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   Table of Contents - Current issue
April-June 2017
Volume 4 | Issue 2
Page Nos. 69-159

Online since Tuesday, March 14, 2017

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Insight into nicotine addiction p. 69
Sahil Handa, Haneet Kour, Charu Khurana
The emergence of the epidemic of nicotine addiction in India and other nations is a global public health tragedy of untoward proportions. Smoking or chewing tobacco can seriously affect general, as well as oral health. Smoking-caused disease is a consequence of exposure to toxins in tobacco smoke and addiction to nicotine is the proximate cause of these diseases. This article focuses on nicotine as a determinant of addiction to tobacco and the pharmacologic effects of nicotine that sustain cigarette smoking. The pharmacologic reasons for nicotine use are an enhancement of mood, either directly or through relief of withdrawal symptoms and augmentation of mental or physical functions. Tobacco cessation is necessary to reduce morbidity and mortality related to tobacco use. Strategies for tobacco cessation involves 5A's and 5R's approach and pharmacotherapy. Dental professionals play an important role in helping patients to quit tobacco at the community and national levels, to promote tobacco prevention and control nicotine addiction. Dentists are in a unique position to educate and motivate patients concerning the hazards of tobacco to their oral and systemic health, and to provide intervention programs as a part of routine patient care.
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A descriptive analysis of psychological traits among the health-care providers p. 76
Farah Ahmed, Tahseer Khan, Wajiha Rashid, Soubia Akhtar, Zaeem Ur Rehman Khan, Bilal Ahmed
Objective: The objective of this study is to access various personality traits of doctors of hospital subspecialties. Introduction: One of the most common perceptions in our society is that of medicine being a very stressful profession. The demands of practicing medicine can have significant effects on general health, work satisfaction, professional, and nonprofessional life. To increase the profitability, organizations curtail the staff to reduce the costs. Hence, it can be argued that doctors are subjected to extreme amounts psychiatric duress. Methodology: A descriptive study was conducted in a tertiary care hospital. In which one hundred and twenty-one doctors were approached randomly varying from different specialties. The short form of the psychopathic personality inventory (PPI-SF) was used as a questionnaire. Results: One hundred and one (81 females and 20 males) doctors from various specialties responded and completed the PPI-SF questionnaire. The subspecialty analysis of the doctors' responses was subdivided into pediatrics, gynecology, medical specialties, surgery, anesthetics, and radiology. Surgeons and GyneObs were the highest scorers on the PPI-SF, with scores of 138 and 149, respectively. Conclusion: This study showed that doctors score higher on a scale of psychopathic personality than the general population. This study also showed that stress immunity is the overriding personality trait in doctors which may, in turn, facilitate better overall patient care. Stress immunity may better facilitate empathy in certain acute situations, which plays a vital role in being a proficient doctor and providing satisfactory patient care and counseling.
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Serum lipids in chronic viral hepatitis B patients in Makurdi, Nigeria p. 81
Ayu Agbecha, Chinyere Adanna Usoro, Maisie Henrietta Etukudo
Background: One of the major causes of liver disease in the world is hepatitis B virus (HBV) infection. The liver as a homeostatic organ plays a pivotal role in maintaining the relative balance of lipid and lipoprotein metabolism in the body. Aim: The study aimed at determining the impact of chronic hepatitis B (CHB) disease on serum lipids and the effect of the stages of this disease on lipid pattern in infected patients. Methodology: The study involved the selection of 70 CHB patients attending clinic at a Tertiary Hospital in Makurdi, Nigeria. After fulfilling the inclusion criteria, 65 anthropometrically matched apparently healthy individuals were selected as control to the CHB group. CHB is defined in the study as persistent infection evidenced by seropositivity for hepatitis B surface antigen without remission for up to 1-year. Results: There was a significantly reduced (P = 0.001) high-density lipoprotein cholesterol (HDL-C) and raised (P = 0.044) low-density lipoprotein cholesterol (LDL-C) in chronic HBV compared to seronegative controls. There was a significantly lowered HDL-C (P = 0.017), very LDL-C (P = 0.005), and triglyceride (P = 0.034) in asymptomatic CHB compared to the matched controls. There was a significantly lowered total cholesterol (P = 0.019) and HDL-C (P = 0.017) in symptomatic CHB compared to the matched controls. Conclusion: Lowered serum lipids are associated with CHB disease and likely to be mediated altered liver metabolism. However, reasons for the low levels of lipids in this viral disease still remains unclear.
