ARCHIVES(Journal of Harmonized Research in Medical and Health Sciences)


Title: IUD ARE WE JUSTIFIED IN DOING POSTPARTUM INTRACESAREAN INSERTION
Author: Dr. Kavita Agarwal
Keyword: Guest Editorial
Page No: i-ii
Abstract: Post Partum Intra Uterine Contraceptive Device (PPIUD) is a solution to rapid repeat pregnancy, is safe, cost effective, long acting, reversible method of contraception which does not interfere with b reast feeding and is included in category 1 of WHO Medical Eligibility Criteria1. Caesarean delivery gives opportunity to obstetrician to counsel woman for contraceptive services. Intracesarean PPIUD can be inserted under vision, thus obviating the fear of perforation of uterus. The main problem encountered is the non visibility of PPIUD strings during follow ups after post partum intracesarean IUD insertion. Sunita Singal et al2 found strings were visible in only 62% of women in follow up visit at one month after post partum intracesarean CuT380A IUD insertion. Visbility of strings increased to 88% at 12 months follow up visit. Pesona Grace Lucksom et al3 followed woman at 6 weeks and 3 months following CuT 380A IUD insertion intracesarean. Only 10% had tail visibility at 6 weeks which increased to 41% at 3 months follow up visit. Lester et al4 found string visibility to be only 44% at 6 months follow up after post partum intracesarean CuT 380A IUD insertion. During follow up visits, string visibility through the external os reassures both client and service provider about its intrauterine location and helps in its removal as and when requested by woman. Non visibility of PPIUD strings during follow ups after post partum intracesarean IUD insertion insertion is a source of anxiety for both client and health care provider. Invasive methods may be required for removal, multiple hospital visits required which have direct and indirect financial impact also. The probable solution for non visibility of strings in the post partum intracesarean CuT 380A IUD insertion could be Cu375 IUD usage. After expulsion of placenta, fundus of the uterus corresponds to five months pregnant uterine size. The length of string of CuT380A IUD is 11.5 cm whereas Cu375 IUD has longer nylon thread of 19.4cms. Therefore, post partum insertion of Cu375 IUD may lead to string visibility in more number of women. Cu375 IUD insertion is done manually within 10min after delivery of placenta and strings are guided through cervical canal by fingers. Bhutta et al5 studied 40 subjects, followed up till 6 months and reported thread visibility in 98% women in follow up at 1 week postpartum after post partum intracesarean Cu375 IUD insertion. Also, Farhat et al6 studied 240 women on Cu375 IUD post partum intracesarean insertion, followed up to 6 months and found 94.7% women had thread visibility at 1st follow up visit at 6 weeks. Thus, Cu375 IUD insertion during caesarean section can increase string visibility to 95% - 98% compared to only 10% - 62% with CuT380A IUD. Menstrual complaints, pelvic pain at follow up visits in study by Singal et al2 with CuT380 IUD was similar to study by Farhat et al6 with Cu 375 IUD use in postpartum intracesarean insertion. Expulsion rate is 1-4% with both CuT380A PPIUD and Cu 375 PPIUD in studies by Lester et al4 and Farhat et al6. The limitations of Cu 375 IUD usage is the short life span of 5years compared to CuT 380A IUD with life span of 10 years. To conclude, both Cu 375 IUD and CuT 380A IUD are safe postpartum method of contraception but Cu375 IUD if used for post partum intracesarean IUD insertion solves the problem of non visibility of strings, avoids radiological investigations and invasive procedures at follow up visits leading to its increased acceptance in eligible women. More studies are required with Cu375 IUD for postpartum intracesarean IUD insertion with large sample size and long follow up. Download PDF


Title: BITE IT RIGHT- A REVIEW
Author: Dr Ifzah and Dr Zain Patel
Keyword: Mastication, Bite force, Bite force recording devices
Page No: 153-157
Abstract: Bite force is a key predictor of masticatory performance. In dentistry bite force determination can be used to understand the mechanics of mastication, muscle activity and mandibular movements during mastication and masticatory performance to study the influence of physiological factors on changes in occlusal forces. Bite force levels vary with method, sex, age among other variables. Keywords: Mastication, Bite force, Bite force recording devices Download PDF


