism, thereby allowing early mobilization and satisfactory functional outcomes. Material and methods: 19 patients with transverse fracture of patella were treated in our institute, using percutaneous tension band wiring. Comminuted fractures, open fractures, patients with injury > 15 days, life threatening conditions and previous knee injury were excluded from the study. Follow-up was done at 3weeks, 6 weeks, 10 weeks and then at monthly interval for first 6 months and then at 3 monthly interval for next 12 months. Results: All patients had successful functional outcomes evaluated in terms of range of knee motion, power of knee extensors, rate of union, VAS score, Lysholm score and Knee society clinical rating scale. All patients achieved successful union with an average time for union 10.1 1.9 weeks. Excellent Lysholm and KSCRS scores were achieved at 18 months. Complications were noted only in two patients which was knee irritation. Conclusion: In our study, we concluded that percutaneous tension band wiring of patella is associated with satisfactory union rate as well as good functional outcome requiring less surgical time. Closed method can be used for displaced fractures of patella, however whether this technique can be used for comminuted fractures needs further evaluation.

Keywords : Knee Society Clinical Rating Scale; Lysholm Knee Scoring Rating System; Patella Fracture; Percutaneous Tension Band Wiring; VAS Score.

Author : Naveen Sharma, Hemant Chaturvedi, Shailendra Pratap Singh, Agrawal Ashish Rakesh

Title : Minimally invasive tension band wiring fixation for patella fractures: A study of 19 cases

Volume/Issue : 2014;2(3)

Page No : 761-766

Aim: The study was undertaken to establish mammaglobin as a marker to differentiate between benign and malignant breast lesions. Materials and methods: The present study was undertaken at Osmania general hospital, Hyderabad from January 2012 to July 2013. A total of 60 samples of various breast lesions were studied. Immunohistochemistry was performed by using mammaglobin antibody. Results: Mammaglobin immunoexpression was seen in 75% cases of breast carcinoma. The invasive ductal carcinoma-NOS type showed stronger and diffuse staining pattern than other variants of breast carcinoma. Interestingly high mammaglobin expression observed in low grade tumours compared to high grade. Conclusion: Mammaglobin is over expressed in malignant breast lesions compared to non-neoplastic lesions of breast (P<0.05). The expression is high in low grade tumours compared to high grade tumours.

Keywords : Breast lesions, Carcinoma, Immunohistochemistry, Mammaglobin

Author : A. Krishnaiah, M. Lavanya, G. Sunitha

Title : Study of utility of Mammaglobin in diagnosis of breast carcinoma and as a valuable marker for mammary tissue

Volume/Issue : 2014;2(3)

Page No : 767-775

Rationale: Traditionally, reversal of neuromuscular blocking agent is monitored using clinical criteria that is subjective and vary depending upon the anaesthetist’s judgment. There is a need for objective methods of monitoring neuromuscular block. Neuromuscular monitoring permits administration of neuromuscular blockers to obtain optimum muscle relaxation desirable for surgical procedures. Design: The study was carried out in tertiary hospital involving 50 patients undergoing elective neurosurgical procedures, receiving atracurium by syringe infusions for maintenance of General Anaesthesia. The patients were randomized into two groups of 25 each, who were be transferred to the recovery room on the basis of clinical criteria and on the basis of Train –of – four (TOF) Guard monitoring at extubation where the TOF ratio was >0.80 as recommended by Eriksson [5] in the year 1988 and Viby Mogensen [6] in the year 1989. Statistical analysis: The data was analyzed using the unpaired Students t- test as the Test for Significance and Standard Error of Difference between Two Proportions for comparing the number of patients with post- operative residual curarization in the two study groups. Significance was asserted to ‘p’ less than 0.05. Results: The TOF ratio in the recovery room was significantly lower in Group transferred on the basis of Clinical Monitoring (Group A) [Mean 0.791 ± 0.144] compared to Group transferred on the basis TOF Monitoring (GroupB) [Mean 0.877 ± 0.051] indicating a high incidence of PORC in Group A. Conclusion: Monitoring of TOF ratio perioperatively and adequate antagonization of non-depolarising neuromuscular blockade can prevent PORC and its complications.