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Compliance and patterns of iron-folic acid intake among adolescent girls and antenatal women in rural Tamil Nadu p. 87
Kalaiselvi Selvaraj, P Arumugasamy, Sonali Sarkar
Background: Anemia continues to be a major public health problem in India despite its long-recognized negative impact on health, especially of women. In a scenario where there is little increase in Hb levels even with implementation of various iron supplementation program apart from compliance, their dietary pattern also may play a role. Moreover, majority of the current literature assessed compliance to Iron Folic Acid (IFA) supplements in facility based settings. Objectives: This study aims to identify the compliance to Iron Folic Acid intake and dietary pattern which could influence the absorption of iron among anaemic pregnant women and adolescent girls in a rural area of Tamil Nadu. Methods: This community based cross sectional study was carried out in one of the primary health centres (PHC) in Tamil Nadu during the period of Feb-Mar 2013 among pregnant women and adolescent girls. From the eligible pregnant women and adolescent girls, information regarding socio economic characteristics, practices related to personal hygiene, dietary patterns, consumption of Iron Folic Acid tablets, and reason for non compliance were collected using structured questionnaires during house-to-house visit. Following this, Haemoglobin was estimated among all study participants. Results: Totally 147 (99.3%), 99 (56.6%) pregnant women, adolescent girls were found to be anemic respectively. Out of these, Iron folic acid tablets were consumed by 136 (91.9%), 60 (60.6%) of pregnant women and adolescent girls respectively. Around 90% of the anemic participants consumed IFA tablets during the night time, immediately after food in rice based diet. Pregnant women who were in their third trimester (OR 0.27, 95% CI: 0.10 to 0.69) and high socio economic status (OR 0.10, 95% CI: 0.02 to 0.55) had significant poor compliance compared to women in second trimester and low socio economic status respectively. Among the adolescent girls, increasing age and current school going status had facilitated the consumption of more number of IFA tablets. Conclusion: In this backward district, prevalence of anemia among pregnant women and adolescent girls were extremely high. Compliance to IFA tablets among pregnant women is favourable whereas among adolescent girls is extremely poor. Some of the dietary practices followed in this region could impair the iron absorption level and treatment effect.
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Prescribing pattern and cost analysis of antihypertensives in India p. 94
Hemalatha Vummareddy, Mohanraj Rathinavelu Mudhaliar, Shaik Mohammad Ghouse Ishrar, Balaiah Sandyapakula, Lokesh Vobbineni, Bijoy Thomas
Background: Hypertension has been reported to be the strongest modifiable global risk factor for cardiovascular morbidity, mortality as well as health burdens. Antihypertensive pharmacotherapy effectively reduces hypertension-related morbidity and mortality. Prescribing pattern surveys are one of the drug use evaluation techniques providing an unbiased picture and identification of suboptimal prescribing patterns. Objective: The 6-month cross-sectional study was designed to assess the prescription pattern and cost of antihypertensives therapy in a health-care resource-limited setting of India. Materials and Methods: The hypertensive patients were divided into two groups according to risk assessment using the World Health Organization and International Society of Hypertension guidelines for the management of hypertension. The average drug acquisition and the percentage expenditure costs were calculated for each drug class on a daily and annual basis, and InStat GraphPad Prism was the statistical tool used. Results: In our study of 100 patients, the most commonly prescribed antihypertensives were calcium channel blockers in 49.81% and beta-blockers in 12.73% patients, respectively. The cost analysis on antihypertensive medications utilized showed a total expenditure of Rs. 3823.58 invested in 1 year. Conclusion: The drug use pattern of antihypertensives was evidenced based but imposed economic burden in patients. Hence, rational use of generic medications was recommended.
