Degenerated broad ligament fibroid mimicking ovarian cyst: A case report

The commonest diagnosis of a cystic mass in the pelvis is ovarian cyst, here we report a case of cystic degeneration of broad ligament fibroid mimicking as a ovarian cyst. A 45-year-old lady presented with abdominal discomfort. On evaluation, a pelvic mass of 20 weeks size of varying consistency was noted. Ultra sonogram and Magnetic Resonance Imaging gave a differential diagnosis of right sided broad ligament fibroid and ovarian cyst. Anticipating possible ovarian mass owing to its size, laparotomy was performed and noted a large false broad ligament fibroid which has undergone cystic degeneration. Total abdominal hysterectomy and bilateral salpingo-oopherectomy was performed, however a differential diagnosis of ovarian mass should always be made before surgery.

Correlation of glycated hemoglobin and diastolic dysfunction in type 2 diabetes mellitus patients in a tertiary care centre

Background: There is a substantial increase in the coincidence of diabetes mellitus and cardiomyopathy. The cardiomyopathy may occur in patients who have no evidence of large vessel disease or abnormalities. The early and commonest hemodynamic derangement of diabetic cardiomyopathy is left ventricular diastolic dysfunction. So, the present study was undertaken to assess the prevalence of diastolic dysfunction in patients with type 2 diabetes and to assess the correlation of diastolic dysfunction and HbA1c% levels. Materials and methods: A total of 100 diabetic patients with minimum 5 years duration of diabetes were selected from Malla Reddy Hospital, Suraram from August 2020 to June 2022. Patients with minimum history of 5 years of type 2 diabetes were scrutinized for Doppler echo cardiography and HbA1c levels. Results: Diastolic dysfunction of left ventricle was observed in 58 patients out of 100, of which 54 (93.1%) patients had HbA1c% of > 6.4. 2 (3.4%) patients belong to HbA1c% group of 5.7-6.4. and 2(3.4%) patients belong to HbA1c% of < 5. Conclusion: Our findings indicate that myocardial damage in patients with diabetes affects diastolic function before systolic function. Diabetic cardiomyopathy is characterized by an early diastolic dysfunction and a later systolic dysfunction. Impaired diastolic function was not affected by sex or type of diabetes. Even young patients with diabetics with normal systolic ventricular function have diastolic dysfunction, which serves as a marker of a diabetic cardiomyopathy. Diastolic seems not to correlate with disease duration. HbA1c% can be a very good indicator of long term prognosis. Strong corelation exists between diastolic dysfunction and HbA1c.

Decoding 揼uitar pick sign� in COVID-19朼ssociated mucormycosis: A case series

揋uitar pick sign,� also referred to as posterior globe tenting, is a radiological surrogate marker of tense orbit and profound vision loss. It is seen commonly in traumatic retrobulbar hemorrhage and carotico-cavernous fistula and less frequently in orbital cellulitis, subperiosteal abscess, and invasive fungal infections. We report a case series of Coronavirus disease-19朼ssociated rhino-orbito-cerebral mucormycosis with guitar pick sign, of which none survived, and discuss the causative pathomechanisms, severity grade, and the clinical relevance of this unique radiological finding.

'Unheard voices': Perceptions of women with mental illness on nurses screening routinely for domestic violence: A qualitative analysis / "Voces no escuchadas": Percepciones de las mujeres con enfermedades mentales sobre el cribado rutinario de la violencia doméstica por parte de las enfermeras. Un análisis cualitativo / "Vozes não ouvidas": percepções de mulheres com transtorno mental sobre o rastreamento cotidiano da violência doméstica por enfermeiras. Uma análise qualitativa

Objective. To explore women's experiences of violence and their opinion on routine screening for domestic violence by nursing professionals in mental health care settings. Methods. This qualitative narrative research design was carried out among 20 asymptomatic women with mental illness at a tertiary care centre in Bangalore, India. Results. Narrative content analysis was performed, and five dominant themes have emerged: 1. Understanding the nature and signs of violence (subtheme: Meaning of violence), 2. Abusive experiences of women with mental illness (subthemes: Physical violence, psychological violence, social violence, sexual violence and financial violence), 3. Experiences on disclosure of violence (subthemes: Identification of violence by nursing professionals, Experiences of disclosure of violence), 4. Barriers for disclosure of abuse(subthemes: Fear of consequences, the hectic schedule of nursing staff, helplessness and hopelessness, perceived poor family support). 5.Routine screening for violence by nursing professionals (subthemes: reasons for routine inquiry of violence, nature of inquiry by the nursing professionals). Conclusion. Women with mental illness were undergoing more than one form of violence, and most of the participants supported routine screening by nursing professionals. Nurses play an essential role in identifying and supporting abused women in mental health care settings.

