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Volume-8 (2009);
Issue 3 (July-September) Published on Nov 15, 2009
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2009;3-1
Review |
Anil Kumar MN, Pai NB, Rao S.
Antipsychotics and Sexual Dysfunction. |
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Abstract: Satisfying sexual experience is an essential part of a healthy and enjoyable
life for most people. Antipsychotic drugs are among the various factors that affect optimal sexual functioning. Both conventional and novel
antipsychotics are associated with significant sexual side effects. This review has presented various studies comparing different antipsychotic drugs.
Dopamine antagonism, increased serum prolactin, serotonergic, adrenergic and cholinergic mechanisms are all proposed to be the mechanisms for sexual
dysfunction. Drug treatment for this has not given satisfactory long-term results. Knowledge of the receptor pharmacology of an individual antipsychotic
will help to determine whether it is more or less likely to cause sexual side effects and its management.
Key words: Sexual dysfunction, Desire, Erection, Orgasm, Ejaculation, Antipsychotics |
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2009;3-2
Original Article |
Purohit BC
Efficiency
of Health Care Sector at Sub-State Level in India: A Case of Punjab. |
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Abstract: In recent years,
WHO and other individual researchers have advocated estimation of
health system performance through stochastic frontier models. It provides
an idealized yardstick to evaluate economic performance of health system.
So far attempts in India have remained focused at state level analysis.
This paper attempts a sub-state level analysis for an affluent Indian
state, namely Punjab, by using stochastic frontier technique. Our results
provide pertinent insight into state health system and facilitate health
facility planning at the sub-state level. Carried out in two stages
of estimation, our results suggest that life expectancy in the Indian
state could be enhanced considerably by correcting the factors that
are adversely influencing the sub-state level health system efficiency.
A higher budgetary allocation for health manpower is recommended by
us to improve efficiency in poorly performing districts. This may be
supported by policy initiatives outside the health system by empowering
women through better education and work participation.
Key words: Health, Efficiency,
Sub-State Level, India, Punjab, disparity, Gini coefficients, Stochastic
frontier model, Health facility planning |
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2009;3-3
Original Article |
Nigam R, Chandorkar RK, Bhagwat AK, Dixit S, Yesikar V,
Sinha U.
Critical Appraisal of Baby Friendly Hospital Initiatives among the beneficiaries of Indore Urban- A Comparative Study. |
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Abstract: Background:
Majority of the women in M.P who breastfeed their babies throw away
the colostrum before they begin actual feed. Only 14.9% females feed
their babies with in 1/2 an hour (National Family Health Survey-3).
In Indore 2 hospitals have been given designation of baby friendly hospital
(BFH) namely M.Y. hospital (MYH) which is a tertiary care center, attached
to Medical College and District hospital (DH). Objectives:
(1) To assess the process of implementation of baby friendly hospital
initiative programme. (2) Knowledge, Attitude, Practice regarding
breast feeding amongst the beneficiaries. Methods: A comparative study was conducted between two BFH and two NBFH (Non
Baby Friendly Hospitals) of Indore. The respondents were categorized
into health care providers and beneficiaries. A pretested questionnaire
was used to interview the respondents which was made taking into consideration
the essential 10 Criteria of BFHI Programme. Results:
89% in BFH and 97% in NBFH were having positive attitude towards
colostrum feeding. 81% postnatal mothers in BFH and 96% in NBFH were
having knowledge about benefits of exclusive breast feeding. 21% postnatal
mothers in BFH and 39% in NBFH initiated breast feeding within ˝ an
hour. 64 % of mothers in BFH and 62 % mothers in NBFH were practicing
exclusive breast Feeding. Conclusion:
The above findings show that although designated as BFH, the breast
feeding practices remained poor as compared to NBFH. There is an utmost
need to reinforce training and constant monitoring of health care providers
regarding BFHI.
Key words: Baby Friendly Hospitals, Essential criteria, Breastfeeding |
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2009;3-4
Original Article |
Chudasama RK, Verma P, Banerjee A, Amin CD, Mahajan R.
