Clinical profile, etiology, type and outcome of neonatal seizures: a hospital-based study

Background: Our study was undertaken to study the etiological factor, clinical profile, types and outcome of newborn with neonatal seizures (NNS).Methods: Our study was hospital based prospective study was done in Sheri Kashmir institute of medical sciences (SKIMS) Bemina from April 2013 to April 2015 in NICU, after obtaining ethical clearance from institutional ethical committee. All neonates fulfilling inclusion criteria were included in our study.Results: In our study, 80 neonates with seizures were included in our study, among them 48 were males and 32 were females. Majority of neonates (57.5%) developed seizures during first 72 hours of life due to birth asphyxia. Commonest types of neonatal seizures observed in our study were subtle observed in 46 cases, followed by tonic (21.2 %), clonic (14.9 %) and mixed (6.2%) seizures. Birth asphyxia was commonest cause (57.5%) of NNS, sepsis with meningitis (18.7%) followed by hypoglycemia (13.7%) and hypocalcemia (5%). Cases of birth asphyxia were associated with higher mortality (58.3%) as compared to cases with metabolic seizures.Conclusions: From our study we conclude that commonest cause of neonatal seizure was birth asphyxia occurring within 72 hours of birth. Sepsis and meningitis were also common infections resulting in neonatal seizure, while as hypoglycaemia and hypocalcemia were common biochemical abnormalities leading to NNS. Early identification and treatment are likely important for long-term outcomes in acute symptomatic seizure.

Clinicopathological, trichoscopic and biochemical parameters in females with patterned hair loss

<p class="abstract"><strong>Background:</strong> Hair has no vital functions in humans but its loss from the scalp can create a sense of negative body image and anxiety. The term ‘female pattern hair loss’ is explained by decrease in hair fiber production and their eventual miniaturization. To evaluate the clinicopathological, trichoscopic and biochemical parameters in females with patterned hair loss.</p><p class="abstract"><strong>Methods: </strong>37 females in age group of 18-45 years complaining of reduction in hair volume with diffuse thinning over the crown were included in our study after applying inclusion and exclusion criteria. Detailed history was taken and clinical examination was done. Written consent and ethical clearance from Institutional Ethical Committee was taken. Ludwig grading, evaluation of other clinical signs of hyperandrogenism and trichoscopy was done. These females then underwent histopathological examination. 10 ml blood was withdrawn to assess anemic, thyroid and hormonal profile in these females.</p><p class="abstract"><strong>Results: </strong>Out of 37 females examined majority of the females had Ludwig grade 1 hair loss. Serum levels of testosterone were found significantly related to clinical signs of hyperandrogenism. Hair diameter variability and peri pilar sign formed the majority in trichoscopy (62.2% each). The most common histopathological finding was perifollicular infiltrate (70.3%).</p><p class="abstract"><strong>Conclusions:</strong> FPHL can contribute to severe psychological distress. Despite its high prevalence, its diagnosis and treatment still impose several difficulties in clinical practice. Although hormonal factors are believed to contribute, its pathogenesis still remains elusive.</p>

Effect of Genetic / Environmental Influence on Growth of Newborn in Himachal Pradesh

Introduction: The effects of altitudinal variation on child growth and development have long been a center of attention for researcher. We believe that hereditary factor primarily affects on child growth and development however environment has secondary effect on it. The available literature on newborns in Himachal Pradesh establishes the fact that as altitude increases the crown heel length decreases. A comprehensive significant finding was also available in both the regions of Himachal Pradesh in terms of head length, foot length, nasal height etc. the comparison between the neonates of the two zones of Himachal Pradesh explains the difference in physical appearance of people of both zones. These features may be biological or behavioral in nature, genetic or developmental in origin. Most instances, a combination of factors are involved. Methods: The present study included 185 parents and their newborns from two zones (Lower zone and Middle zone) of Himachal Pradesh and separated as per the criteria. Measurement of newborn parameters was taken in 12-24 hours after birth by using digital vernier caliper. Ethical clearance from university and permission from Himachal Pradesh government was taken. All the newborns were separated as per criteria 1. Mother / Father from Lower Zone. (Zone category 1) 2. Mother / Father from Middle Zone. (Zone category 2) 3. Mother from Lower Zone / Father from Middle Zone. (Zone category 3) 4. Mother from Middle Zone / Father from Lower Zone. (Zone category 4) Results: Statistically significant difference was obtained in all the four categories. Different parameters were compared across different parent- zone categories by one way ANOVA. The results showed that four parameters shows significantly across groups, viz, Weight, Facial Length, Nasal Height and Philtrum width in all the Zone categories. Conclusions: The early historical studies mention that people living in Himachal Pradesh have migrated from different geographical locations hence their genetics, as well as culture is different from each other. This study clearly demonstrates the effects of environmental factors on child growth and development in Himachal Pradesh. KEY WORD: Anthropometry, Newborn, Himachal, Environment, Genetics.