Objetivo. Explorar las experiencias de violencia que sufren las mujeres y su opinión sobre el cribado rutinario de la violencia doméstica por parte de los profesionales de enfermería en los centros de salud mental. Métodos. Esta investigación narrativa cualitativa se llevó a cabo con 20 mujeres asintomáticas con enfermedades mentales en un centro de atención terciaria en Bangalore, India. Resultados. Se realizó un análisis de contenido narrativo y surgieron cinco temas dominantes: 1. Comprensión de la naturaleza y los signos de la violencia (subtema: Significado de la violencia), 2. Experiencias abusivas de las mujeres con enfermedades mentales (subtemas: Violencia física, violencia psicológica, violencia social, violencia sexual y violencia económica), 3. Experiencias sobre la revelación de la violencia (subtemas: Identificación de la violencia por parte de los profesionales de enfermería, Experiencias de revelación de la violencia), 4. Barreras para la revelación del abuso (subtemas: Miedo a las consecuencias, el agitado horario del personal de enfermería, impotencia y desesperanza, percepción de un escaso apoyo familiar). 5. Indagación rutinaria de la violencia por parte de los profesionales de enfermería (subtemas: razones para la indagación rutinaria de la violencia, naturaleza de la indagación por parte de los profesionales de enfermería). Conclusión. Las mujeres con enfermedades mentales sufrieron más de una forma de violencia y la mayoría de las participantes apoyó el cribado rutinario por parte de los profesionales de enfermería. Las enfermeras desempeñan un papel esencial en la identificación y en el apoyo a las mujeres maltratadas en los entornos de atención en la salud mental.

Objetivo. Explorar as experiências de violência sofrida por mulheres e sua opinião sobre o rastreamento rotineiro de violência doméstica por profissionais de enfermagem em centros de saúde mental. Métodos. Esta pesquisa narrativa qualitativa foi realizada com 20 mulheres assintomáticas com doença mental em um estabelecimento de cuidados terciários em Bangalore, Índia. Resultados. Realizou-se uma análise de conteúdo narrativo e emergiram cinco temas dominantes: 1. Compreendendo a natureza e os sinais da violência (subtópico: Significado da violência), 2. Experiências abusivas de mulheres com transtorno mental (subtópicos: Violência física, violência psicológica, violência social, violência sexual e violência econômica), 3. Experiências sobre a divulgação da violência (subtópicos: Identificação da violência por profissionais de enfermagem, Experiências da divulgação da violência), 4. Barreiras para a divulgação do abuso (subtópicos: medo das consequências, enfermagem ocupada horas de trabalho, desamparo e desesperança, percepção de pouco apoio familiar) 5. Inquérito de rotina sobre violência por profissionais de enfermagem (subtópicos: motivos de inquérito de rotina sobre violência, natureza do inquérito por profissionais de enfermagem). Conclusão. Mulheres com doença mental sofreram mais de uma forma de violência e a maioria das participantes apoiava o rastreamento de rotina pelos profissionais de enfermagem. Os enfermeiros desempenham um papel essencial na identificação e apoio às mulheres agredidas em ambientes de cuidados de saúde mental.

MINIMAL ACCESS SURGERY IN CARCINOMA OESOPHAGUS - A CASE REPORT

Surgery plays an important role in curative treatment of oesophageal carcinoma. Ivor-Lewis procedure modified by McKeown is the procedure of choice, which is an open approach. Here, we present our experience with a modified three-stage procedure i.e. right thoracoscopy, mini-laparotomy and cervical anastomosis, which shows that oncological procedures can be performed by minimally invasive procedures; this helps in reducing complications associated with open technique, especially pulmonary, without any oncological disadvantage for the patient. Thus, we propose that a minimally invasive approach is a significantly better technique for tumour resection, combined with neo adjuvant chemotherapy, in reducing hospital stay and improved quality of life.

