Kasai Portoenterostomy at a Slightly Delayed Age and Native Liver Survival in Children With Biliary Atresia: Single Center Experience

Objectives: We studied the modifiable prognostic factors that extend native liver survival at 2 years after Kasai portoenterostomy (KPE). Methods: We reviewed hospital records of patients with neonatal cholestasis, with focus on infants diagnosed with biliary atresia in a tertiary care hospital between January, 2014 and May, 2021. We determined the association of outcome with clinical and laboratory variables. Results: Infants who underwent KPE at a median (IQR) age of 76 (72-79) days had best outcomes, with minimal severe post-KPE complications and 2- year survival rate of 84.6%, compared to other infants (younger and older age at KPE). The median (IQR) weight at KPE in this group was 4.66 (4.2, 5.0) kg. Conclusions: In contrast to traditional recommendations, babies with median age at KPE of 76 days had superior native liver survival (84.6%) and reduced post-KPE complications, as compared to earlier KPE age. Nutritional status and weight of infant at KPE could be associated with this survival difference. This observation needs confirmation through multicentric prospective studies in different settings.

Overall and Event Free Survival of Childhood Cancer - Report From a Hospital-based Cancer Registry in Northern India, 2013-21

Objectives: Using data from a hospital-based cancer registry (HBCR) in the private sector in Northern India, we provide overall survival (OS) and event-free survival (EFS) for childhood cancer patients. Methods: All newly diagnosed childhood (age <18 years) cancer patients in our HBCR registered between March 1, 2013 till July 31, 2021 were eligible. 3-year and 5-year OS (death was an event), EFSc (death, progression/relapse was an event), and EFSa (death, progression/relapse, abandonment of treatment was an event) were calculated using the Kaplan-Meier method. Regression analysis was done to see their association with demographic, diagnostic and treatment variables. Results: 705 newly diagnosed children (36.2% female) with cancer were registered. Common cancers were leukemias (26%), CNS tumors (20%) and bone tumors (16%). 202 (28.6%) had experienced an event at median follow up of 1.95 years (range 0-8.14 years), which included 23 (3.3%) who abandoned treatment. The 3- year OS, EFSc, EFSa were 70.8%, 64.4% and 63.6%, respectively. Correspondingly, 5-year OS, EFSc, EFSa were 66%, 58.6% and 57.5%, respectively. There was no significant difference by age group, gender, nationality, and if cancer directed treatment initiated elsewhere. The OS, EFSa and EFSc by the main and the extended International Childhood Cancer Classification categories varied significantly (P<0.001). Conclusion: We add more recent registry-based OS data on childhood cancer in India and present the first estimates on EFS.

Changing Sleep Patterns and Anxiety due to Covid?19 Home Confinement among Working Population: A Cross?Sectional Study

Introduction: The COVID?19 pandemic took the entire world unawares and people were forced to stay indoors overnight. Due to this a drastic change ensued in lifestyle with many succumbing to various kinds of stresses and psychological problems. This study aims to study the changing sleep patterns and level of anxiety among the working population due to the COVID?19 Pandemic lockdown. Methodology: An online survey was conducted using a cloud?based website. The sleep patterns both prior to and during the lockdown period of the pandemic were assessed using a self?administered questionnaire. The level of anxiety during both these periods (before and during lockdown) amongst the working population was also assessed using the Generalized Anxiety Disorder Scores (GADS). Results: A total of 224 individuals participated in the study of which 52.7% were males and 47.3% were females. On analysis, the lifestyle and sleep deprivation scores showed that before the lockdown only 2.7% reported a low score out of total participants. However, this number was raised to 13.4% during the lockdown. The percentage of people reporting deteriorated sleep quality gradually increased with females reporting moderate to severe category of Generalized Anxiety Disorder scores as compared to Males. Conclusion: The study suggests that there has been a significant change in the sleep quality of the study participants due to Covid enforced lockdown which if unnoticed might lead to significant health problems. The effective use of programs like yoga, meditation, and deep breathing exercises, if followed timely could reduce psychological distress to some extent.