Keywords : Post Operative Residual Curarization (PORC), Train –Of- Four (TOF) Guard Monitoring, Atracurium

Author : Sanesh V. Tuteja , Lalita V. Tuteja

Title : Evaluation of post - operative residual curarization in neurosurgical patients with the use of a neuromuscular monitor Train-of-Four Guard

Volume/Issue : 2014;2(3)

Page No : 776-782

The in vitro susceptibilities of fluconazole and voriconazole against a total of 95 Candida isolates during the one year study period August 2010 – July 2011 in a tertiary care centre , South India was determined by the agar disc diffusion test using the Clinical and Laboratory Standards Institute (CLSI) M44-A2 guidelines. Out of 95 total isolates, we got 43 Candida tropicalis, 31 Candida albicans and 21 Candida parapsilosis. 3.2 % of total isolates were fluconazole resistant but all were sensitive to voriconazole. None of them show Susceptible- dose- dependence (S-DD). 100% of C.albicans were sensitive to both fluconazole and voriconazole. 2.3% of C.tropicalis isolates and 9.5% of C.parapsilosis were resistant to fluconazole. The study demonstrated a better in vitro activity of voriconazole, against the fluconazole resistant strains of Candida. But as the fluconazole resistance is rare and the species which are intrinsically resistant to fluconazole like C.krusei and C.glabrata were not prevalent , flucoconazole can still be used as the drug of choice for empirical therapy of uncomplicated candidiasis. Voriconazole can be reserved for salvage treatment of refractory candidiasis caused by resistant strains.

Keywords : Candidiasis, Fluconazole, Voriconazole

Author : Regha I. R, Prithi Nair K

Title : Invitro susceptibilities of Candida isolates to Fluconazole and Voriconazole determined by disc diffusion in a tertiary care centre, South India

Volume/Issue : 2014;2(3)

Page No : 783-786

Aim: To access the knowledge and practices of interns, graduates and post graduates of Ahmedabad Dental College and Hospital, Ahmedabad, Gujarat regarding radiographic protection. Materials and Method: The present cross sectional questionnaire study was conducted in Ahmedabad Dental College, to assess the knowledge and practices of interns, graduates and post-graduates regarding radiographic protection. The study sample included 136 interns, graduates and postgraduates students. The survey was scheduled to spread over a period of 1 month. Data was collected by using self designed questionnaire (Annexure C). The questionnaire was developed in English. Questionnaire was administered by investigator himself to each participant on scheduled days and collected after two days. Collected data was coded, compiled and tabulated. The data was analysed by applying descriptive & inferential statistical analysis using SPSS package version 17. Result: Majority of the study subjects were aware of the side-effects of a radiograph on pregnant women and ALARA. On the contrary, almost half of the participants were not aware of NCRP/ICRP recommendations. Majority of the participants were not using lead apron while taking radiographs. Almost all the participants were aware of the symbol of radiation hazard. Most of the participants supported that they would use radiation protection protocols at the time of their private practice. Conclusion: The participants had unsatisfactory knowledge about the radiation protection protocols and radiation hazards.

Keywords : Radiographic Protection, Interns, Graduates, Postgraduates

Author : Harsh G Shah, Swagat Patel, Krutarth Patel, Vishal Patel , Vasudha Sodani , Suyog Savant

Title : Knowledge and practices of interns, graduates and post-graduates of Ahmedabad dental college and hospital, Ahmedabad, Gujarat regarding radiographic protection

Volume/Issue : 2014;2(3)