Application Of Central Composite Design For Citalopram Hydrogen Bromide Mouth Dissolving Films

Citalopram is an antidepressant used for treating major depressive disorder. In the current work Citalopram HBr is formulated as mouth dissolving film with enhanced drug dissolution. The Central Composite Design (CCD), employed to examine the effects of amount of HPMC E50 (A), amount of maltodextrin (B) and amount of glycerol (C) on response variables tensile strength, disintegration time and cumulative % drug release. 27 formulations prepared according to CCD and evaluated for physicochemical parameters and in vitro dissolution studies. Citalopram HBr mouth dissolving films formulated by employing solvent-casting method using HPMC E50, maltodextrin and glycerol, optimized for the effective dosage of superdisintegrants. The formulation CF21 with maximum tensile strength of 67.21±1.31 gm, least disintegration time of 9±1.60 sec and highest drug release of 98.41±1.81% is chosen optimal formulation with maximum content uniformity and folding endurance. It is evident from the above results that the developed formulation can be an innovative dosage form to improve the drug delivery, quick onset of action as well as improve patient compliance in the effective management of depression.

Molecular mechanisms of tobacco induced oral and oropharyngeal cancer: Results of a tissue microarray and immunohistochemistry-based study from a tertiary cancer center in India

Background: It is well established that chronic exposure to tobacco induces head and neck cancers but the exact etiopathogenesis is not known. Though studies have shown expression of TIMP1, EPS8 and AXL in cancers, their role in tobacco-induced cancers is not known. We aimed this study to evaluate the role of these molecules in oral and oropharyngeal squamous cell cancers (SCC). Materials and Methods: In this single institutional study, 31 patients of oral and oropharyngeal SCC with history of chewing tobacco were included. Smokers were excluded from the study. After informed consent biopsies were taken from affected and contralateral normal mucosa. Paraffin blocks were made and tissue microarray (TMA) were constructed using these blocks. Immunohistochemistry (IHC) for TIMP1, EPS8, AXL kinase was carried out on these tissue microarrays. The intensity of staining was scored from 0 to 3+, related to expression of each of the three molecules. Results: The expression of TIMP1, EPS8 and AXL kinase was significantly more in the cancerous mucosa versus non-cancerous mucosa (P = 0.000 in all three) in oral and oropharyngeal SCC exposed to chewing tobacco. Conclusion: Immunohistochemical expression of these molecular markers in oral and oropharyngeal SCC correlated with their molecular based studies. Significant IHC expression of TIMP1, EPS8 and AXL establishes their role in the pathogenesis of oral and oropharyngeal squamous cell carcinomas. Novel targeted therapies may be researched that can detect and target these molecules at an earlier stage of pathogenesis of these tumors.

South Africans' understanding of and response to the COVID-19 outbreak: An online survey

Background. The COVID-19 outbreak is in an accelerating phase, and South Africa (SA) has had the highest number of documented cases during the early phase of the pandemic in sub-Saharan Africa.Objectives. To assess South Africans' understanding of and response to COVID-19 during the first week of the country's lockdown period.Methods. An online survey was conducted in SA from 27 March to 2 April 2020. The survey was distributed widely among several websites and social media networks, including on a data-free platform. Descriptive statistics of knowledge, risk perception, access to and trust in information sources, and public and media opinions were calculated. Estimates were benchmarked to the 2019 national adult population estimates.Results. Of the 55 823 participants, the majority (83.4%) correctly identified the main symptoms of COVID-19. Over 90% had correct knowledge of the incubation period, with lower rates for 18 - 29-year-olds. Knowledge of symptoms and the incubation period varied significantly by population group (p<0.001), dwelling type (p<0.001) and sex (p<0.001). A quarter (24.9%) perceived themselves as at high risk of contracting COVID-19. Risk perception varied by age, population group, employment status and dwelling type (p<0.001). The most prevalent COVID-19 information sources were government sources (72.9%), news websites/apps (56.3%), satellite television (51.6%) and local television (51.4%).Conclusions. Understanding knowledge, attitudes and behaviours of people facing the COVID-19 pandemic is crucial for guiding strategic policy. These findings provide public understanding of COVID-19 as the phases of the country-level epidemic progress, and also directly inform communication needs and gaps

Design And In Vivo Evaluation Of Manidipine By Self-Nanoemulsifying Drug Delivery Systems