Ectopic Pregnancy in Tigray, Ethiopia: A Cross-Sectional Survey of Prevalence, Management Outcomes, and Associated Factors

Background. Ectopic pregnancy is a neglected and challenging gynecologic problem in developing countries including Ethiopia. Objective. The present study is aimed at assessing the prevalence of ectopic pregnancy, its management outcomes, and factors associated with management outcomes in Tigray, North Ethiopia. Methods. We employed a four-year retrospective cross-sectional study from September 2015 to August 2019. We extracted data about all pregnant mothers who were admitted and managed for EPs in Axum, Tigray. Ectopic pregnancy and its outcomes (favorable and unfavorable) were the dependent variables, and age, residence, ethnicity, religion, parity, history of abortion, history of EP, pelvic infections, history of surgical procedures, and use contraceptives were the independent variables. We employed descriptive statistics and bivariate and multivariate logistic regression analyses using SPSS. Ethical clearance was obtained from Axum University, Tigray, Ethiopia. Results. The overall prevalence of ectopic pregnancy was 0.52% of total deliveries, which equates to 1 : 193 deliveries. Surgery for ectopic pregnancy accounts for 7.6% of all gynecological surgeries. Most participants were in the age group 26–30 years and lived in rural areas. Among the different EP implantation sites, most cases (92.4%) occurred in the fallopian tube, followed by 5.1% in the ovary and 2.5% in abdominal EPs. Surgical management (laparotomy) was undertaken for all the 79 women diagnosed with EPs, including laparotomy (100%), salpingo-oophorectomy (17.7%), salpingectomy (73.9%), oophorectomy (3.4%), cornual resection (2.5%), and removal of concepts tissue 2.5. The record reports that intraoperative procedure was correctly managed for 47 (59.5%) women but the condition of EP procedure was ruptured for about two-thirds (63.3%) of the women. Thirty (38%) patients had developed some complications after surgery including anemia ( hemoglobin < 10.5 ) ( n = 12 ), fever ( n = 10 ), wound infection ( n = 2 ), and pneumonia ( n = 2 ). Women who were from urban ( AOR = 11.2 , 95% CI: 2.65-47.2) and who had normal hemoglobin at presentation ( AOR = 9.94 , 95% CI: 2.03-48.7) were associated with favorable maternal outcomes. Conclusions. More than one-third of women with ectopic pregnancies had an unfavorable maternal outcome, which was higher among rural residents and anemic mothers. Women living in rural areas and anemia during pregnancy should seek special attention in the management of EPs. We also recommend improving the data management of hospitals in Ethiopia.

EFFECT OF NEBULIZED KETAMINE AND MAGNESIUM SULPHATE ON INCIDENCE OF POSTOPERATIVE SORETHROAT – A COMPARATIVE STUDY

BACKGROUND: Post-operative sorethroat(POST) following endotracheal intubation is a well-known complication, several methods have been tried to reduce this incidence. We are comparing the effects of nebulized ketamine & Magnesium Sulphate to reduce this. AIMS AND OBJECTIVES: To compare the efcacy of nebulized ketamine and magnesium sulfate in reducing the incidence of POST. MATERIALS AND METHODS: After obtaining Ethical clearance and patient consent, 40 Patients undergoing surgery under general anesthesia were randomized in to two groups. Five minutes prior to the induction of anesthesia, patients were nebulized with Group K = 1 ml of ketamine [50 mg] +4 ml normal saline, Group M = 0.5 ml of Magnesium Sulphate [250 mg] +4.5 normal saline, and Group S – 5 ml normal saline. RESULTS: There is moderate signicant difference between both the groups at 0 hr. No signicant difference between two groups at 2,6,12 and 24 hrs. CONCLUSION: Ketamineand Magnesium sulfate reduce the incidence of POST, are almost similar in their effects.

Predicting the growth and feed intake of Bonsmara cattle on forage based rearing systems

This study aimed at estimating models to predict the growth and feed intake of Bonsmara bulls and heifers in backgrounding or pasture-based production systems (Ethical clearance number A16-SCI-AGR-001). Growth and intake data were collected from the Kromme Rhee Bonsmara stud in the Stellenbosch region. The growth curves of steers and heifers were modelled using the Gompertz function. Parameter estimates of the function showed that the mature weight (A) parameter was greater (P <0.05) for bulls than heifers (ca. 878.4 vs 562.1 kg, respectively). The maturation rates (parameter B) did not differ between the sexes, while the days at maximum growth (parameter C) was higher for bulls (291.5 days) than for heifers (182.4 days). Linear functions were used to describe the average feed intakes, as well as cumulative intakes, with body weights from growing bulls and heifers from the ages 6-20 months reared on lucerne hay and protein supplement. On average, it was observed that on the lucerne hay-based diet, Bonsmara bulls and heifers consumed about 2.43% of body weight daily throughout the study period. These models can be used in precision beef rearing systems to predict the production and market weights of Bonsmara calves that are either reared on hay or pasture.