Current iodine status and progress over the last decade towards
elimination of iodine deficiency in Rajkot district, Gujarat. |
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Abstract: Objective:
To find out prevalence of goitre in primary school children; to compare
prevalence with previous survey; to determine median urinary iodine
concentration; to assess level of iodine in salt samples at household
and retail shop level; and to study profile of salt sold at retail shops. Design &
Settings: 30 cluster survey study in primary schools of Rajkot district. Subjects:
Children studying in 1st to 7th standard. Methods:
Total 70 students including five boys and five girls from 1st
to 7th standard present in class on the day of visit were
selected randomly for Goitre examination, so, total 2100 students were
examined in schools. Urine sample was collected from one boy & one
girl from each standard in each cluster. From community, 28 students
including two boys and two girls from each standard in same age group
were examined and also salt samples were tested from their households.
From each village, one retail shop was visited and salts were purchased
and tested for iodine on the spot with spot kit. Results:
Goitre prevalence was found 8.8% among primary school children compare
to 5.6% in 1999. As the age increases the Goitre prevalence also increases
except in age group of 12 years. Median urinary iodine excretion level
was found 110 µg/L. Iodine level >15 ppm was found in 81% salts
samples tested at household level. Conclusion:
Present study showed mild Goitre prevalence in primary school children
in Rajkot district of Gujarat but still iodine content of salt found
inadequate at household level.
Key words: Goitre survey, IDD, Elimination, Prevalence, Primary school children,
Household level |
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2009;3-5
Original Article |
Meshram II, Hiwarkar PA, Kulkarni PN.
Reproductive
risk factors for breast cancer: A case control study. |
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Abstract: Background: Breast
cancer is second most important cancer among Indian women. Although
risk factors are not much prevalent as in western countries, incidence
rate is increasing in India. The study was undertaken to study various
risk factors associated with breast cancer. Methods: A hospital
based group matched case control study was undertaken to identify risk
factors. The study consisted of 105 hospitalized cases confirmed on
histopathology and 210 group matched controls selected from urban field
practice area, Sadar, without any malignancy. Bivariate analyses included odds
ratio (OR), 95% confidence interval (CI) for odds ratio and Chi
square
tests. Results: Earlier age at menarche ≤ 12 years of age,
late age at first full term delivery, nulliparity, Lack of breast-feeding
were found to be significantly associated with the risk of breast cancer
in both pre menopausal & post menopausal women while age at menopause
at or after 50 years was significantly associated with the risk in post
menopausal women. Conclusions: Study suggests that the changes
in menstrual and reproductive patterns among women i.e. early age at
menarche and late age at first childbirth and some environmental factors
in Central India may have contributed to the increase in breast cancer
risk, particularly among younger women.
Key words: Breast
cancer, breast-feeding, menarche, parity |
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2009;3-6
Original Article |
Durrani AM, Bano R.
The Study of Dysmennorhea in Secondary
School Girls in Aligarh City. |
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This paper is
removed due to several errors found on post publication review,
which remain unrectified by the authors [Aug 7, 2010]
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2009;3-7
Original Article |
Elizabeth J, Dayananda G, Kusumadevi MS, Sunil
KC, Sujayasri S, Suhas S.
The
Response of Serum Cortisol and Leptin Levels to Academic Stress. |
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Abstract: Background:
Medical students are subjected to various types of stress during the
academic course and they react differently. This study is an attempt
to establish a relationship between the coping abilities, serum cortisol
and leptin levels in response to academic examination stress in first
year medical students. Methods:
Thirty four 1st year medical students between 18 to 21 yrs
of age were randomly selected and their coping abilities were assessed
using the State Trait Anxiety Inventory. Two fasting blood samples were
drawn, one on the day of examination (Situation I) and the second after
the completion of the examination (Situation II). Serum cortisol and
leptin levels were estimated using a standardized RIA Kit and the levels
obtained were correlated with the psychometric data. Results:
The results showed increased levels of cortisol prior to examination
in the poor adjusters in comparison to the good adjusters. The levels
of cortisol decreased after examination in both good and poor adjusters
with the poor adjusters showing higher levels. On the other hand, leptin
levels increased in good adjusters in comparison with poor adjusters
in Situation I and in Situation II the good adjusters showed a marginal
decrease and poor adjusters maintained the same levels of leptin. Conclusion:
Cortisol and leptin respond inversely to academic stress. Cortisol levels
sharply decline from stressful to post-stressful situation indicating
the wane of stress.