The current research is aimed at developing liquid self-nanoemulsifying drug delivery system (liquid-SNEDDS) of Manidipine for enhanced solubility and oral bioavailability. The Manidipine SNEDDS are formulated with excipients comprising of Capmul MCM (oil phase), Transcutol P (surfactant) Lutrol L 300 as co-surfactant. The prepared fifteen formulations of Manidipine SNEDDS analysed for emulsification time, percentage transmittance, particle size, in vitro drug release, and stability studies. In vivo pharmacokinetic studies of the optimized formulation were carried out in Wistar rats in comparison with control (pure drug). The morphology of Manidipine SNEDDS indicates spherical shape with uniform particle distribution. The percentage drug release from optimized formulation F14 is 98.24 ± 5.14%. The particle size F14 formulation was 22.4 nm and Z-Average 23.3 nm. The PDI and zeta potential of Manidipine SNEDDS optimized formulation (F14) were 0.313 and-5.1mV respectively. From in vivo bioavailability data the optimized formulation exhibited a significantly greater Cmax and Tmax of the SNEDDS was found to be 3.42 ± 0.46ng/ml & 2.00 ± 0.05 h respectively. AUC0-∞ infinity for formulation was significantly higher (11.25 ± 3.45 ng.h/ml) than pure drug (7.45 ± 2.24ng. h/ml). Hence a potential SNEDDS formulation of Manidipine developed with enhanced solubility and bioavailability.

Neonatal umbilical myiasis

Infestation is a state of being invaded or overrun by parasites. Myiasis is an infestation caused by dipterous fly. Even though human myiasis is a rare infestation particularly in newborn period unlike animal myiasis as neonate is just newly introduced to the environment and during this period neonate usually more protected and taken care by us. In rural areas of tropical countries where good hygiene conditions will not be there, authors are still identifying these cases. Risk factors for myiasis usually poor socioeconomic conditions and unhygienic environment. Finding cases of umbilical myiasis usually indicates poor environmental sanitary measures at that particular place. Here authors are presenting a case of neonatal umbilical myiasis caused by Chrysomya megacephala. These flies usually lay their eggs over the wounds or moisture dead necrotic tissues unlike other species of flies where they usually lay eggs over the animal fecus. But some other free-living flies(saprophagous) also cause myiasis due to accidental laying of eggs over dead necrotic tissues due to open defecation. In present case authors identified myiasis as early as third completed day of life, means infestation occurred at the time of delivery as incubation period for hatching eggs to larvae usually 4-8 days. These larvae able to survive inside deep tissue by breathing through a small hole. Even though myiasis usually have good prognosis it will become a focus for secondary infections. If deep-seated causes severe morbidity and even in extreme cases causes death also. Diagnosis is mainly clinical, authors can identify the species by microscopic examination of third stage larvae and finding age of the larvae also useful in identifying time of infestation. Treatments usually direct removal of larvae from the site by manipulation, irrigation, suffocation by ether and surgery if deep-seated. As they usually create nadir for infection by bacteria ruling out secondary infection and treatment is necessary. It is better to take preventive strategies like birthplace cleanliness and environmental sanitation. Tracking the case helpful in finding the places where authors need to improve sanitary measures it is better to give feedback to appropriate administrative officers to prevent home deliveries.

A Study On Incidence Of Cystic Kidney Disease In Patients On Maintenance Hemodialysis

INTRODUCTION: Cystic kidney disease is a unilateral or bilateral cystic disease characterized by small cysts distributed throughout the renal cortex and medulla of patients with ESRD unrelated to inherited renal cystic diseases. ACKD is a disease of chronic renal failure of any etiology and has to be differentiated from other types of cystic kidney disease. It is defined as more than three macroscopic cysts in each kidney of a patient who does not have a hereditary cause of cystic disease. It can be present at early stages of CKD or more commonly in patients on dialysis & to a lesser extent in native kidneys of renal transplant recipients. Most of them are asymptomatic but rarely complications like infection, rupture, bleeding, spontaneous perinephric hematoma may occur There is increased incidence of renal neoplasms in acquired cystic kidney disease that some authors consider ACKD pre-neoplastic. 1 Its prevalence and severity are higher in men than in women and increases with the duration of azotemia and duration of dialysis as well. With better health care facilities and penetration of nephrology services, the life span of patients on dialysis is increasing. The easy availability & application of imaging services to the above group has led to more frequent diagnosis of acquired cystic kidney disease. AIMS:To study the prevalence of kidney cysts in patients on maintenance hemodialysis. OBJECTIVES: Ÿ To study correlation between duration of dialysis and cystic changes and complications arising out it. Ÿ To study the impact of age and gender on cystic changes. METHODS:The study was done in Maintenance hemodialysis unit of Gandhi Hospital, secunderabad. 140 patients were enrolled over a period of one year from May,2016 to April,2017. Patients who had past history of polycystic kidney disease and had acquired kidney disease on sonography prior to dialysis were excluded. Radiological imaging was done using Computerized tomography KUB to look for acquired renal cysts. Cystic changes were considered as presence of one or more cysts in either or both the kidneys. STUDYDESIGN: prospective cross-sectional observational study. STATISTICALMETHODS: Data analysed using the Statistical Package for Social Science (SPSS) software version 19. ANOVAtest is applied for comparison variables. APvalue of < 0.05 is taken as significant. RESULTS: 22.8% of the incident MHD cohort were found to have cystic changes, of which 78.1% constitute males and 21.8% females. Cystic changes were observed in 46.6%in patients on MHD between 4-5yrs, 57.6% in patients on MHD between 5-6 yrs and to 75%in patients on MHD greater than 6 yrs. CONCLUSION: This study showed that Cystic kidney disease is an important complication of long term HD regardless of etiology of renal failure, more seen in males and relates to duration of hemodialysis. Hence renal surveillance with USG or CT every 3yrs in all dialysis patients and annually in patients with cystic changes.