Page No : 787-791

Background Umbilical cord acid - base analysis is the most objective assessment of the acid - base status at birth. Method: Total 159 antenatal mother with singleton pregnancy of 34 to42 completed gestational weeks were taken for this study. Cord blood was collected just after delivery and analysed within 30 minutes by ABG machine in NICU. Results: Mean gestational period was lowest in emergency LSCS (37.34 ±1.57) followed by elective LSCS, normal delivery and highest in instrumental delivery (39.30±1.71). Mean labour duration was lowest in emergency LSCS (9.90±4.53), followed by normal vaginal delivery, and highest in instrumental delivery (14.23±24). Mean cord blood pH was lower in instrumental vaginal deliver y (6.99±38) followed by normal delivery, emergency LSCS and highest pH value in elective LSCS (7.3±33). Lowest mean Apgar score was obtained in instrumental vaginal delivery (5.70±1.149), followed by normal vaginal delivery, emergency LSCS and finally with highest mean Apgar score in elective LSCS (7.6±1.095). Conclusions: Association between umbilical cord blood pH level and others variable help in assessing perinatal outcome like Apgar score, low birth weight, NICU admission; labour duration was found to be statistically significance in relation to the mode of delivery

Keywords : Acidosis; Cord blood Ph; Fetus; NICU; Perinatal hypoxia; Umbilical cord

Author : Shweta Goyel, Gargi Sen, Dipnarayan Sarkar, Subhendu Choudhury, Debasish Bhattacharjee, Sudip Saha

Title : Prospective study to evaluate correlation between umbilical cord blood pH at birth and perinatal outcome in relation to the mode of delivery

Volume/Issue : 2014;2(3)

Page No : 792-799

The incidence of deaths resulting from non obstetric causes has increased in the recent past. Chief among them are the neurologic disorders. Those most common during pregnancy are low back pain, intracranial tumors, subarachnoid hemorrhage, and neuro-trauma. The management of the neurosurgical pathologies during pregnancy needs some specifications for both the mother and the fetus. The aim of present work was to study the maternal and fetal outcome while managing neuro problems encountered during pregnancy. The present study was a retrospective study evaluating the clinical, radiological, and surgical characteristics of 10 patients who have cranial neuro pathologies and have undergone neuro surgical intervention. Observations from this study showed that, most of the patients in this study had vaginal delivery. Prominent neurosurgical disease related to cerebral damage. Every patient underwent a laboratory and radiological evaluation. All except one survived the neurosurgical pathology. Neither baby nor mother had significant problem during delivery and neurosurgical intervention. To conclude, pregnant women may face to every kind of neurosurgical pathology that non pregnant women have faced. In addition, pregnancy itself, gives rise to some metabolic changes in the women and those changes may cause some neurologic pathologies to be symptomatic or to aggravate the present symptomatology. Because of those reasons, close neurologic follow up of a pregnant woman is of vital importance. At the end of a pregnancy having experienced some neurologic interventions including diagnostic evaluation or surgical intervention does not necessitates the cesarean section for a neurologically intact infant and mother.

Keywords : Cranial neuro pathologies; Neurosurgery; Pregnancy; maternal and fetal outcome

Author : Murali GV, Vijayasree M, Durga Suresh B, Anand Goud K, Adishankar Rao P

Title : Study of outcome of neurosurgical procedures in pregnancy

Volume/Issue : 2014;2(3)

Page No : 800-805

Background: Chronic anal fissure is a common problem across the world treated largely by surgical methods. Studies have demonstrated the efficacy of topical agents like Glyceryl-trinitrate in anal fissure but it has been shown to have side effects like headache and dizziness. There is a need for a pharmacological therapy for fissure which has fewer side effects. Hence, this study was taken up to assess the efficacy and adverse effects of topical 2% Diltiazem gel. Method: 50 patients with chronic anal fissure were considered for this study and they were treated with regular topical application of 2% Diltiazem gel. Patients were followed up at regular intervals for symptomatic relief and healing of fissure. Results: Fissure healed completely in 42 (89.36%) patients by 8 weeks. Of the 47 patients who applied Diltiazem, 13 (27.7%) were pain-free at the end of 4 weeks, 39 (83%) by 8 weeks and 42 (89.4%) by 14 weeks, while 5 (10.6%) patients remained symptomatic at the end of 14 weeks. However, mild headache (6.4%) and local irritation (4.3%) were noted. Conclusion: Topical 2% diltiazem gel is an effective agent in the treatment of chronic anal fissure. The need for hospital stay is abolished; psychological and financial burden on the patient is reduced. With a healing rate close to 90%, topical Diltiazem can be easily advised as the first line of treatment of chronic anal fissure.