Algorithm for Reducing Overall Biological Detriment Caused by PET/ CT: an Age‑Based Study / 대한핵의학회잡지

Purpose@#This study is to use a simple algorithm based on patient’s age to reduce the overall biological detriment associated with PET/CT. @*Materials and Methods@#A total of 421 consecutive patients (mean age 64 ± 14 years) undergoing PET for various clinical indications were enrolled. For each scan, effective dose (ED in mSv) and additional cancer risk (ACR) were computed both in a reference condition (REF) and after applying an original algorithm (ALGO). The ALGO modified the mean dose of FDG and the PET scan time parameters; indeed, a lower dose and a longer scan time were reported in the younger, while a higher dose and a shorter scan time in the older patients. Moreover, patients were classified by age bracket (18–29, 30–60, and 61–90 years). @*Results@#The ED was 4.57 ± 0.92 mSv in the REF condition. The ACR were 0.020 ± 0.016 and 0.0187 ± 0.013, respectively, in REF and ALGO. The ACR for the REF and ALGO conditions were significantly reduced in males and females, although it was more evident in the latter gender (all p < 0.0001). Finally, the ACR significantly reduced from the REF condition to ALGO in all three age brackets (all p < 0.0001). @*Conclusion@#Implementation of ALGO protocols in PET can reduce the overall ACR, mainly in young and female patients.

Study of Maternal and Fetal Outcomes in Obese Women

Background: Obesity in Indian women had increased from 10.6% to 14.8% in India. Mothers who are overweight or obese during pregnancy and childbirth cause significant antenatal, intrapartum, postpartum and also neonatal complications. Aim and Objective: The present study aimed to explore various maternal and fetal outcomes influenced by maternal obesity. The objective was to find the effect of obesity on maternal and perinatal outcome among obese pregnant women compared to those of normal weight. Methods: The study was conducted in antenatal women attending antenatal outpatient department of of Obstetrics and Gynecology in a teriary care referral hospital in Mumbai. Results recorded in simple percentages. Results: Eighteen percent cases developed gestational diabetes mellitus during their antenatal period and 15% developed gestational hypertension. 44% patients underwent lower segment caesarean section. The need for induction of labour and caesarean section was found to be 37% which is significantly higher. Increased NICU admissions due to hypoglycemia or congenital malformations,prematurity was found to be on a higher side. Conclusions: It was clearly evident from the present study that maternal obesity had adverse maternal and fetal outcomes. Maternal obesity was strongly associated with antenatal complications like gestational diabetes mellitus, gestational hypertension, preeclampsia and increase in need for induction of labour and operative interference.

Health insurance coverage and out-of pocket expenditure: A study among rural and urban households of Faridabad, Haryana

Introduction: Catastrophic health spending is one of the major factors pushing people into poverty. Reducing “out-of-pocket expenditure (OOPE)” on health through health insurance coverage is an effective approach. The objectives of this study are (1) to estimate health insurance coverage among rural and urban households (HHs) and (2) to determine the proportion of income spent on health as OOPE among the selected HHs. Material and Methods: A cross-sectional study was conducted in rural and urban parts of district Faridabad, Haryana. A sample of 374 were taken from rural and urban areas. The unit of the study was HHs in both the areas. The proportion of income spent on health care (both direct and indirect expenses included) as OOPE was taken as outcome variable. Results: Health insurance coverage was higher among urban HHs (58.0%) as compared to the rural (38.5%). The rural population was availing of private consultation, laboratory, and pharmacy services to a greater extent than the urban; hence, they were spending a substantial proportion of their income on health-care services. The majority of the HHs in the rural and urban areas spent up to 20% of their income on health care. Conclusion: Universal health coverage without health insurance is unlikely.