Title: A RETROSPECTIVE ANALYSISOF TSH RESULTSOF CHILDREN UNDER THE AGE OF FIVE YEARS ANALYSED AT THE NAMIBIA INSTITUTE OF PATHOLOGY, WINDHOEK, NAMIBIA
Author: Biggar Shanice B, Munyaradzi Mukesi*, and Sylvester Rodgers Moyo
Keyword: Thyroid; Children; Abnormal; Windhoek; Namibia
Page No: 158-163
Abstract: Thyroid hormones are essential for central nervous system development and growth of the babies. Thyroid disorders can negatively affect the normal metabolic processes within the body and cause perman ent mental retardation in children. Neonatal screening, with thyroid stimulation hormone (TSH) as a screening tool, can give a better understanding of the foetal thyroid function. A retrospective cross sectional study was conducted over a six year period from 2009 to 2014 on TSH records collected on children under the age of five years who had a TSH test done while in the Windhoek Central and Katutura Hospitals, Windhoek, Namibia. A total number of 263 TSH records were included in this study. There were more males (58.2%) than females (38.4%). The prevalence of abnormal TSH was found to be 21.3%, with low TSH values being predominant within the population (20.2%). Males had more abnormal TSH values (40%) than the females (21%). The high prevalence of abnormal TSH is a cause for concern as this may be an indication of thyroid disorders in neonates and children. Early neonatal screening and detection of these thyroid disorders may increase the chance for the child to live a normal and healthy life. Key words: Thyroid; Children; Abnormal; Windhoek; Namibia Download PDF


Title: EARLY EXPERIENCE WITH CT-GUIDED CORE BIOPSY OF LUNG TUMORS: DOES SIZE PREDICT DIAGNOSTIC ACCURACY AND COMPLICATION RATE?
Author: Shahnawaz Ansari M.D., David Schwartzberg M.D., Ryane Panasiti M.D., Utkarsh Anil B.A.
Keyword: Lung cancer, Biopsy, pneumothorax
Page No: 164-168
Abstract: Lung cancer remains the leading cause of cancer-related deaths and is expected to increase over the next decade. The World Health Organization and the National Comprehensive Cancer Network (NCCN) hav e advocated a low dose computed tomography (LDCT) scan of the chest for individuals at high risk for lung cancer3. With the proliferation in CT scans performed annually, there has been a corresponding increase in lung nodules identification resulting in an increase in invasive procedures to obtain a tissue diagnosis8. Given the increasing number of sub-centimeter lung nodules detected, this pilot study sought to determine if there is a size limit where a successful biopsy is outweighed by the potential risks, i.e. the risk of clinically significant pneumothorax. A retrospective review of CT-guided core lung biopsies performed on 98 patients between January 2013 and January 2015 was performed. The diagnosis and pneumothorax rates were analyzed for <1 cm, 1-2 cm, 2-3 cm, 3-5cm, and >5 cm pulmonary lesions. The presence of clinically significant pneumothorax (requiring tube thoracostomy) was obtained from the patient Electronic Medical Record (EMR). The overall diagnosis and pneumothorax rates were 94.0% and 7.0% respectively. The diagnosis rate was 87.5% for <1 cm, 86.67% for 1-2 cm, 100% for 2-3 cm, 95.45% for 3-5 cm, and 100% for >5 cm pulmonary lesions. The clinically significant pneumothorax rate was 12.5% for <1 cm, 10.0% for 1-2 cm, 18.7% for 2-3 cm, 0% for 3-5 cm, and 0% for >5 cm pulmonary lesions. Our findings show a high level of diagnostic accuracy for core biopsies of lung tumors of all sizes, including sub-centimeter lung nodules while the clinically significant pneumothorax rate remained unchanged. Given this data, we believe core biopsy of small (<1cm) pulmonary nodules can be performed without a significant rise in the rate of clinically significant pneumothorax, providing for earlier detection and treatment of lung carcinoma. Keywords: Lung cancer, Biopsy, pneumothorax. Download PDF


Title: FIND THE INCIDENCE OF COMPLICATIONS RELATED TO INFUSION THERAPY AMONG THE CHILDREN ADMITTED AT PAEDIATRIC WARD IN SELECTED HOSPITALS AT MORADABAD.
Author: Tulika Srivastava*, Mr. Nageshwar V., Mr. Sandeep K. Raju.
Keyword: Incidence, complications related to infusion therapy, children and paediatric ward.
Page No: 169-175
Abstract: Background of the study: Peripheral infusion is a stressful procedure for children. It is estimated that over 80% of all children entering hospital to receive IV therapy, some of the minor problems w ere pain, trauma, swelling, joint immobility, but these can lead to life threatening conditions like thrombosis, embolism, variety of infections and so on. Aim: The main objective of the study was to find the incidence of complications related to infusion therapy among the children admitted at paediatric ward in selected hospitals at Moradabad. Material and Methods: The descriptive research design was used. The study was conducted at various hospitals of Moradabad, U.P. 100 children’s (1-18 years) selected as a sample for the study. Non-probability convenient sampling technique was used for the selection of samples. The tool designed to collect the data were sociodemographic Performa and observational checklist regarding incidence of complications related to infusion therapy. Results: Data gathered were analyzed by using descriptive statistics in terms of frequency, percentage. The results revealed that out of 100 children were had 82% infection, 41% infiltration, 33% air embolism, 25% hematoma, 7% phlebitis, 4% thrombophlebitis and 1% cellulitis. Conclusion: This study concluded that majority of incidence of complication related to infusion therapy was infection i.e 82%. Keywords: Incidence, complications related to infusion therapy, children and paediatric ward. Download PDF