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A descriptive study to assess the knowledge and practice regarding menstrual hygiene among adolescent girls of Government School of Shimla, Himachal Pradesh Highly accessed article p. 99
Anjali Mahajan, Kanica Kaushal
Introduction: Adolescent girls belong to vital age group, not only because they are the entrant population to motherhood but also because they are threshold between childhood and motherhood. The girls should be educated about significance of menstruation and development of secondary sexual characteristics, selection of sanitary menstrual absorbent and its proper disposal. Aims and Objectives: The objectives of the present study were to assess the existing knowledge and practice regarding menstrual hygiene among adolescent girls and to determine the co-relation of knowledge and practice score among the adolescent girls. Materials and Methods: The study conducted was a descriptive cross sectional study done on 100 adolescent girls from class 9th to 12th of Govt. Girls School in Shimla, Himachal Pradesh (Convenience sampling). Prior to the commencement of the study, they were explained the purpose and nature of the study. Information on demographic variables which include age, class, type of family, education of mother, family income, age of menarche were collected from the participants. Results: The data on knowledge scores revealed that 29% had adequate knowledge about menstrual hygiene, 71% had inadequate knowledge about menstrual hygiene. The data revealed on practice scores revealed that 19%, 69%, 12% samples had poor, fair and good score of practices regarding menstrual hygiene respectively. Knowledge and practice scores of participants shows positive correlation between the two scores (*P < 0.001). Conclusion: Lack of information about menstrual hygiene can be attributed to various factors which need to be studied separately. The above findings reinforce the need to encourage safe and hygienic practices among the adolescent girls and bring them out of traditional beliefs, misconceptions and restrictions regarding menstruation. The investigators improved the general awareness about cause of menstruation and the organs involved. Use of sanitary napkins was promoted and various schemes regarding menstrual health were briefed to the students. Early awareness can prevent students from suffering from the various reproductive tract infections.
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The effects of Moringa Oleifera on lipid profile status, heart histology, and liver histochemistry in adult Wistar rats p. 104
Adelaja Abdulazeez Akinlolu, Elizabeth Oluwafunmilayo Bayode, Kamal Olaide Ghazali, Mubarak Oloduowo Ameen
Background: Moringa oleifera's leaves are globally used for nutritional and medicinal purposes. We evaluated lipid profile status, heart and liver histology, and the activities of alanine and aspartate transaminases of the liver in M. oleifera-treated adult Wistar rats. Materials and Methods: Twenty-four adult male Wistar rats were employed in the study. Rats of control Group I received physiological saline while rats of Groups II–IV received 250, 500, and 750 mg/kg bodyweight of methanolic extract of M. oleifera, respectively, for 21 days. Results: No gross morphological or behavioral anomalies were observed in rats of Groups I–IV. Histological examinations showed normal histoarchitecture of the heart in Group I and the liver of Groups I–III. Comparative histological analyses showed dose-dependent increased nucleated cells in heart tissues of rats of Groups II–IV than those of Group I. Furthermore, histological evaluations showed hypertrophy of central vein of the liver in rats of Group IV when compared to Group I. Statistical analyses showed dose-dependent nonsignificant higher mean levels (P > 0.05) of total cholesterol and triglycerides in the sera of rats of Groups II–IV compared to rats of Group I. Evaluations of levels of alanine and aspartate transaminases showed a statistically significant higher mean values (P < 0.05) in Group II, but statistically nonsignificant higher mean values (P > 0.05) in Groups III–IV compared to Group I. Conclusions: No significant adverse effects on lipid profile status, heart histology, and liver histochemistry were observed in M. oleifera-treated rats.
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Assessment of quality of life in children with epilepsy in rural settings of South India: A cross sectional study p. 110
Mullazy Paramadam Srujana, Easwaran Vigneshwaran, Gandesiri Sangeeth Kumar, Kolisetty Jyoshna, Mantargi Md Jaffar Sadiq
Background: Epilepsy is the most common pediatric neurological disorder which alters the conscious, behavior, motor activity, and autonomy function leads to compromised quality of life (QoL) in children. Objective: The aim is to assess the QoL, and to evaluate the influence of demographic and clinical factors on QoL in children with epilepsy. Materials and Methods: This is a cross-sectional study conducted over 1 year from October 2013 to September 2014. Baseline demographic characteristics and other details were collected from patient case data and through a semi-structured interview during their recruitment into the present investigation. The child version of TNO-AZL Children's QoL questionnaire was administered by the trained research coordinator to collect data from and about the study subjects. Statistical Analysis: ANOVA and student t-test were performed for the statistical analysis. The data analysis was performed using Graph pad instat Results: The educational status, socioeconomic status, and maternal education were the demographic characters that significantly affected the QoL of study subjects. Type of seizures, early childhood history of seizures, duration of therapy and duration of epilepsy were the most important clinical characteristics that could significantly affect the QoL of study subjects. Conclusion: Further QoL studies and interventional programs may be conducted to improve the QoL and to individualize management in rural resident children with epilepsy.