Synthesis of Zinc Oxide Nanoparticles, its characterization and anti-microbial activity assessment

Zinc oxide nanoparticles (ZnO NPs) are one of the most abundant metal oxides nanoparticles. It provides excellent thermal, electrical and chemical stabilities with low biotoxicity; its photo-oxidising and photo-catalytic impact on biological and chemical species is of great importance, thereby making it a promising candidate to be used for in-vitro and in-vivo studies in biomedical field. Hereby, ZnO NPs were synthesized using precipitation method with zinc acetate and sodium hydroxide as starting materials. This study has characterized the synthesized ZnO NPs using different techniques such as UV-Visible spectroscopy indicating a peak at 365 nm wave length, size of ZnO NPs was determined to be 286.7 nm by measuring hydrodynamic radii using Dynamic Light Scattering (DLS) phenomena. Further predominant charge existing at surface of the synthesised ZnO NPs was evaluated to be 31.6mV. Anti-microbial activity of ZnO NPs was determined by Kirby-Bauer method for both Gram-positive and Gram-negative bacteria, S. aureus and E. colirespectively. Anti-microbial activity was determined as Zone of Inhibition that measures both bactericidal and bacteriostatic activity of ZnO NPs and was found to be more potent for Gram-positive (S. aureus)bacteria and its activity increased with increasing concentration of nanoparticles. Growth kinetics was studied to determine percentage growth inhibition, for this optical density was recorded as a function of time in bacterial culture broth with and without treatment. Further DNA fragmentation assay was performed to determine genotoxicity caused by nanoparticles and its effect on genomic DNA of bacteria. Highlighting its potential role as a nano-carrier system for leading antibacterial drugs for enhanced effectiveness of the antibacterial therapies

A COMPARISON BETWEEN TWO METHODS OF FALLOPIAN TUBAL LIGATION FOR STERILIZATION OF WOMEN IN A LOW RESOURCE SETTING

Objective: To compare two methods of tubal sterilization; modi?ed Pomeroy and a modi?cation added to modi?ed Pomeroy's method, in a low resource setting. In this prospective study conducted from Methods: 2019 to 2021 in one thousand women, we compared Pomeroy's method with an other method in which a slight modi?cation in the original modi?ed Pomeroy's technique was introduced, in a very low resource rural community hospital with only basic operation theater facility. In modi?ed Pomeroy's method, a loop of fallopian tube is resected and trans?xed with 2-0 chromic catgut surgical suture material. In our study we added another modi?cation to the modi?ed Pomeroy's method, wherein the proximal end of the fallopian tube was additionally ligated with a 2-0 silk suture. The patients were followed up from 6months-2 years. A failure rate of 0.4% was observed in women who underwent Modi?ed Pomeroy's method in contrast to no Results: failure in women in whom the proximal end of the tube was additionally ligated. Additional modi?cation to the Conclusion: original modi?ed Pomeroy's method of sterilization can be potentially promising in reduction of sterilization failure rate in parts of world where salpingectomy is less readily accepted

Emerging role of physiotherapy in management of crush injury over forearm

The objective of the case report is to discuss the case of a patient with crush injury over right forearm. A 37 years old male came with complain of pain, swelling, restricted range over affected side, muscle weakness over right forearm, wrist and hand, reduced grip strength on right hand, and difficulties in ADL扴 over right-handfollowing crush injury over right forearm. Treatment involved physical therapy and Electro modalities for the elimination of pain and returning the patient抯 full range of motion in the wrist and hand. After range of motion was restored, a home exercise program was initiated. The home exercise program included a return to ADLs and occupational related activity and active, resistive, gripping activities of the hand. After 11/2 month follow up, our patient showed dramatic recovery after appropriate Surgical and physiotherapy management. Physiotherapy plays significant role in the elimination of pain, improving range; muscle strength and hand function and also reduces the risk of stiffness, contracture and deformity in crush injuries.

STUDY OF MEDICAL TERMINATION OF PREGNANCY IN A TERTIARY CARE HOSPITAL- A RETRO-PROSPECTIVE STUDY.