Keywords : Chemical sphincterotomy; Chronic Anal Fissure; Diltiazem; Lateral internal sphincterotomy; Glyceryltrinitrate.

Author : Madhusudhan M. Gopivallabh, Gananpathy Puranik

Title : Chemical sphincterotomy with topical 2% diltiazem for chronic anal fissure: Our experience

Volume/Issue : 2014;2(3)

Page No : 806-811

Objective: To confirm various cardiovascular manifestations in Chronic Obstructive Pulmonary Disease (COPD) patients and to observe correlation with its severity. Methodology: This prospective cross sectional study conducted at Department of TB & Chest Diseases, Hamidia Hospital, Gandhi Medical College, Bhopal between March 2008 to Dec 2013. Patient having diagnosed COPD were subjected to this study. Purpose of study was explained and informed consent was obtained. Results: Total 37% (n=74) males and 4% (n=8) females were found to have cardiovascular complications in the study group. Cardiovascular manifestations were most commonly observed in very severe stage of COPD, which were 54 out of 76 (71.05%). In mild cases no patient was diagnosed with cardiovascular manifestations, moderate 4 out of 38 (10.5%) and severe disease stage 24 patients out of 62 (38.7%). Majority of the patients= 97(48.5%) were in the age group of 60-70 years, out of which 41(20.5%) were having cardiovascular complications. Likewise, 28(14%) out of 74 (37%) patients were having cardiovascular complication in the age group of 50-60 years and 13(6.5%) out of total 29(14.5%) were with cardiovascular complication in 40-50 years. Conclusion: Stage of COPD is proportional to prevalence and severity of Pulmonary artery hypertension (PAH). Electrocardiogram (ECG) can be used for screening of COPD with most common parameters observed may be Right axis deviation, P pulmonale, and Right Ventricular Hypertrophy. 2D-Echocardiography (ECHO) may be better modality for detection of Left Ventricular dysfunction. Most common complication detected in ECHO is PAH. Duration of smoking (smoking index) increases the incidence of Cardiovascular manifestations. ECG and ECHO being noninvasive and easily available, can be routinely recommended for COPD patients.

Keywords : COPD, Cardiac manifestation, ECG, ECHO, PAH

Author : Lokendra Dave, Preksha Dwivedi, Nishant Srivastava, B. S. Yadav, Ravi Dohre

Title : A study of cardiovascular manifestations of COPD

Volume/Issue : 2014;2(3)

Page No : 812-817

Introduction: Dengue virus infection is one of the most important human arboviral infection in India. Dengue viral infection outbreaks are frequently reported from various states of India. Activity of all 4 serotypes of dengue virus is constantly reported from different parts of Tamil Nadu. As dengue related mortality and morbidity is more common, this hospital based seroprevalence study was conducted to assess the magnitude of dengue virus infection and to know, whether there is an overall increase in the dengue infection prevalence in Kanchipuram. Materials & Methods: Total of 1,170 (606 males and 564 females) serum samples from suspected dengue fever cases were obtained for three years from January 2010 to December 2012. Samples were tested by a rapid qualitative immunochromatographic assay (Insight / DenV-Ab, Tulip Diagnostics (P) Ltd) for differential detection of dengue specific IgM and IgG antibodies. Results & Analysis: The overall seropositivity was 32.1% [298 (25.5%) were positive out of 1170 for dengue specific IgM and 78 (6.7%) were positive for dengue specific IgG or both IgM and IgG]. There was a gradual increase observed in dengue seropositivity over the study period of three years. Conclusion: This increase in dengue seroprevalence observed, may be an alarming /warning sign of the future epidemics which is again a serious matter of concern.