Key words: Academic stress, Cortisol, Leptin, State Trait Anxiety Inventory |
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This Article |
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2009;3-8
Original Article |
Ogbadoyi EO, Tsado RD.
Renal and Hepatic Dysfunction in
Malaria Patients in Minna, North Central Nigeria. |
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Abstract: Information on kidney and liver involvement in
malaria in Africa is still very scanty. Kidney and liver functions were assessed
in 70 malaria patients. using serum levels of creatinine and urea and urinary
protein levels as test indicators of kidney function and serum levels of
bilirubin, aspartate aminotranferase (AST or SGOT), alanine aminotransferase
(ALT or SGPT), and alkaline phosphatase (ALP) as indicators of liver function.
Descriptive analysis of results obtained showed that 67.14% of patients had
creatinine level above the 126µmole/L which is considered the upper limit of the
normal range. Three cases (4.29%) had creatinine levels well above 265µmoles/L.
The serum concentrations of creatinine, urea, protein, conjugated and total
bilirubin, AST, ALT, and ALP in malaria patients were significantly higher
(p<0.05) than those of malaria free individuals. We conclude that renal
dysfunction, acute renal failure and liver dysfunction are clinical features of
malaria in Minna, North Central Nigeria.
Key words: Malaria,
Transferases, Creatinine, Bilirubin, Hepatic dysfunction, Renal dysfunction |
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This Article |
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2009;3-9
Original Article |
Trivedi SS, Chudasama RK, Srivastava A.
Study of Early Predictors of
Fatality in Mechanically Ventilated Neonates in NICU. |
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Abstract:
Objective:
To evaluate the risk factors associated with fatality in mechanically
ventilated neonates using multiple regression analysis. Design &
settings: Prospective study conducted at Neonatal ICU at New Civil
Hospital, Surat – a tertiary care centre, from December, 2007 to May,
2008 for 6 months. Methods:
Fifty neonates in NICU consecutively put on mechanical ventilator during
study period were enrolled in the study. The pressure limited time cycled
ventilator was used. All admitted neonates were subjected to an arterial
blood gas analysis along with a set of investigations to look for pulmonary
maturity, infections, renal function, hyperbilirubinemia, intraventricular
hemorrhage and congenital anomalies. Different investigation facilities
were used as and when required during ventilation of neonates. Multiple
logistic regression analysis was done to find out the predictors of
fatality among these neonates. Results:
Various factors suspected as predictors of fatality of mechanically
ventilated neonates were assessed. Hypothermia, prolonged capillary
refill time (CRT), initial requirement of oxygen fraction (FiO2)
> 0.6, alveolar to arterial PO2 difference (AaDO2)
> 250, alveolar to arterial PO2 ratio (a/A) <
0.25, & oxygenation index (OI) > 10 were found statistically
highly significant predictors of mortality among mechanically ventilated
neonates. Conclusion:
Hypothermia and prolonged capillary refill time were independent
predictors of fatality in neonatal mechanical ventilation. Risk of fatality
can be identified in mechanically ventilated neonates
Key words: Mechanical ventilation, Neonates, Hypothermia, Capillary refill time |
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2009;3-10
Original Article |
Patel BJ, Shankar G.
Correlation
between subtalar varus angle & disability in patients with
patellofemoral arthritis. |
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Abstract: Aim: To find the correlation between subtalar
varus angle & disability in patients with patellofemoral arthritis. Methods: A total of 30 subjects aged (48.86±5.74)
referred to the department of physiotherapy, with patellofemoral arthritis
and fulfilling the criteria of inclusion were recruited for the study,
sampling method being convenient sampling. Disability score was
measured of each patient by WOMAC index (Western Ontario and McMaster
Universities Index of Osteoarthritis) disability questionnaire and
subtalar varus angle was measured in non weight bearing position in
prone lying. Results: Pearson’s correlation coefficient
test showed a highly significant (p=0.000) positive correlation (r=0.821)
between disability scores and subtalar varus angle. Conclusion: There is a highly significant relation
between disabilities due to patellofemoral pain in patellofemoral arthritis
patients and sub talar varus angle
Key words: Patellofemoral arthritis, Subtalar
varus angle, Rear foot, Disability, Osteoarthritis knee |
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This Article |
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2009;3-11
Original Article |
Goyal S, Sagoo HS, Pramod J.