Background: Medical termination of pregnancy is de?ned as termination of pregnancy before the age of viability of foetus under any grounds of Medical termination of pregnancy Act 1971.The Medical Termination Bill 2020, passed in March 2020 amends to increase the upper limit for termination to 24 weeks for certain categories of women. Also the bill allows unmarried women termination of pregnancy for contraceptive failure. Safe and legal abortions are considered a key intervention to improve women’s health and quality of life. The current study is to assess the perception of eligible women on MTP services in cases of unwanted pregnancies amid determine the indications, complications and the contraceptive method used along with the procedure. Results: In the present study 60% patients belonged to the age group of 20-30. 41% patients had undergone termination due to failure of contraception,26% patients had multiple congenital anomalies,23.5% patients had maternal medical condition that could cause grave injury to physical and mental health of the mother making termination necessary.9% patients had termination due to social reasons. 53% patients had undergone medical abortion with Misoprostol alone compared to 19% who had undergone termination with combined Mifepristone and Misoprostol. Conclusions: It is needed that more number of females need to be counselled to adopt one or other method for contraception at time of termination to avoid further unwanted pregnancies.Medical termination of pregnancy with mifepristone and misoprostol is a safe, simple and effective approach. It permits greater privacy to the patients. Wide spread use of medical abortion may reduce number of deaths due to traumatic illegal termination of pregnancies Misoprostol, Mifepristone

In vivo evaluation of clinical performance of Cention N and glass ionomer cement in proximal restorations of primary molars

Introduction: Restoring a proximal lesion in primary tooth has met with many challenges which has led to evolution of many materials. An alternative to Glass Ionomer Cements which has fluoride releasing capacity, offers good bond strength and is esthetic have been long looked for. Aim: This study aimed to compare the clinical performance of GIC and Cention N in proximal restorations of primary molars. Materials and Methodology: A prospective study was conducted on 154 primary molars in patients aged between 5 and 8 years using a split-mouth design. Patients were divided into two groups. Control group restored with GIC and study group received Cention N. Both groups were assessed at baseline 3, 6 and 9 months according to Ryge criteria and data was statistically analysed using Fisher's Exact. Results: Statistically significant difference was found between GIC and Cention N restorations for color match at baseline and color stability at 3 months (P < 0.001), while the other parameters did not show any significant difference among the two restorative materials. Conclusion: Cention N can be used as a suitable alternative to GIC for restoring Class II restorations in primary molars.

Capillary electrophoresis methods for impurity profiling of drugs:A review of the past decade / 药物分析学报

Capillary electrophoresis(CE)is widely used for the impurity profiling of drugs that contain stereo-chemical centers in their structures,analysis of biomolecules,and characterization of bio-pharmaceuticals.Currently,CE is the method of choice for the analysis of foodstuffs and the determination of adulterants.This article discusses the general theory and instrumentation of CE as well as the classification of various CE techniques.It also presents an overview of research on the applications of different CE techniques in the impurity profiling of drugs in the past decade.The review briefly presents a comparison between CE and liquid chromatography methods and highlights the strengths of CE using drug compounds as examples.This review will help scientists,fellow researchers,and students to understand the applications of CE techniques in the impurity profiling of drugs.

An Interventional Study on Knowledge and Practice of Injection Safety and Appropriate Biomedical Waste Disposal among Students of One of the Nursing Colleges, Ahmedabad

Background: Injection is an important drug delivery system especially for severely ill patient, acute emergency condition and immunization. A safe injection is that, does not harm the recipient (patient), does not expose the provider (Health Workers) to any avoidable risk and does not result in waste that is dangerous for the community. Nursing personnel are an important risk group for occupational exposure to needle stick injuries as they are directly involved in the patient care activities like giving injections, starting IV line, taking blood sample etc. Objectives: To study the knowledge & impact of educational intervention of injection safety, post exposure prophylaxis following needle stick injury and segregation of bio medical waste among study nd rd nd rd participants. Methods: An Interventional study was carried out among 2 ,3 and final year B.Sc. & 2 ,3 year GNM nursing students of one of the Nursing Colleges in Ahmedabad. Results: Out of total, 233 (89.6%) were females and 27(10.4%) were males. Overall comparison between pre-test and post-test score regarding various factor of knowledge and practice of safe injection was statistically significant. Out of total, 36(13.8%) study participants were suffered from needle stick injury due to quickness or not wearing gloves. Only 11.1% study participants were not taking post exposure prophylaxis because of lack of knowledge and dread about long time medication course. Conclusion: Practice of injection safety standards was inappropriate except for routine use of hand gloves. The level of knowledge was poor especially in Post-Exposure Prophylaxis and Needle-prick injury accident management (NPIAM) protocol and register for post-exposure prophylaxis. Post-intervention assessment showed significant improvement in Knowledge for injection safety, PEP/NPIAM and category wise segregation of Bio-medical waste. Periodic reinforcement of the Nursing students by MBBS level educator with IEC and hands on training intervention will significantly protect them from NSIs and prevent the spread of blood borne pathogens.