Keywords : Dengue fever, dengue haemorrhagic fever, outbreak, serodiagnosis, Tamil Nadu

Author : Sandhya Bhat K, Apurba Sankar Sastry, S. Senthamarai, S. Sivasankari

Title : Seroprevalence of dengue viral infection in patients attending to a tertiary care hospital in Kanchipuram, Tamil Nadu, India

Volume/Issue : 2014;2(3)

Page No : 818-822

Foreign body in the ear is common in children and mentally ill adults. In our experience we encountered two cases of foreign body (Neem extract) in the middle ear accidently during mastoidectomy with tympanoplasty. Both the patients disclosed the traditional way of instilling neem leaves extract as medication in the postoperative period. This article states the rare foreign body (neem extracts) in middle ear found during the middle ear surgery which is purposefully used as medication.

Keywords : Azadarichta indica; Chronic ear discharge; Ear foreign body; Middle ear foreign body; Neem extracts

Author : Nagendran Navaneethan, Raj Prakash Dharmapuri Yaadhava Krishnan, Ramasubramaniam Harihara

Title : Foreign body seen in middle ear surgery - Our experience and review of literature

Volume/Issue : 2014;2(3)

Page No : 823-826

The aim of this study was to investigate the efficacy and outcome of IV steroids followed by oral steroids in patients with sudden sensorineural hearing loss (SSHL). The study also evaluated the various comorbidities influencing the outcome of treatment with steroids. 30 patients who presented to the ENT department with sudden sensory neural hearing loss during the 15 month period from January 2013 to March 2014 were included in the study. Of the 30 patients, 20 were males and 10 females and they were in the age range of 20 to 60 years. Treatment was in the form of intravenous (IV) Hydrocortisone 100mg as a stat dose followed by IV Dexamethasone 8mg 8th hourly and then tapered over 5 days. This is followed by oral Prednisolone for 2 weeks. A pretreatment and follow up pure tone audiometry (PTA) was done and compared. According to our study, emergency administration of IV steroids to patients with sudden sensorineural hearing loss is highly recommended. The critical time for commencing treatment is within 6 hours from the onset of symptoms.

Keywords : Intravenous steroids; Oral steroids; Sudden Sensorineural Hearing Loss (SSHL)

Author : Asha Annie Abraham, Thomas Rony K M

Title : Effect of administration of steroids in the management of sudden sensorineural hearing loss - Our experience

Volume/Issue : 2014;2(3)

Page No : 827-830

Aim: This observational study was aimed at assessing the effectiveness and tolerability of Heptral® (brand of ademetionine 1, 4-butane disulfonate) in Indian patients presenting with intrahepatic cholestasis (IHC) due to chronic alcoholic liver disease (ALD). The study also aimed at understanding the prescribing practice of physicians as well as the profile of patients being prescribed Heptral®. Material and Methods: This prospective observational study included 250 patients across 21 study sites. The assessments of health-economic parameters, liver biochemistry, signs and symptoms of IHC (fatigue, jaundice and pruritus) were performed at two visits, ie, at baseline and after six weeks of Ademetionine treatment. Ademetionine was prescribed as part of the routine medical treatment as per the local label and not as a study intervention. Results: Of the 243 patients included in the analysis population, cirrhosis was present in 42.8% (104); 72% (175) were heavy drinkers, ie, taking four or more drinks per day. Ademetionine administration resulted in significant (p<0.0001) reduction in health-economic burden (number of days off work [-4.28 days], number of visits to healthcare services as an outpatient [-0.72], number of days in hospital [-1.42 days]), levels of biochemical markers, signs and symptoms of IHC. Beneficial effects were seen irrespective of presence/absence of cirrhosis, drinking patterns (heavy or not heavy drinkers), varied dosage of Heptral® and use of concomitant medications. Conclusions: Administration of Heptral® in patients with ALD and IHC resulted in significant improvement in burden of disease, laboratory markers, signs and symptoms of cholestasis. The treatment was well tolerated.