A prospective observational study and survival pattern of organo phosphorous poisoning patients with intensive care treatment in a tertiary care hospital

Background: Organophosphate poisoning is poisoning due to organophosphates (OP’s), used in insecticides, medications and nerve agents. It occurs mostly during suicide attempts in the farming areas, developing world and less by accident. The study is to evaluate the drugs used, respiratory conditions, complications occurred during course of treatment.Methods: This was a prospective observational study conducted for 9 months in a tertiary care hospital. The study was conducted in a 500 bedded tertiary care hospital in an intensive care unit. The study was conducted for nine months (September 2016 - May 2017).Results: A total of 234 patients who had consumed OPP with known and unknown agents were admitted in the emergency department. Out of which 180 males and 54 females.Conclusions: This study concluded that the patients consumed poison is mainly due to mental disturbances and financial problems. The stress and burden on the life will shows the effect after consumption, the maximum people suffer with respiratory problems due to poison consumption. If the government should take the measures to avoid consumption of poison and availability of poison to the public may overcome the complications and reduce the deaths due to poison.

Tribal Odisha Eye Disease Study # 4: Accuracy and utility of photorefraction for refractive error correction in tribal Odisha (India) school screening

Purpose: To compare the photorefraction system (Welch Allyn Spot™) performance with subjective refraction in school sight program in one Odisha (India) tribal district. Methods: In a cross-sectional study school students, aged 5–15 years, referred after the preliminary screening by trained school teachers received photoscreening and subjective correction. The photoscreener was compared to subjective refraction in the range of +2D to ?7.5D. Statistical analysis included Friedman nonparametric test, Wilcoxon signed-rank test, linear regression, and Bland–Altman plotting. Results: The photoscreener was used in 5990 children. This analysis included 443 children (187 males, 256 females, and the mean age was 12.43 ± 2.5 years) who received both photorefraction and subjective correction, and vision improved to 6/6 in either eye. The median spherical equivalent (SE) with spot photorefraction was 0.00 D (minimum ?5.0D; maximum +1.6 D), and with subjective correction was 0.00D (minimum ?6.00 D; maximum +1.5 D). The difference in the SE between the two methods was statistically significant (P < 0.001) using Friedman nonparametric test; it was not significant for J 45 and J 180 (P = 0.39 and P = 0.17, respectively). There was a good correlation in linear regression analysis (R2 = 0.84) and Bland–Altman showed a good agreement between photorefraction and subjective correction in the tested range. Conclusion: Photorefraction may be recommended for autorefraction in school screening with reasonable accuracy if verified with a satisfactory subjective correction. The added advantages include its speed, need of less expensive eye care personnel, ability to refract both eyes together, and examination possibility in the native surrounding.

Conocimientos, actitudes y prácticas de las enfermeras hindúes sobre el uso de restricciones físicas en pacientes psiquiátricos / Conhecimentos, atitudes e práticas das enfermeiras hindus sobre o uso de restrições físicas em pacientes psiquiátricos / Indian nurses' Knowledge, Attitude and Practice towards use of physical restraints in psychiatric patients