Estimation of salivary proteins in early childhood caries before and after treatment using gel electrophoresis

Background: Saliva being an important biological fluid of our body contains both specific and nonspecific protective factors which form an integral part of our immune system. Salivary proteins play a substantial role in protecting humans against infection. Their level in oral cavity is subject to constant variations which is dependent on various factors. Purpose: The purpose of the study was to compare the levels of salivary proline-rich proteins (PRPs), glycoproteins, amylase bands, and salivary pH in children with early childhood caries before and after treatment using gel electrophoresis. Materials and Methods: The whole salivary pH, mean protein concentrations, and electrophoretic profiles of the salivary proteins were measured using sodium dodecylsulfate–polyacrylamide gel electrophoresis in both pre- and posttreatment groups. Statistical analysis was done using Statistical Package for Social Sciences (SPSS) version 15.0 software. Chi-square test and independent t-test were used to further compare the results. Results: The results were statistically significant in all the groups. There was variation in pre- and posttreatment values seen. Conclusion: Salivary proteins (glycoproteins, PRPs, and amylase) establish an imperative defense mechanism as antimicrobial agents.

Yoga nidra practice shows improvement in sleep in patients with chronic insomnia: A randomized controlled trial

BACKGROUND Yoga nidra is practised by sages for sleep. The practice is simple to use and has been clearly laid out, but its role in the treatment of chronic insomnia has not been well studied. METHODS In this randomized parallel-design study conducted during 2012–16, we enrolled 41 patients with chronic insomnia to receive conventional intervention of cognitive behavioural therapy for insomnia (n=20) or yoga nidra (n=21). Outcome measures were both subjective using a sleep diary and objective using polysomnography (PSG). Salivary cortisol levels were also measured. PSG was done before the intervention in all patients and repeated only in those who volunteered for the same. RESULTS Both interventions showed an improvement in subjective total sleep time (TST), sleep efficiency, wake after sleep onset, reduction in total wake duration and enhancement in subjective sleep quality. Objectively, both the interventions improved TST and total wake duration and increased N1% of TST. Yoga nidra showed marked improvement in N2% and N3% in TST. Salivary cortisol reduced statistically significantly after yoga nidra (p=0.041). CONCLUSION Improvement of N3 sleep, total wake duration and subjective sleep quality occurred following yoga nidra practice. Yoga nidra practice can be used for treatment of chronic insomnia after supervised practice sessions.

Effects of maxillary expansion on hearing and voice function in non-cleft lip palate and cleft lip palate patients with transverse maxillary deficiency: a multicentric randomized controlled trial / Efeitos da expansão maxilar na função auditiva e vocal em pacientes sem fissura labiopalatina e com fissura labiopalatina e deficiência maxilar transversa: um estudo controlado multicêntrico e randomizado

