Cord blood albumin as predictor of neonatal hyperbilirubinemia

Background: Measuring the Cord blood Albumin level and predicting neonatal hyperbilirubinemia.Methods: Prospective study was performed on 160 healthy term neonates. Relevant maternal history was collected. Cord blood was collected from the healthy term neonates at birth and cord serum albumin measured. Neonate was assessed for jaundice every day using transcutaneous bilirubinometer. Total Serum Bilirubin (TSB) was assessed if the Transcutaneous Bilirubin (TCB) values were found high and treated according to NICU protocol.Results: Study cohort was grouped as Group A, Group B and Group C based on Cord Serum Albumin (CSA) level ?3.3 g/dl, 3.3-3.8 g/dl and ?3.8 g/d respectively. Statistical analysis was done for correlation of CSA with Neonatal Hyperbilirubinemia (NH). It showed that cord serum albumin level ?3.8 g/dl is critical, as it was seen in 9.1% of neonates who developed neonatal hyperbilirubinemia (p value-0.032).Conclusions: There is a correlation between cord serum albumin level and neonatal hyperbilirubinemia. Cord serum albumin level of ?3.8 g/dl is a risk indicator in predicting the development of neonatal hyperbilirubinemia.

Clinico-bacteriological profile of neonatal sepsis

Background: Neonatal sepsis is the commonest cause of neonatal mortality responsible for about 30-50% of total neonatal deaths in developing countries. Surveillance of causative organisms and their antibiotic sensitivity pattern promotes rational use of antibiotics and antibiotic stewardship.Methods: A retrospective study, relevant data regarding the neonates diagnosed with culture positive sepsis was obtained from the case records during the period from July 2014 to June 2017. Culture positive sepsis was defined as isolation of bacterial pathogen from blood in neonates with clinical suspicion of sepsis.Results: Of the 414 neonates with clinical suspicion of sepsis, 110 neonates had blood culture positive sepsis. Sepsis was predominant in males (64.5%). Low birth weight (47.2%) and prematurity (40.9 %) were important neonatal risk factors for sepsis. Early onset sepsis occurred in 58.1% of the cases and late onset sepsis in 41.9% of the neonates. Gram-positive cocci constituted 67.52% of all isolates and gram negative 30.76%. The most frequently isolated organism in blood was methicillin resistant coagulase negative staphylococcus(MRCONS) (32.47%). Gram positive organisms included MRCONS, methicillin resistant Staphylococci aureus (MRSA), group B Streptococci (GBS), Staphylococcus aureus and Enterococci. Among Gram-negative organisms, Acinetobacter was most frequently isolated followed by Klebsiella, Escherichia coli, Pseudomonas, Citrobacter and Burkholderia species. The mortality in the study group was 13.5%. Gram negative organisms were most resistant to ampicillin and cephalosporins. Gram positive isolates were least resistant to vancomycin and linezolid.Conclusions: Gram positive sepsis was the most common type of sepsis among the neonates, although mortality was more in gram negative sepsis.

Problem Based Learning In Anatomy – Our Experience.

Background: Presently Anatomy is taught in a traditional way through lectures, small group teaching and demonstration. All these are teacher-controlled methods for teaching as per Medical Education Technology. So it was decided to introduce a learner-controlled method for teaching of Anatomy i.e. problem-based learning (PBL) with the following. Objectives:To compare the performance of the students undergoing PBL with the performance of the students taught in a traditional way To compare the perception of the students about PBL in comparison to Traditional way Materials and methods: 32 students who volunteered for the study were divided into two groups. The first group was taught cerebellum by PBL method and the second group was taught cerebrum by PBL method. Cross over method was then applied. Thereafter a theory examination was conducted. A feedback questionnaire was given to the students after the examination. Results: The average score of the students in the PBL group was more than that of the students in the lecture group in 60% questions. The score was same in 20% questions. The score was reverse in 20% of questions. PBL was appreciated and accepted by the students. It can be introduced partly in the existing curriculum.

Variations In The Formation Of The Median Nerve.

Background: Variations in the formation of median nerve can result in misinterpretation of clinical signs due to median nerve palsy and hence they are of great clinical significance. Thus this project was taken up to study these variations and also to measure the distance of the site of formation of the median nerve from the tip of the coracoid process of the scapula. Methodology: Ninety-eight formalin fixed upper limbs were used for the study (50 right, 48 left). The variations in the formation of the median nerve were noted. The level of formation of the median nerve was measured from the tip of the coracoid process of the scapula. Results: The median nerve was formed from an anterior cord of brachial plexus in two cases, both on the left side. Double lateral root of the median nerve was present in 4 specimens, 3 on the left side and 1 on the right side. Conclusion: Variations in the formation of median nerve have embryological basis and clinical significance and the distance of site of the union of two roots of the median nerve from the tip of the coracoid process will be helpful to surgeons to locate median nerve in surgeries around the shoulder.

Quality of reporting of randomized controlled trials in ten academic Indian dental journals.