Objective. To assess nurses' knowledge, attitude and practice towards using physical restraints among psychiatric patients. Methods. A descriptive cross sectional survey was carried out among conveniently selected sample of nurses working in psychiatry departments at a tertiary care center. The data was collected using self reported questionnaires of Suen. Results. The findings revealed that nurses had good knowledge (7.2±1.7, maximum posible=11), favorable attitudes 30.8± 3.3 (maximum posible=48) and good practice 31.2±6.2 (maximun posible=42) about use of physical restraints in psychiatric patients. Females had better knowledge (p<0.001), attitudes (p<0.05) than males towards use of physical restraints. Nurses those had more than ten years of experience found to have more favorable attitudes towards using physical restraints than nurses with less experience (p<0.05) and nurses with higher education differed significantly on practice score than nurses with basic education in nursing (p<0.05). Conclusion. This study revealed good knowledge, positive attitudes and good practices among nurses about using physical restraints in mental health services. However there is need to improve even more nurses practice through continuing education programs on this topic.(AU)

Objetivo. Evaluar los conocimientos, las actitudes y las prácticas de las enfermeras hacia el uso de restricciones físicas en los pacientes psiquiátricos. Métodos. Se realizó un estudio descriptivo de corte transversal en una muestra por conveniencia de enfermeras que laboraban en departamentos de psiquiatría de un hospital de atención terciaria al sur de la India. Los datos se recolectaron utilizando el cuestionario de Suen, el cual fue contestado por autorreporte. Resultados. Los hallazgos revelaron que en cuanto al uso de restricciones físicas en pacientes psiquiátricos las enfermeras tenían buen conocimiento (media =7.2±1.7, máximo posible=11), actitudes favorables (media=30.8±3.3, máximo posible=48) y buenas prácticas (media=31.2 ± 6.2, máximo posible=42). Las mujeres tenían mejores conocimientos (p<0.001) y actitudes (p<0.05) que los varones hacia el uso de restricciones físicas. Las enfermeras con más de diez años de experiencia tuvieron actitudes más favorables hacia el uso de estas restricciones que las de menor experiencia (p<0.05) y las enfermeras con educación superior difirieron significativamente en el puntaje de la práctica comparadas con aquellas con educación básica en enfermería (p<0.05). Conclusión. Este estudio reveló buenos conocimientos, actitudes positivas y buenas prácticas de las enfermeras sobre el uso de restricciones físicas en los servicios de salud mental. Sin embargo, es necesario mejorar aún más las prácticas de las enfermeras a partir de programas de educación continua sobre este tema (AU)

Objetivo. Avaliar os conhecimentos, as atitudes e as práticas das enfermeiras para o uso de restrições físicas nos pacientes psiquiátricos. Métodos. Se realizou um estudo descritivo de corte transversal numa amostra por conveniência de enfermeiras que trabalhavam em departamentos de psiquiatria de um hospital de atenção terciaria no sul da Índia. Os dados foram recolhidos utilizando o questionário de Suen, o qual foi contestado por auto-reporte. Resultados. As descobertas revelaram que em quanto ao uso de restrições físicas em pacientes psiquiátricos as enfermeiras tinham bom conhecimento (media =7.2±1.7, máximo possível=11), atitudes favoráveis (media=30.8±3.3, máximo possível=48) e boas práticas (média=31.2 ± 6.2, máximo possíveis=42). As mulheres tinham melhores conhecimentos (p<0.001) e atitudes (p<0.05) que os homens para o uso de restrições físicas. As enfermeiras com mais de dez anos de experiência tiveram atitudes mais favoráveis para o uso destas restrições que as de menor experiência (p<0.05) e as enfermeiras com educação superior deferiram significativamente na pontuação da prática comparadas com aquelas com educação básica na enfermagem (p<0.05). Conclusão. Este estudo revelou bons conhecimentos, atitudes positivas e boas práticas das enfermeiras sobre o uso de restrições físicas nos serviços de saúde mental. Embora, seja necessário melhorar ainda mais as práticas das enfermeiras através de programas de educação continua sobre este assunto. (AU)

Surgical Repair of Scimitar Syndrome

Scimitar syndrome (SS) is a form of partial anomalous pulmonary venous drainage that is dramatically visible on plain chest radiography (CXR). In these individuals, the entire venous drainage from the right lung enters a single anomalous large vein that descends to the inferior vena cava. This descending vein is visible on CXR as a curvilinear density along the right heart border and resembles the curved Turkish sword that gives the condition its name. SS forms part of the large spectrum of associated conditions known as venolobar syndrome. These include right lung hypoplasia or sequestered segments of right lung, congenital heart disease and various others. We report, along with our other five cases, a special case of a young woman who presented incidentally, with a murmur, at 16 years of age. Full investigation including angiography showed a large atrial septal defect (ASD) with right heart dilation and SS. She underwent surgical correction with uneventful and complete correction by baffling of the scimitar vein from its entry into the inferior vena to the left atrium through the enlarged ASD.