Title: PEDIATRIC DENTAL IMPLANTS
Author: Dr Ifzah and Dr Zain Patel
Keyword: implants, Osseointegration
Page No: 176-179
Abstract: Teeth are integral part of the stomatognathic system. Apart from teeth being absent congenitally, caries and periodontal breakdown may also be a reason for the absence of teeth from the dental arch. Dental implants are considered as a treatment modality for children. Key Words- implants, Osseointegration. Download PDF


Title: EFFECTS OF DICHLORVOS INHALATION ON THE KIDNEY IN ADULT WISTAR RATS
Author: Tela IA.* and Sagir MS.
Keyword: Dichlorvos, inhalation, kidney, serum electrolytes
Page No: 180-187
Abstract: Dichlorvos, (2, 2, dichlorovinyl dimethyl phosphate; DDVP), is an organophospharous compound used as insecticides and pesticides in homes and farms. It constitutes the active ingredient of Ota-piapia or Madarar piapia, a locally formulated insecticide in Nigeria. It is absorbed into the body via inhalation, dermal or oral routes and metabolized by the liver and excreted by the kidney. The frequency of renal failure is on the increase. The study aimed at assessing the effects of dichlorvos on the histology of the renal cortices in Adult Wistar Rats. Twenty - five adult wistar rats weighed about 195 – 400g were randomly selected and divided into five groups, two positive and negative groups and three treated groups exposed to 11.25mg/m3, 7.50 mg/m3, and 3.75 mg/m3, of dichlorvos in 96% (purity) ethanol solution and experimented for 28 days. The animals were sacrificed twenty four hours after the last exposure, the blood and the kidney tissues were collected for serum and histopathological analyses. The slides were observed under light microscope while the blood was run for serum analysis. One way analysis of variance (ANOVA) followed by Post – hoc test (Tukey) was conducted for the serum analysis. Graded degenerations in kidney cellularity were observed. There was significant difference (P < 0.001) in the serum electrolytes across the groups. Prolonged use of dichlorvos could be injurious to the architecture of renal cortex that might lead to renal failure. Keywords: Dichlorvos, inhalation, kidney, serum electrolytes Download PDF


Title: PROFILE OF HYPERCALCEMIA WITH DEMOGRAPHIC CHARACTERISTICS, STUDY CARRIED IN A TERTIARY CARE CENTRE AT SMHS HOSPITAL, GMC, SRINAGAR.
Author: Dr. Mohammad Hayat Bhat, Dr. Henna Naqash, Prof. Parvaiz Ahmad Shah
Keyword: Elderly, hyperparathyroidism, cholecalciferol, hypercalcemia, malignancy.
Page No: 188-194
Abstract: Objective: The number of patients with hypercalcemia due to different causes has been ever increasing in our settings, mostly because of both prescribed as well as over the counter supplements. In o rder to see the trends of such patients and to understand the most common etiology, the present study was conducted in this hospital over a period of 16 months. Methods: Over a period of 16 months, all such patients who were admitted in this hospital with symptomatic hypercalcemia due to different causes were studied and their data was collected and interpreted. Besides serum calcium levels, the serum levels of PTH and 1, 25 dihydroxy Vitamin D were measured. Results: In this study of 16 months duration, a total of 24 patients were admitted with hypercalcemia, out of whom 13 patients had Vitamin D intoxication (54%) as the cause, 9 patients had malignancy, 3 patients were having primary hyperparathyroidism and 2 patients had hypercalcemia of undiagnosed cause. Conclusion: Hypercalcemia due to vitamin D intoxication (a treatable cause) is becoming the leading cause of hypercalcemia in this setting of a tertiary care centre. Keywords: Elderly, hyperparathyroidism, cholecalciferol, hypercalcemia, malignancy. Download PDF