Keywords : alkaline phosphatase, bilirubin, cirrhosis, fatigue, health-economic parameters, jaundice, pruritus, S-adenosyl-L-methionine, SAMe, serum γ-glutamyl transpeptidase

Author : Gourdas Choudhuri, Tina Singh

Title : 19. Heptral® (Ademetionine) in Patients with Chronic Alcoholic Liver Disease: Results of a Multicentre Observational Study in Indian Patients

Volume/Issue : 2014;2(3)

Page No : 831-841

Background: Laparoscopy has been found to be very useful in the evaluation of tubo-peritoneal factors in female infertility in Nigeria. This is because of the peculiarity of infective tubo-peritoneal disease as the main aetiological factor of infertility in the region. Objective: The main objective of this study was to highlight the experience with out-patient laparoscopy at Olabisi Onabanjo University Teaching Hospital (OOUTH), Sagamu with particular reference to findings, its safety and complications. Materials and Methods: This is a retrospective study of 516 patients who had laparoscopy for infertility at the Olabisi Onabanjo University Teaching Hospital, Sagamu between January 1st, 1993 and December 31st, 2002. Results: Five hundred and sixteen women had diagnostic laparoscopy under conscious sedation for infertility evaluation at OOUTH, Sagamu from January 1st, 1993 to December 31st, 2002. The median age of the patients was 31.4 ± 3.8 years. Four hundred and seven (78.9%) of the women had secondary infertility. Pelvic adhesions were found in 60.3% of the women irrespective of tubal patency while 61.1% had varying forms of tubal occlusion. Fibroid nodules were the commonest additional significant findings in this study, present in 32.8% of the women. The complication rate was 0.6%. Conclusion: Diagnostic laparoscopy under conscious sedation is safe and very useful in the investigation of infertility.

Keywords : Infertility; Laparoscopy; Nigeria; Reproductive health; Tubal disease

Author : Mustafa Adelaja Lamina

Title : A ten-year review of laparoscopy in the evaluation of infertility at a tertiary health center in Southwestern Nigeria

Volume/Issue : 2014;2(3)

Page No : 842-846

Gastric cancer is one of the leading causes of mortality in the world. It is the second most common carcinoma in the world and around 10 percent of all cancers. Objective: To study the gross and histologic type of the various gastric lesions. Method: The present study for a period of 7 years from June 1999 to June 2006 was done in the Department of Pathology, Kurnool Medical College, Kurnool. During the above period resected gastric specimen were analyzed. Results & Conclusion: In the present study, malignant tumors were more common. The incidence of malignant tumors were more common in males than in females. The peak incidence is observed during fifty to sixty years. The youngest age incidence was observed in 25 years male. The oldest age incidence observed in 80 years male. The common blood group observed in male was A-Group. The most common site involved was pyloric end.

Keywords : gastric carcinoma; pyloric end; fungating; well differentiated; peptic ulcer; carcinoid

Author : M. Phani Kumar, M. Janaki, M. Hemalatha

Title : A pathological study of gastric carcinoma in a tertiary care hospital

Volume/Issue : 2014;2(3)

Page No : 847-852

Background and Objectives: Proximal third fractures of femur like intertrochanteric and subtrochanteric fractures, are a leading cause of hospital admissions in elderly people. The number of such admissions is on a raise because of increasing life span and sedentary habits. Conservative methods of treatment results in malunion with shortening and limitation of hip movement as well as complications of prolonged immobilization like bed sores, deep vein thrombosis and respiratory infections. This study is done to analyze the surgical management of proximal third fractures of femur using Proximal Femoral Nail. Materials and Methods: This is a prospective study of 40 cases of fresh trochanteric and subtrochanteric fractures admitted to Mamata general Hospital, Khammam, A.P., From Aug 2010 to Sep 2012. Cases were taken according to inclusion and exclusion criteria i.e., patients with Proximal third fracture femur above the age of 18yrs. Medically unsuitable and patients not willing for surgery were excluded from the study. Results: In our series of 40 cases there were 24 male and 16 female, maximum age of 85 yrs and minimum age of 20 yrs, most of the patients were between 60 to 80 yrs. Mean age of 53.9yrs. 45% of cases were admitted due to slip and fall and with slight predominance of right side. Out of 40 cases, 10 were trochanteric and 30 were subtrochanteric. In Trochanteric class 60% were Boyd and Griffin type 2, in subtrochanteric class 40% were Sinsheimer type 3a and 30% were 2b. Mean duration of hospital stay is 19.62 days and mean time of full weight bearing is 10.6 wks. Out of 40 cases 5 cases expired before first follow up time of 6 wks and 5 cases were lost for follow up. Out of 30 remaining cases 6 were Trochanteric and 24 were subtrochanteric. Good to excellent results are seen in 100% cases of trochanteric fractures and 91.5% cases in subtrochanteric fractures. Conclusion: From this sample study, we consider that PFN is an excellent implant for the treatment of Peritrochanteric fractures. The terms of successful outcome include a good understanding of fracture biomechanics, proper patient selection, good preoperative planning, accurate instrumentation, good image intensifier and exactly performed osteosynthesis.