Oncogenic Potential
of Radiofrequecy Emissions for Mobile Phones. |
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Abstract: With
the advent of the rising telecom industry there is growth in the usage
of the mobile phones by manifold and when we are in country like India,
in order to cover one billion population, several transmission towers
have been installed to create a jungle of such masts rising atop many
buildings in the densely populated parts of India. The erection of these
towers has lead to speculations that there may be increased incidence of cancer
after exposure to the RF emissions from mobile telephone base stations.
There are no high-quality epidemiologic studies that can be used to
evaluate health risks from RF exposure. Laboratory studies in this area have
been somewhat confusing. Some animal studies suggest that RF fields
accelerate the development of sarcoma colonies in the lung, mammary
tumors, skin tumors, hepatomas, and sarcomas. In contrast, other studies conducted
on large scale on the cell lineage and people working in areas with
high RF emissions have not found carcinogenic effects. These conflicting
results indicate the need for more well-conducted studies. This paper
provides a review of the laboratory studies and indicates what conclusions
about RF-induced cancer can be drawn.
Key words: Radiofrequency fields,
Cancer, Health effects, Laboratory studies, Mobile phones |
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2009;3-12
Original Article |
Padmaja U, Adhikari P, Pereira P.
A Prospective Analysis
of Adverse Drug Reactions in a South
Indian Hospital. |
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Abstract: Adverse drug reactions are a great cause of concern to the medical profession, the patients and the pharmaceutical industry.
However ADR reporting and monitoring is yet to catch up in India. Hence we undertook a study to record and analyze adverse reactions among all patients admitted to
the medical wards of a tertiary care. Centre patients admitted to all medical wards over one year were assessed for ADRs throughout their admission. Suspected ADRs
were recorded and analyzed for i) the type of reaction ii) severity iii) Consequence on treatment that is if the drug was continued, or stopped, or needed to be treated
with other drugs, iv) Physiological system involved and the v) group of the drugs associated with ADRs. Among 1250 patients admitted during the study period, 250 adverse
events were observed. Majority (76.8%) were of mild type, 66% were severe requiring intensive care and 3 patients died. Antimicrobials were responsible for maximum (42.4%)
ADRs followed by drugs acting on CNS (20%). When we analyzed the systems affected, CNS side effects were more common in our study. While in many other studies Cardiovascular
and gastrointestinal side effects were the most common. Combination of drugs was responsible for a large percentage of ADRs. Inadvertent use of antipsychotics with sedatives
led to respiratory failure in 4 patients of which 1 died. Contaminated IV fluids are suspected to be the cause of death in another fatal ADR. In conclusion there is a need for
vigilant ADR monitoring to be done by all doctors to prevent morbidity and mortality from ADRs.
Key words: Adverse drug reactions, Monitoring, Antimicrobials,
Combination of drugs, Hospital
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2009;3-13
Case Report |
Taksande AM, Vilhekar KY, Arvind Kumar.
Arthrogryposis: A Rare Manifestation in Infant of Diabetic
Mother. |
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Abstract: Arthrogryposis multiplex congenita is characterized by
non-progressive, multiple joint contractures present at birth. The major cause of arthrogryposis is fetal akinesia due to
fetal abnormalities like neurogenic, muscle, connective tissue abnormalities or maternal disorders Here we report a rare case
of arthrogryposis in infant of diabetic mother with multiple congenital anomalies.
Key words: Infant of diabetic mother,
Arthrogryposis, Lower limb |
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2009;3-14
Case Report |
Naniwadekar MR, Jagtap SV, Nikam BP, Sanghavi KD.