Title: A STUDY TO EVALUATE THE EFFECTIVENESS OF ROLE PLAY AND VIDEO ASSISTED TEACHING ON PREVENTION AND TREATMENT OF SWINE FLU AMONG HIGH SCHOOL STUDENTS IN SELECTED SCHOOLS IN MORADABAD.
Author: Gaurav Kumar, Mr. Prabhu J, Prof. Dr. N.V. Muninarayanappa, Mr. Nageshwar V.
Keyword: Swine flu, knowledge, prevention, role play, video assisted teaching.
Page No: 195-200
Abstract: Swine flu refers to swine influenza or the viral infection caused by any of the several types of swine influenza virus. Only people who used to have direct contact with pigs were observed to get swin e flu in the past. But, H1N1 virus is a new swine flu virus and it contains the genetic material of swine, bird and human influenza virus. H1N1 is an Influenza A virus. Swine flu can produce a number of symptoms in both adults and children. the study shows that, in India day by day the graph of infected person has been climbed up so, it is important to take into consideration about this disease as it may prove deadly one. The intensity of this disorder can be lowered by diagnosing and taking proper treatment. The main objective of the study was to assess the level of knowledge on prevention and treatment of swine flu among high school students in selected high school at Moradabad, U.P. Quasi experimental research design was adapted. The study was conducted at high school in Moradabad. 90 high school students were selected as a sample by simple random sampling technique. The tool designed to collect the data were socio demographic Performa, Self-structured knowledge questionnaire on prevention and treatment of swine flu. The study revealed that out of 90 sample, 42 (46.67%) sample had poor knowledge, 46 (51.11%) sample had average knowledge and 2 (2.22%) sample had good knowledge on prevention and treatment of swine flu during the pretest, and after intervention 15 (16.67%) sample had poor knowledge, 59 (65.56%) sample had average knowledge and 16 (17.77%) sample had good knowledge on prevention and treatment of swine flu the posttest among high school students in selected high schools at selected high school during. The chi-square test showed that there was no significant association selected demographic variables with level of knowledge. Overall knowledge of high school students on prevention and treatment of swine flu was Average. So by the help of different teaching method and teacher can improve the knowledge of students on prevention and treatment of swine flu. And also teachers can make study interesting by using different method of teaching. Keywords: Swine flu, knowledge, prevention, role play, video assisted teaching. Download PDF


Title: PERCEPTION OF DENTAL STUDENTS TOWARDS OSCE, A STANDARDIZED CLINICAL ASSESSMENT METHOD
Author: Dr. Samer Kasabah and Dr. P Sridhar Reddy
Keyword: Assessment, Education, Formative, OSCE, Validity
Page No: 201-204
Abstract: OSCE (objective structured clinical examination), one of the standardized clinical assessment techniques, is widely implemented in medical and dental education in European countries. In Saudi Arabia, OSCE alertness is expanding, and a few tentative attempts have been made in its execution. This article describes the experience by using an experimental study of OSCE for formative assessment of dental diagnostic and surgical skills. Apart from our experience in OSCEs, the other purpose was to study their validity, objectivity, feasibility, acceptability to students and faculty, and impact on student performance. The result showed that the OSCE was able to test clinical judgment and skills and is a better method for evaluation. Although the students reported that it was well organized and that the time allocated for each station was appropriate. The dental students perceived that the OSCE was a suitable method to test surgical clinical judgment and skills. Keywords: Assessment, Education, Formative, OSCE, Validity Download PDF


Title: THE AWARENESS OF SAUDI PEOPLE FOR BLOOD DONATION: CURRENT SITUATION AND FUTURE DIRECTIONS
Author: Hessah Alsulami
Keyword: Awareness, Blood donation
Page No: 205-208
Abstract: In Saudi Arabia, blood donation system depends mainly on non-voluntary donors or what is called, replacement policy where the patient's family or friends donate blood to replace their patient require ment. Such a policy puts effort on patient's family to find blood donors. Moreover, the safety of the blood is jeopardized, because such donors might hide some information in order to donate. On the other hand, implementing voluntary blood donors system would lead to markedly decrease in the blood supply because of many reasons such as the infrastructure for the blood transfusion service which is a hospital based blood banking system and the awareness of Saudi people for blood donation. The aim of this study is to assess the level of awareness for blood donation among Saudis. Method: A questionnaire based cross-sectional study was carried out in Riyadh, the capital city of Saudi, in the period from February to June 2014. The questionnaire was prepared after a review of published reports that assesses the awareness toward blood donation in different countries and was distributed equally in the four main districts of Riyadh (north, south, east, and west) attracting Saudi people in shopping malls, mosques, and other public places. Result: Of 475 participants 67% didn't know the benefits of blood donation, 59% didn't know the location of the blood donation center in their area, 49.7% underestimated the length of blood donation process, 64.6 %, didn't have any idea about the need for blood in their area or the city, 91.2% didn't know the date for World blood donor day, and 74% believed that the blood should be free for patients who need it and patients shouldn't be asked to replace the blood they got. Conclusion: The study shows that Saudi population are not enough aware about the blood donation system as well as the need for blood in the country. This might be the cause for decreased number of voluntary blood donors. This study also highlights the need for using public media to increase the level of awareness which we miss in Saudi. Key words: Awareness, Blood donation Download PDF