Abstract Introduction The association between the treatment of transverse maxillary deficiency and the recovery of hearing and voice functions has gained attention in recent years. Objective This prospective controlled trial aimed to evaluate the effects of rapid maxillary expansion on hearing and voice function in children with non-cleft lip palate and bilateral cleft lip palate with transverse maxillary deficiency Methods 53 patients (26 non-cleft and 27 bilateral cleft lip palate; mean age, 11.1 ± 1.8 years) requiring rapid maxillary expansion for correction of narrow maxillary arches were recruited for this trial. Eight sub-groups were established based on the degree of hearing loss. Pure-tone audiometric and tympanometric records were taken for each subject at four different time periods. The first records were taken before rapid maxillary expansion (T0), the second after expansion (T1) (mean, 0.8 months), the third after three months (T2) (mean, 3 months) and the fourth at the end of retention period (T3) (mean, 6 months). ANOVA and Tukey HSD post-hoc tests were used for data analysis. Additionally, voice analysis was done using an updated PRAAT software program in a computerized speech lab at T0 and T2. A paired-samplet-test was used for comparisons of mean values of T0 and T2 voice parameters within both groups. Results Rapid maxillary expansion treatment produced a significant increase in the hearing levels and middle ear volumes of all non-cleft and bilateral cleft lip palate patients with normal hearing levels and with mild conductive hearing loss, during the T0-T1, T1-T2, T0-T2, and T0-T3 observation periods (p < 0.05). The significant increase was observed in right middle ear volumes during the T0-T1, T0-T2 and T0-T3 periods in non-cleft patients with moderate hearing loss. For voice analysis, significant differences were observed only between the T0 and T2 mean fundamental frequency (F0) and jitter percentage (p < 0.05) in the non-cleft group. In the cleft group, no significant differences were observed for any voice parameter between the T0 and T2 periods. Conclusion Correction of the palatal anatomy by rapid maxillary expansion therapy has a beneficial effect on both improvements in hearing and normal function of the middle ear in both non-cleft and bilateral cleft lip palate patients. Similarly, rapid maxillary expansion significantly influences voice quality in non-cleft patients, with no significant effect in BCLP patients.

Resumo Introdução A associação entre o tratamento da deficiência maxilar transversa e a recuperação das funções auditivas e vocais ganhou atenção nos últimos anos. Objetivo Avaliar os efeitos da expansão rápida da maxila na função auditiva e vocal em crianças sem fissura labiopalatina e com fissura labiopalatina bilateral com deficiência maxilar transversa. Método Foram recrutados para este estudo 53 pacientes (26 sem fissura e 27 com fissura labiopalatina bilateral; média de 11,1 ± 1,8 anos) que necessitam de expansão rápida da maxila para correção de arcos maxilares estreitos. Oito subgrupos foram estabelecidos com base no grau de perda auditiva. Registros audiométricos e timpanométricos de tons puros foram obtidos para cada indivíduo em quatro períodos. Os primeiros registros foram obtidos antes da expansão rápida da maxila (T0), o segundo após a expansão (T1) (média de 0,8 meses), o terceiro após três meses (T2) (média de 3 meses) e o quarto no fim do período de retenção (T3) (média de 6 meses). Anova e o teste post-hoc de Tukey HSD foram usados para análise dos dados. Além disso, a análise da voz foi feita com um programa PRAAT atualizado em um laboratório de fala computadorizadaem T0 e T2. Foi usado um teste t de amostras pareadas para comparação dos valores médios dos parâmetros de voz em T0 e T2 nos dois grupos. Resultados O tratamento com expansão rápida da maxila produziu um aumento significativo nos níveis auditivos e nos volumes da orelha média de todos os pacientes sem fissura e pacientes com fissura labiopalatina bilateral e níveis auditivos normais e com perda auditiva condutiva leve, durante os períodos de observação T0-T1, T1-T2, T0-T2 e T0-T3 (p < 0,05). Aumento significativo foi observado nos volumes da orelha média direita durante os períodos T0-T1, T0-T2 e T0-T3 em pacientes sem fissura e com perda auditiva moderada. Para a análise de voz, diferenças significantes foram observadas apenas entre a frequência fundamental média T0 e T2 (F0) e a porcentagem de jitter (p < 0,05) no grupo sem fissura. No grupo com fissura, não foram observadas diferenças significantes para nenhum parâmetro de voz entre os períodos T0 e T2. Conclusão A correção da anatomia palatal pela expansão rápida da maxila tem um efeito benéfico tanto na melhoria da audição quanto na função normal da orelha média em pacientes sem fissura e com fissura labiopalatina bilateral. Da mesma forma, a expansão rápida da maxila influencia significativamente a qualidade da voz em pacientes sem fissura, sem efeito significativo em pacientes com fissura labiopalatina bilateral.