Diferencias por sexo en el índice de masa corporal, percepción del peso corporal, satisfacción con el peso, desórdenes de la alimentación y estrategias para el control de peso en estudiantes de medicina y enfermería de la India / Diferenças por sexo no índice de massa corporal, percepção do peso corporal, satisfação com o peso, desordens da alimentação e estratégias para o controle de peso em estudantes de medicina e enfermagem da Índia / Gender Differences in Body Mass Index, Body Weight Perception, weight satisfaction, disordered eating and Weight control strategies among Indian Medical and Nursing Undergraduates

Objective. To assess gender disparity in body weight perception, Body Mass Index (BMI), weight satisfaction and role of depression among undergraduate Medical and Nursing students. Methods. A descriptive cross sectional descriptive study was conducted in conveniently selected medical (n=241) and nursing (n=213) students of Bangalore, South India. Data was collected using self-administered SCOFF questionnaires. Results. Our findings revealed that men had a significantly higher BMI than women (t=5.403, p<0.001). More number of women compared to men, perceived themselves as over weight (74.8%) and not satisfied with their weight status (81.6%). More men than women scored positively for disordered eating behaviors on SCOFF (45.4% vs. 31.1%) and EAT scale (16.5% vs. 8.7%). While, 48.2% of the women practice binge eating, 41.2% of the men practice it (p<0.004); more men (47.4%) than women (25.4%) exercised for more than sixty minutes (p<0.001) to control their weight. Conclusion. Findings indicate small differences between the genders that have to be taken in consideration in planning interventional programs to prevent eating disorders in this population. (AU)

Objetivo. Evaluar la disparidad por sexo en el índice de masa corporal, la percepción del peso corporal, la satisfacción con el peso, los desórdenes de la alimentación y estrategias para el control de peso en estudiantes de medicina y enfermería de la India. Métodos. Se realizó un estudio descriptivo de corte transversal con una muestra tomada a conveniencia de estudiantes de Medicina (n=241) y de Enfermería (n=213) de Bangalore, en el sur de India. Los datos se recolectaron usando los instrumentos auto-administrados SCOFF y EAT-26. Resultados. Los hombres tenían un IMC significativamente mayor que las mujeres (t=5.403, p<0.001); un mayor porcentaje de mujeres, en comparación con los hombres, percibía que pesaba más (74.8%), sin embargo, no estaban satisfechas con su peso (81.6%). Los hombres y las mujeres tuvieron puntajes que mostraban riesgo de tener trastornos de conductas alimentarias en el SCOFF (45.4% vs. 31.1%) y en el EAT (16.5% vs. 8.7%). Mientras que el 48.2% de las mujeres practicaba el atracón, el 41.2% de los hombres lo tenía (p <0.004); más hombres (47.4%) que mujeres (25.4%) se ejercitaban por más de sesenta minutos (p<0.001) para controlar su peso. Conclusión. Los hallazgos indican pequeñas diferencias por sexo que deben ser tenidas en cuenta en la planeación de programas de intervención para prevenir los trastornos en la alimentación en esta población. (AU)

Objetivo. Avaliar a disparidade por sexo no índice de massa corporal, percepção do peso corporal, satisfação com o peso, desordens da alimentação e estratégias para o controle de peso em estudantes de medicina e enfermagem da Índia. Métodos. Se realizou um estudo descritivo de corte transversal com uma amostra tomada a conveniência de estudantes de Medicina (n=241) e de Enfermagem (n=213) de Bangalore, no sul da Índia. Os dados foram coletados usando os instrumentos auto-administrados SCOFF e EAT-26. Resultados. Os homens tinham um IMC significativamente maior que as mulheres (t=5.403, p<0.001), mas um maior número de mulheres em comparação com os homens, percebiam que pesavam mais (74.8%) e não estavam satisfeitas com seu peso (81.6%). Os homens e as mulheres tiveram pontuações que mostravam risco de ter transtornos de condutas alimentar no SCOFF (45.4% vs. 31.1%) e no EAT (16.5% vs. 8.7%). Enquanto que 48.2% das mulheres praticavam o excesso, já os homens 41.2% (p <0.004); mais homens (47.4%) do que mulheres (25.4%) se exercitavam por mais de sessenta minutos (p<0.001) para controlar seu peso. Conclusão. As descobertas indicam pequenas diferenças por sexo que devem ser tidas em conta no planejamento de programas de intervenção para prevenir os transtornos na alimentação nesta população. (AU)