Knowledge, attitude, and barriers toward polio immunization among pre-clinical students in Malaysia

Background: Polio is reported as reemerging disease in Malaysia after 27 years of being free from it. It is important to identify the awareness towards polio vaccine among the medical students who are the future and the pillars of the nation, to develop a country. Aims and Objectives: This study aims to assess the knowledge, attitude, and barriers toward polio immunization among pre-clinical medical students. Materials and Methods: A cross-sectional study was conducted among 190 pre-clinical students from a private university after obtaining informed consent and institutional ethical clearance. Data collected from Google Forms questionnaire were analyzed using SPSS version 20. Results: Insufficient knowledge, especially on disease nature, transmission, and correct dosage of vaccine, was noticed. Findings revealed that 79.5% of the students showed unfavorable attitude toward polio immunization. Year 2 students are more positive toward the vaccination compared to year 1. Main barriers toward polio immunization selected by the respondents are disagreement from the spouse, insecure about vaccine safety, and distance of the health center. Conclusion: Pre-clinical students should enhance their knowledge to be able to recognize the various barriers of polio immunization in our country and be part of the effort in solving these barriers as polio eradication is critical to ensuring a healthier future for children.

Trends in oxygen therapy in patients with moderate to severe COVID-19 admitted to the ICU

The most concerning complication of severe acute respiratory syndrome corona virus 2 (SARSCoV-2) pneumonia is acute hypoxemic failure. Though various antivirals, steroids, immunomodulators have been tried, oxygen therapy remains the mainstay of treatment. After obtaining institutional ethical clearance, a prospective observational study was conducted on 102 COVID-19 positive patients aged 20 years and above, admitted in the ICU with moderate to severe disease. COVID-19 infection was confirmed by polymerase chain reaction or rapid antigen test. Data of two demographically comparable groups i.e., patients on HFNO and NIV was analysed outcome was defined as discharge from ICU, shift to other non-invasive modes of oxygen therapy, endotracheal intubation or death, and comfort level for each mode. The data was analysed using SPSS-16.0, Chi-square test and “t” value test were applied.Comparison ofthe mean number of invasive ventilator free days of HFNO and NIV was insignificant(p&#62;0.05). Among the patients on HFNO (high flow nasal oxygen) 49.09% were stepped down to NRB (non-rebreathing mask) whereas 7.27% went for intubation which is significant compared to NIV mask (non-invasive ventilation), where 13.64% were stepped down to HFNO and 34.09% were intubated (p=0.000).Oxygen therapy with HFNO is associated with better outcome and less mortality when compared with NIV.

A study to assess the knowledge and practices related to menstruation and menstrual hygiene among adolescent girls of selected school of District Ambala, Haryana

: Menarche, among Adolescence girls, signifies the adaptation to womanhood as it is associated with pubertal changes and beginning of the capacity to reproduce. This is a period of gonadal development and growth spurt. Menstrual hygiene is crucial to healthy reproductive system and in return to good physical health and wellbeing. Therefore, enhanced awareness regarding menstruation and related hygiene, right from adolescence may escalate safe practices that are helpful in alleviating the distress of millions of women.: To assess the knowledge and practices related to menstruation and menstrual hygiene among adolescent girls of selected schools of District Ambala, HaryanaA descriptive cross sectional study was conducted in selected schools of Mullana and Barara District Ambala, Haryana. Total enumeration sampling technique was used to enroll 192 adolescent girls from class 9 to class 12 from selected schools after obtaining written informed consent from parents and verbal consent from girls. Ethical clearance was obtained from Institute Ethics committee. Doubts of the participants were cleared after data collection.Among 192 girls, nearly half girls were aware of menstrual hygiene and reported use of sanitary nepkins and 40.1% girls were aware of the symptoms of poor menstrual hygiene. . There is a need to implement an education program for adolescent girls on menstruation and menstrual hygiene to ensure healthy menstrual practices.

ROLE OF KRISNADI CHURNA IN THE MANAGEMENT OF TAMAKA SWAS (BRONCHIAL ASTHMA)

Since ancient times, humans are constantly threatened by diseases of respiratory disorders and Bronchial Asthma is one of them1. Ayurveda referred to Bronchial Asthma as “Tamaka Swas" which is a well-documented disease comparable to the parameters of etiopathology, risk factors, clinical manifestations and treatment principles. This study was conducted to evaluate the role of Krisnadi Churna in the management of Tamaka Swas (Bronchial Asthma). Ethical clearance was obtained from the Ethical Committee of Govt Ayurvedic College & Hospital, Gu- wahati and prior consent was taken from the patients before conducting the study The patients were given Krisnadi Churna for a period of 2 months in the Dept. of Kayachikitsa, Govt. Ayurvedic College & Hospital, Guwahati. There was a marked improvement in the symptoms as well as the Sr. IgE and AEC of the patients at the end of the treatment period. Keywords: TamakaSwas, Bronchial Asthma, Krisnadi Churna, respiratory disease