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Knowledge, attitude, and behavioral practices pertaining to human immunodeficiency virus/acquired immune deficiency syndrome among secondary school adolescents in makurdi, Nigeria p. 117
Ayu Agbecha, James Saa-Aondo Gberindyer
Background: Adolescents knowledge with their safe practices pertaining to human immunodeficiency virus (HIV) has a critical impact on the prevention of contracting and spreading HIV. Reports have shown that adolescents in the general setting engage in activities that enhance the spread of the virus. Aim: The study assessed school adolescent's HIV/acquired immune deficiency syndrome (AIDS) knowledge, with its impact on their behaviors and attitudes regarding the infection. Materials and Methods: Two hundred randomly selected adolescent students from 10 different schools in the city metropolis were involved in the cross-sectional study. Primary data were collected using a validated self-administered questionnaire on students HIV/AIDS knowledge, attitude toward people living with HIV/AIDS (PLWHA), and safe practices preventing the spread of HIV/AIDS. Results: The study observed that majority of the students had good knowledge about HIV/AIDS, had good attitude toward PLWHA, and engaged in safe practices that prevent the spread of HIV. The sources of HIV/AIDS information were hospital, school, home, electronic, and print media. The study also found that HIV/AIDS knowledge instilled good attitudes and behavioral practices in the students. Conclusion: The study shows that school sex education, as well as health promotion campaigns through media platforms, could impact positively on the knowledge, attitude, and behavioral practices of adolescents in curbing the spread of HIV/AIDS.
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Neuroradiological and histopathological findings of intraventricular central neurocytoma p. 125
Reddy Ravikanth
Central neurocytomas are rare neuroectodermal tumors believed to arise from the subependymal matrix of the lateral ventricles. Intraventricular central neurocytoma is a benign primary central nervous system tumor of neuronal origin that is usually located within the lateral and third ventricles. Central neurocytoma should be considered in the differential diagnosis of lesions involving bilateral lateral ventricles with symmetrical growth around the center of septum pellucidum in young patients. Here, we report the radiological and histopathological findings in a rare case of intraventricular central neurocytoma.
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Implant-retained overdenture as a standard treatment modality for severely resorbed mandibular ridges p. 128
Angleena Y Daniel, Supneet Singh Wadhwa, B Vinod
Edentulous patients are a diverse group comprised those who are anatomically deficient, medically compromised, economically depressed, geriatric as well as the general population that, for a number of other reasons have been rendered edentulous. Satisfying a completely edentulous patient is always considered a difficult task. Various treatment options for rehabilitation of a completely edentulous patient are available: conventional complete dentures, overdentures, implant-supported overdenture, and full arch fixed implant-supported prosthesis. While the conventional denture may meet the needs of many patients, others require more retention, stability, function, and esthetics, especially in the mandible. With the continued advancements in dental implant therapy, it is becoming increasingly easier for the clinician to provide treatment solutions that can effectively meet functional, economic, and social expectations of each individual patient. This paper presents a case report of prosthetic rehabilitation of a completely edentulous patient with implant-retained overdenture.
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Implant-supported rehabilitation of unicystic ameloblastoma: A 2 years follow-upclinical report p. 132
Nitasha Gandhi, Sumir Gandhi, Nirmal Kurian
Ameloblastoma is a rare, benign, epithelial odontogenic tumor that tends to grow slowly in the mandible or maxilla but is locally invasive and can be highly destructive of the surrounding dental anatomy. Osseous resection with clear margins is the recommended treatment modality taking into consideration of 50% rate of recurrence within 5 postoperative years. Loss of the continuity of the mandible destroys the balance and the symmetry of mandibular function, leading to altered mandibular movements and deviation of the residual fragment toward the surgical side. The use of osseointegrated dental implants for rehabilitation is advisable, as it allows the recovery of the masticatory function. This clinical report reveals 2 years follow-up of rehabilitation of a 19-year-old patient who underwent surgical enucleation for the treatment of unicystic ameloblastoma followed by dental implant placement.