A Drug Utilisation Study of Antihyperglycaemic Agents in a Rural Tertiary Care Hospital

Diabetes mellitus is an emerging non communicable, life style disease. The aim was to evaluate the drug utilization pattern of anti-diabetic drugs in diabetic outpatients and monitor the adverse drug reactions (ADRs) associated with anti-diabetic therapy

Outcome and complications of percutaneous nephrolithotomy as primary versus secondary procedure for renal calculi

ABSTRACT Purpose To compare the efficacy of percutaneous nephrolithotomy (PCNL) as a primary procedure of patients following previous open surgery or post percutaneous nephrolithotomy (PCNL) for renal calculi. Materials and Methods The medical records of 367 patients who underwent PCNL by a single surgeon from January 2008 to December 2013 were reviewed retrospectively. All patients were divided into 3 Groups. Group-1 (n=232) included patients with no history of ipsilateral open stone surgery. Group 2 (n=86) patients had undergone one or more open stone surgeries before PCNL, patients with failed or recurrence following PCNL were placed in Group-3 (n=49). The demographic data, operation duration, stone free rate (SFR), number of attempts to access the collecting system and intra operative and postoperative complications between the three Groups were compared. Results There was no difference in sex, Body Mass Index (BMI), stone burden and laterality among the three Groups. Operation time was significantly less in first Group, while there was a statistically significant difference in operation duration between second and third Groups (p<0.05). The number of attempts to enter the collecting system was lower in the first Group in comparison to other two Groups (p<0.5). There was no significant differences among three groups in stone free rate. Intra operative and postoperative complications were slightly more frequent in Groups 2 and 3. Mortality occurred in 1 patient with colon perforation in Group-2. Conclusion Our study demonstrated that PCNL can be performed in patients even as secondary procedure without further complications.

Clinical effects of photodynamic and low‑level laser therapies as an adjunct to scaling and root planing of chronic periodontitis: A split‑mouth randomized controlled clinical trial.

Background: There are limited clinical experiments addressing the effects of photodynamic therapy (PDT) and low‑level laser therapy (LLLT) as an adjunct to conventional scaling and root planing (SRP) alone. Aim: The aim of this clinical trial was to evaluate the clinical effects of adjunctive use of PDT, combination of PDT with LLLT as adjunct to conventional SRP alone in the treatment of chronic periodontitis. Materials and Methods: In a single‑centered randomized and controlled clinical trial, 24 patients (15 males and 9 females) with untreated chronic periodontitis were randomly assigned in a split‑mouth design into three treatment groups which included Group I: SRP only, Group II: SRP and PDT (1% methylene blue [MB] solution), and Group III: SRP, PDT, and LLLT. Clinical parameters such as plaque index, gingival index, modified sulcular bleeding index, probing depth (PD), and clinical attachment level (CAL) were measured at baseline, 1, 3, and 6 months after therapy. Results: Within each group, significant improvements (P < 0.001) were found for all variables in 6‑month follow‑up compared with baseline. The improvement in clinical parameters was significantly greater in Group III compared to Group I and Group II. The mean PD (mm) reduction from baseline to 6 months in Group I was 2.50 ± 0.54, Group II was 2.57 ± 0.53, and Group III was 3.14 ± 0.50. The mean CAL (mm) gain from baseline to 6 months in Group I was 2.63 ± 0.47, Group II was 2.55 ± 0.44, and Group III was 3.07 ± 0.55. Conclusion: In patients with chronic periodontitis, a combination of a single application of PDT (using a 980 nm laser and MB) and LLLT provide additional benefit to SRP in terms of clinical parameters 6 months following the intervention.

Poorly Differentiated Synovial Sarcoma over Tendo Achilles: A Rare Case.

Synovial sarcomas of Tendo Achilles are rare tumors. The name “synovial sarcoma” is a misnomer, as it does not arise from synovial membrane. These tumors occur usually in the upper and lower limbs, more often in lower limbs in the distal parts. Distal extremities are more commonly associated with this tumor. It is seen to affect mostly tendon sheath, bursa, and joint capsule; knee being the commonly affected large joint. The common age group is 15-40 years. In our case, the initial pathology report came as hemanioma to us, but the immunohistochemistry report revealed it to be poorly differentiated synovial sarcoma.