Subcutaneous Phycomycosis in a Child |
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Abstract: Subcutaneous phycomycosis is a rare entity. We hereby
report a case of subcutaneous phycomycosis in 18 months old female child who presented with a painless, non-tender
swelling on the thigh. Skin biopsy showed eosinophilic granuloma lying deep in the subcutaneous tissue, with sparse
hyphae. Culture on Sabouraud's dextrose agar showed characteristic colonies. Patient was started on oral potassium iodide.
The swelling was completely resolved after one month of treatment.
Key words: Subcutaneous phycomycosis,
Subcutaneous zygomycosis, Basidiobolus ranarum, Potassium iodide |
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2009;3-15
Case Report |
Roychowdhury J, Kundu AK, Bhattacharya M.
Successful Pregnancy Outcome in a Patient of Chronic Myeloid Leukaemia (CML) Without Any Therapy. |
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Abstract: The management of cancer during pregnancy may pose
difficulty for patients, their families and physicians. The concomitant occurrence of pregnancy and CML is very
rare since it is a malignancy which is most commonly detected in elderly. A 30 years old female was diagnosed as a
case of CML and prescribed hydroxyurea which she stopped on her own after taking for few months. The patient conceived
one month after stopping hydroxyurea. She did not agree to terminate the pregnancy even on repeated requests. Though the
total leucocyte count was in the range of 150- 200 X 103 /ml, she refused to take any form of therapy till delivery.
Antenatal period was uneventful and at term she delivered a male child normally. The mother developed secondary
postpartum hemorrhage which was controlled after exploration and removal of retained bits of placenta. Hydroxyurea
was started 4 weeks after delivery. Both the mother and the child are doing well
till date.
Key words: Chronic myeloid leukemia, Pregnancy |
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2009;3-16
Case Report |
Kaul R, Sharma J.
Primary Leiomyosarcoma of Ovary. |
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Abstract: Primary ovarian leiomyosarcomas is a rare neoplasm
which comprises less than 3% of ovarian tumors. Their origin, etiology, histologic features, clinical behavior, and
optimal treatment are still obscure. We report a case of leiomyosarcoma of ovary, diagnosed on histopathology in a 60
year old female and discuss the literature
Key words: Ovary, Leiomyosarcoma, Ovarian neoplasms |
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2009;3-17
Case Report |
Sudhakar S, Praveen Kumar B, Prabhat MPV.
Peripheral Ossifying Fibroma. |
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Abstract: Peripheral ossifying fibroma is a relatively uncommon
gingival growth that is considered to be reactive in
nature and postulated to appear secondary to irritation or trauma. They usually occur in young adults with a female
predominance and are solitary in nature. We report a
case of peripheral ossifying fibroma in a 55-year old female.
Key words: Peripheral ossifying fibroma; Gingiva; Multicentric; Periosteum; Recurrence |
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2009;3-18
Case Report |
Roychowdhury J, Kundu AK, Sen A, Dawn S.
Successful Pregnancy Outcome In A Patient With Aortoarteritis. |
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Abstract: Aortoarteritis, also known as Takayasu’s arteritis,
aortic arch syndrome or pulseless disease is a rare vascular disease that cause progressive damage including inflammation,
scarring, narrowing and abnormal ballooning inside the wall of aorta and major arteries. This case report of aortoarteritis
in pregnancy was diagnosed during pregnancy,and successful pregnancy outcome was achieved by combined multidisciplinary
supervision of experts.
Key words: Takayasu’s disease, Aortoarteritis, Intrauterine growth restriction |
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2009;3-19
Response |
Oshikoya KA.
Response: Accidental Potassium Bromate Poisoning Causing Acute Renal Failure. |
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Abstract: No abstract
Key words: Potassium bromate, Poisoning, Acute renal failure |
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2009;3-20
Letter |
Ramana KV, Rao R.
Significance of Screening for Colonization and Vancomycin Resistance in
Staphylococcus aureus Isolated from Anterior Nares of School Going Children. |
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Abstract: No abstract
Key words: Staphylococcus aureus,
Colonization, Vancomycin |
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