Background: Biased results from poorly reported trials can mislead decision‑making in health care at all levels, from treatment decisions for the individual patient to formulation of national public health policies. Objective: To evaluate the quality of reporting of randomized controlled trials (RCTs) in ten Indian dental journals over the period 2011–2012. Materials and Methods: This study included all RCTs published as full‑text articles reported in ten Indian dental journals over the period from 2011 to 2012. The relevant trials were identified by searching Medline. Hand searching of the journals was also carried out by three of the authors to check if any potential trial was missing. Each article was assessed against the Consolidated Standards of Reporting Trials criteria tool, as described by Schulz et al. (2010). Results: The mean number of criteria present per article was 12.2 (standard deviation [SD] =2.2) and only 5 of 106 articles got total possible score. Most of the articles (69%) did not mention about justification for sample size calculation, 89% of the articles did not mention about allocation concealment, 86% of the articles did not mention about funding and 63% of the articles did not mention about limitations of the study. Conclusion: The quality of reporting of Randomized clinical trials in ten Indian academic journals was poor.

Oral manifestations and radiographic changes in the jaw-bones of patients with end-stage renal disease onmaintenance hemodialysis: a descriptive study / Estudo descritivo das manifestações bucais e alterações radiográficas em maxilares de pacientes com doençarenal terminal e sob hemodiálise

Objectives: The purpose of the present study was to assess the oral manifestations and radiographic changes in the jawbones of patients undergoing hemodialysis, diagnosed with end-stage renal disease (ESRD). Methods: Forty patients on maintenance hemodialysis were clinically examined for oral manifestations and evaluated for radiographic changes in the jaws with panoramic and intra-oral periapical radiographs. Results were expressed as Percentage. Results: Out of 40 patients, 37 patients (92.5%) showed at least one or more oral manifestations. The most common oral manifestations were mucosal pallor (70%), xerostomia (57.5%), petechiae and ecchymoses (37.5%), and less common were taste alterations (15%), uremic odor (7.5%), coated tongue (10%) and mucosal pain (2.5%). Radiographic changes seen were loss of lamina dura (22.2%), altered trabecular pattern (5.5%), multiple radiolucent lesions (5%), and pulp calcification (2.7%). Conclusions: Most of the patients presented with oral signs and symptoms. However it was observed that patients demonstrating radiographic changes were mostly those who were on dialysis for a relatively long duration.

Objetivos: O objetivo do presente estudo foi avaliar as manifestações orais e alterações radiográficas nos maxilares de pacientes submetidos à hemodiálise e com diagnóstico de doença renal em estágio terminal (DRET). Métodos: 40 pacientes em hemodiálise de manutenção foram examinados clinicamente e avaliados radiograficamente por meio de radiografias panorâmicas e periapicais em busca de manifestações orais nas mandíbulas. Resultados: Dos 40 pacientes, 37 pacientes (92,5%) apresentaram pelo menos uma ou mais manifestações orais. As manifestações orais mais comuns foram: palidez da mucosa (70%), xerostomia (57,5%), petéquias e equimoses (37,5%); e menos comuns: alterações do paladar (15%), odor urêmico (7,5%), língua saburrosa (10%) e mucosa dolorida (2,5%). As alterações radiográficas observadas foram a perda da lâmina dura (22,2%), padrão trabecular alterado (5,5%), lesões radiolúcidas múltiplas (5%) e calcificação pulpar (2,7%). Conclusões: A maioria dos pacientes apresentava sinais e sintomas orais. Entretanto, foi observado que os pacientes demonstrando alterações radiográficas foram principalmente aqueles que estavam em diálise por um período relativamente longo.

A baseline study of rural Bancroftian filariasis in southern India.

Night mass blood surveys were carried out for parasitological evidence of Bancroftian filariasis in 45 rural areas belonging to 9 National Filaria Control Program (NFCP) zones of East Godavari and West Godavari districts of Andhra Pradesh, India during the period 1998 to 2001. Mf prevalence range between 2.9 to 10.2%, and mf intensities in 20 mm3 blood samples ranged from 1-281. The present study explains the trend of microfilaria dynamics in the rural population, where mass drug delivery has been implemented since 1997, and anti-larivicidal and adulticidal control measures have not been adopted.

Control of persistent vesical bleeding due to radiation cystitis by intravesical application of 15 (S) 15-methyl prostaglandin F2-alpha.

A 45 year old female who received radiotherapy for stage II-B uterine cervical cancer four and half years ago, presented with persistent hematuria due to radiation cystitis. 15 (S)-15-methyl prostaglandin F2-alpha (1 mg in 100 ml of normal saline) was instilled into the bladder daily for two days. The severity of bleeding decreased considerably. However, significant hematuria recurred 19 days later which continued despite bladder irrigation with normal saline. 1 mg of 15 (S) 15-Me PGF2 alpha mixed with hydroxyethyl cellulose gel to a volume of 10 ml was then instilled into the urinary bladder daily for three days and macroscopic hematuria ceased. Urinary frequency and urgency were the side effects which lasted for ten days. There has been no recurrence of macroscopic hematuria during the five months follow-up. In conclusion, 15 (S) 15-Me PGF2-alpha may be administered intravesically to control moderate hematuria due to radiation cystitis.