Placenta Accreta - Diagnosis and Management

Placenta accreta is a potential grievous obstetric condition that calls for a multidisciplinary timely management. Placenta accreta refers to placenta that is firmly adherent to the myometrium.1 Three types of adherent placental attachments are, placenta accreta (the uterine decidua is absent and the chronic villi attaches to the myometrium directly), placenta increta (the chronic villi invades into the myometrium), and placenta percreta (the villi penetrate the myometrium up to the serosal layer).2The incidence of placenta accreta has increased ten-fold in the past 50 years.3 It can lead to excessive bleeding, haemorrhagic and neurogenic shock, sepsis, uterine inversion, or need for hysterectomy.4Previous obstetrics interventions like caesarean deliveries are the largest risk factor for the placenta accreta, or previous dilatation and curettage or previous manual removal of placenta. Increasing maternal age and parity, as well as other uterine surgeries also have increased risks. When placenta accrete is suspected, a multidisciplinary team with expertise should be there to take care of such cases. Although ultrasound and magnetic resonance image (MRI) may or may not indicate clearly an invasive placenta, the final diagnosis is made intra-operatively and is supported by histopathological examination.4Placenta accreta is associated with high morbidity and mortality of the mother and the foetus and has high demands on health resources. Antepartum haemorrhage may occur in such cases if there is associated placenta previa. MRI is the best modality for diagnosis when there is suspicion of placenta accreta clinically.

A study to assess the magnitude of atypical pneumonia by serum polymerase chain reaction in children aged 3 years to 18 years at Kempegowda Institute of Medical Sciences hospital, Bengaluru, Karnataka, India

Background: Atypical organisms are a common causative agent of pneumonia in children more than 3 years of age, causing around 10-30% of the cases. Though atypical pathogens are said to cause relatively milder form of pneumonia as compared to other bacterial and viral pathogens, severe manifestations can also occur. Early identification of these pathogens can help in starting treatment with macrolides, which can reduce the length of hospital stay and mortality. Hence in this study the prevalence of atypical organisms was identified by using serum Polymerase chain reaction (PCR).Methods: This was a prospective observational study conducted in children between 3 years to 18 years of age with clinical diagnosis of pneumonia admitted in wards and PICU in KIMS hospital. Authors excluded Immunocompromised children. Detailed history and clinical examination was done. Investigations - complete hemogram, Chest Xray, blood Culture and sensitivity and serum PCR was done for a sample size of 100 children.Results: In this study among the three atypical organisms, Legionella pneumoniae was identified in 2% of the cases by serum PCR.Conclusions: In this study among the three atypical pathogens authors could only identify Legionella pneumoniae. Prevalence of Legionella pneumoniae was 2%. While treating children aged 3 years to 18 years with pneumonia, a high degree of suspicion of atypical pathogens is required, especially in Legionella because of its high mortality rate. In such circumstances adding macrolides along with other antibiotics will be beneficial to the patients outcome and duration of hospital stay.

Assessment of knowledge and attitude about child abuse amongst parents visiting a tertiary care hospital in Bengaluru, India

Background: Child abuse is one of the problems in our society which still needs to be highlighted for general public in our country. It is a pressing human right issue and public health concern and the efforts to assess the awareness and mass education is very limited. Current study aimed to access knowledge and attitude for child abuse among parents attending a tertiary care hospital.Methods: The study was conducted amongst parents visiting pediatric OPD at Kempegowda institute of medical sciences, Bengaluru. Total 200 Parents were required to answer a series of questionnaire and then was statically analyzed.Results: It was seen that majority of parents lack knowledge regarding child abuse, 25% of parents believe that child abuse is just sexual violence, 23% parents thought that stubborn children can only be handled by physical punishment, 46% parents believed that only a girl child can be a victim of sexual abuse and only 19% had firm belief that boys can also be victim, 45% of parents believed that it is necessary to discuss with the child before making important decision concerning them, 35% parents were against the corporal punishment.Conclusions: There is a need to evolve strategies to protect the children from abuse and the measures should address both boys and girls and minimize impact.