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Ovarian filariasis presenting as tubo-ovarian mass: Report of a rare case p. 136
Santosh Kumar Mondal, Anindya Adhikari, Rohini Nandan Chakraborty, Saikat Mandal
Filariasis of ovary is rare. Exact incidence is not known. Herein, we report a case of filarial worm affecting right ovary in a 35-year-old female patient who presented with chronic pelvic pain. Ultrasonography of lower abdomen revealed a tubo-ovarian mass on the right side. Right-sided salpingo-oophorectomy was done. Grossly, ovary was slightly enlarged in size (5 cm × 2.5 cm × 2 cm). Cut surface showed several tiny cysts at the periphery. The lumen of the fallopian tube was blocked. Histopathological examination of the ovary showed lymphangiectasia with microfilaria in one of the dilated lymphatics. Few cystic follicles were also seen in the sections. Section from the tube showed features of chronic salpingitis. She was given a course of diethylcarbamazine citrate (DEC) for 3 weeks postoperatively. On follow-up, the patient was doing well without any complication.
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Siblings with pierre robin sequence p. 139
Medhini Madi, Subhas G Babu, Sonika Achalli, Supriya Bhat, Kumuda Rao, Ananya Madiyal
Pierre Robin anomalad is a syndrome characterized by cleft of the palate, micrognathia of the mandible, and glossoptosis. This syndrome can occur as an individual presentation, or it may be associated with a wide variety of syndromes and anomalies. Such patients are burdened with several problems, some obvious and some less so. The most obvious problems such as the psychological difficulties the patients will have to face due to the appearance and associated problems such as feeding and speech difficulties and serious consequences such as airway obstruction. Here, we report two cases of Pierre Robin sequence seen in the same family in two children of the same parents.
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Thyroid hormone resistance misdiagnosed as Graves' disease p. 144
Manish Gutch, Annesh Bhattacharya, Sukriti Kumar, Syed Mohd Razi, Rao Somendra Singh, Rajendra Kumar Pahan
Resistance to thyroid hormone (RTH) syndrome is a very rare disorder characterized by mutations of the thyroid hormone receptor beta and is usually inherited as an autosomal dominant trait. Patients with RTH are usually euthyroid but rarely may present with signs and symptoms consistent with hyperthyroidism. Here, we describe the case of a young girl with goiter who was previously misdiagnosed to have hyperthyroidism and was subsequently diagnosed to be suffering from RTH.
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Neuroretinitis with vitiligo: A rare case report p. 147
Anubhav Chauhan, Lalit Gupta
Optic neuritis (ON) is an acute inflammatory disorder of the optic nerve and is characterized by a unilateral sudden visual loss in the affected eye, often accompanied by periocular pain. We report a classical case of neuroretinitis (a subtype of ON) with vitiligo in a 52-year-old female. Vitiligo is associated with a few ocular disorders, and neuroretinitis is not one of them. Autoimmune etiologies are associated with both the diseases. To the best of our knowledge and after extensive literature search, this is probably the first reported case of neuroretinitis with vitiligo.
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Goldenhar syndrome: A case report and review p. 150
Sonika Achalli, Subhas G Babu, Murali Patla, Medhini Madi, Shishir Ram Shetty
Goldenhar syndrome (GS) is also known as hemifacial microsomia or oculo-auriculo-vertebral dysplasia. This condition mainly affects the oral cavity, eyes, ear, and vertebrae. This is a rare congenital anomaly. Here, we present a case of GS with a brief review on its etiology, clinical and radiographic features, differential diagnosis, and management.
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Seroprevalence of sexually transmitted diseases (herpes, Chlamydia, and syphilis) in pregnant women in Warri, Nigeria p. 155
Favour Osazuwa, Otutu-Moses Ifueko
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Swachh bharat: A long voyage from rhetoric to implementation p. 157
Rohit Sharma, PK Prajapati
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