Keywords : Intertrochanteric; PFN; Peritrochanteric; Subtrochanteric; Trochanteric

Author : S K Venkatesh Gupta, Adi Shankara Rao, P. Lakshmi Narayana Reddy, Satish M Pathak, K Sachin Avinash, K Gopichand

Title : Surgical management of proximal femur fractures by proximal femoral nail

Volume/Issue : 2014;2(3)

Page No : 853-859

Being a urological emergency and probably under reported, an analysis of 15 penile fracture cases that underwent surgical repair in our center was attempted to share the experience. The interval from injury to presentation was between 2 to 46 hours. Strained sexual intercourse followed by masturbation was the most common cause of penile fracture. Unilateral corporeal rupture predominantly on right side was seen frequently and concomitant urethral injury was a rare finding. Follow up patients were contacted through phone or mail and reevaluated by local examination, questionnaire and Color Doppler Sonography where ever necessary. Nearly 75% of patients were followed up for more than one year without any complaints. Palpable scarring, ED and penile deviation were few less frequently seen problems. Scar formation was high when non absorbable sutures are used.

Keywords : Tunica Albuginea; Penile fracture; Priarpism; Urethral injury; Khammam

Author : J. Sasi Kumar, Gurunath Rao K, Satyam Sharma, Subith Kumar K

Title : Management of penile fracture - An institutional experience

Volume/Issue : 2014;2(3)

Page No : 860-863

Diabetic foot is one of the most common, but unfortunately less talked about complication among Diabetic adults in our scenario. The present study was undertaken to enhance the knowledge of diabetic adults regarding foot care. Fifty subjects were enrolled in the study and their knowledge level was assessed at the baseline. The structured teaching programme was developed and administered. After seven days, post test was conducted which revealed significant gain in the knowledge score. Hence, it is recommended that such cost effective interventions should be held frequently in chronic care self-management.

Keywords : Adults; Diabetes; Diabetic Foot; Knowledge; teaching programme

Author : Manpreet Kaur, Shweta, Rajwant Kaur

Title : Enhancement of knowledge of diabetic foot care among diabetic adults

Volume/Issue : 2014;2(3)

Page No : 864-866

Toxoplasma gondii is an intra cellular protozoan. it is the one of the most common focal neurological disease in patients with HIV/AIDS. Because of defective cell mediated immunity, patients are at a higher risk of developing toxoplasma encephalitis. A 50 year male presented with fever with altered sensorium and focal neurological deficit. An imageology shows multiple ring enhancing lesions in basal ganglia and subcortical regions. Toxoplasma serology revealed raised IgG antibody levels and positive PCR test for Toxoplasma organism. Based on MRI and positive serology a diagnosis of cerebral toxoplasmosis was made.

Keywords : HIV/AIDS; MR spectroscopy; Primary CNS lymphoma; Toxoplasmosis; Tuberculoma

Author : Sreeramulu Diguvinti, Pothula Ramarao, P.S. Krishna Chaitanya, Chennakesavulu Dara, N. Madan Mohan

Title : Cerebral toxoplasmosis in HIV mimicking as primary CNS lymphoma/tuberculoma: Case report

Volume/Issue : 2014;2(3)

Page No : 867-870