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   Table of Contents - Current issue
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April-June 2019
Volume 8 | Issue 2
Page Nos. 77-149

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ORIGINAL ARTICLES  

Social support and household disaster evacuation readiness in a flood-affected rural village in Tamil Nadu, South India Highly accessed article p. 77
Venkatesh Ashok, Bijaya Nanda Naik, Ravi Philip Rajkumar, KC Premarajan
DOI:10.4103/ijhas.IJHAS_76_18  
OBJECTIVE: To assess the social support and household disaster evacuation readiness among flood-affected households in a rural village of Tamil Nadu. METHODS: We conducted this cross-sectional analytical study in the flood-affected Koonimedu village of Villupuram District, Tamil Nadu, 8 months after the flood. One adult member (age >18 years) from each of the flood-affected households was included and interviewed face to face at his/her house. Information on sociodemographic details, loss of property, and household evacuation readiness plan was obtained using a semistructured pretested questionnaire. Social support was measured using the Crisis Support Scale (CSS). RESULTS: Nearly 60% of the households were still waiting for government assistance for house repair. Less than a quarter of households reported adequate social support. Availability of people to listen to them, able to discuss their thoughts and feelings, and contact with people in similar situations showed improvement after 8 months of flood. CSS score on feeling letdown showed a significant increase 8 months after the flood. Although all the households were ready to evacuate if flood recurs, none have undergone training on disaster preparedness. Majority of the households reported to secure ration card first during evacuation. CONCLUSION: The level of adequate social support during flood as well as 8 months after the flood was low among the study population. Although all households have their own disaster evacuation plan, none have been given information and training on disaster preparedness.
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Feasibility of endoscopic dacryocystorhinostomy in patients with coexistent atrophic rhinitis and chronic dacryocystitis Highly accessed article p. 83
Satvinder Singh Bakshi
DOI:10.4103/ijhas.IJHAS_1_18  
AIM: Atrophic rhinitis and chronic dacryocystitis are common in India. Sometimes, both of these conditions coexist. Conventionally, these patients are operated by external approach; however, we endeavor to prove the efficacy of the endoscopic approach in these patients. MATERIALS AND METHODS: Six patients with atrophic rhinitis and chronic dacryocystitis were seen by the authors over a period of 2 years. They were treated preoperatively for atrophic rhinitis for 6–8 weeks, following which they were operated by endoscopic approach. RESULTS: A total of ten eyes were operated, two of which required revision surgery, which was also operated by the endoscopic approach. The operative time and blood loss were comparable to those of normal patients; however, there was increased crusting and delayed wound healing, requiring prolonged follow-up. CONCLUSION: Meticulous preoperative preparation and regular postoperative follow-up help improve the results of endoscopic dacryocystorhinostomy in patients with atrophic rhinitis.
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Sociodemographic determinants of substance use among school-going adolescents in Delhi, India p. 87
T Varun Kumar
DOI:10.4103/ijhas.IJHAS_103_18  
BACKGROUND: Adolescents experience a rapid physical and emotional growth. Conflicting and influential cultural messages account for the unique nature of their health concerns. Recent studies have found an increased use of substance among adolescents, and the present study is designed to find the socioeconomic determinants of substance use among adolescents in Delhi, India. MATERIALS AND METHODS: A descriptive cross-sectional study was conducted using a self-administered questionnaire adapted from the Global Youth Tobacco Survey among school-going adolescents from February 2017 to September 2017 in Delhi, India. All the students studying in classes 11 and 12 were included in the study. RESULTS: The study found that the prevalence of ever smokers and current smokers was 16.4% and 13.1%, respectively. Alcohol consumption was found in 12.5% of the study participants. Approximately 1.1% and 0.4% of the study participants reported using hashish and solvent, respectively. All forms of substance use were found to be significantly more among male adolescents (P = 0.000). CONCLUSION: The prevalence of substance use was high among school-going adolescents in Delhi, and there is an urgent need to take effective steps in curbing this problem.
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Stress assessment of mandibular incisor intrusion during initial leveling in continuous arch system with different archwire shapes of superelastic nickel-titanium: A three-dimensional finite element study p. 92
Pornpat Theerasopon, Weerachai Kosuwan, Chairat Charoemratrote
DOI:10.4103/ijhas.IJHAS_3_19  
INTRODUCTION: Orthodontic leveling of mandibular teeth with deep curve of Spee usually creates an intrusive force on mandibular incisors with labial tipping. After placing an archwire, a deactivation force causes tooth movement within the periodontal space which induces the first step and is the first signal for further remodeling processes. This study aimed to investigate stress distribution and types of mandibular incisor movement after initial leveling with different nickel-titanium (Ni-Ti) archwires using finite element analysis. MATERIALS AND METHODS: A three-dimensional finite element model of well-aligned mandibular teeth with a deep curve of Spee was created to investigate intrusive force on mandibular incisors within the periodontal ligament (PDL) space. Round, square, and rectangular superelastic Ni-Ti archwires of 0.016” in height were tested to compare stress magnitude and the pattern of distribution on the root surface and PDL as well as the pattern of tooth displacement between the archwires. RESULTS: Intrusive force by an archwire within the PDL space caused the highest stress at both labial and lingual cervical roots, but much higher stress was found at the labial than the lingual cervical roots. The highest labial stress was more cervical than lingual in all models. Round wires showed much higher stress than either square- or rectangular-shaped archwires. Displacement in the labial direction of round wires moved the farthest, whereas square and rectangular wires showed less labial displacement. CONCLUSIONS: Lower incisor intrusion with round wires produced more stress at the labial cervical root and tipped more labially compared to square and rectangular archwires.
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Assessment of Rasa dusti lakshanas among patients with polycystic ovarian disease p. 98
Rajani Kulkarni, M Subash Chandra Bose, DT Usha
DOI:10.4103/ijhas.IJHAS_77_18  
BACKGROUND: Rasadushti doashas can predispose a patient to metabolic disorders such as polycystic ovarian disease (PCOD). Hence, it is important to screen patients of PCOD with Rasa dusti lakshanas in routine clinical checkups. This study conducted to assess the presence of Rasa dusti lakshanas in PCOD. METHODS: This cross-sectional hospital-based study was conducted among fifty consecutive previously diagnosed patients with PCOD attending JSS Ayurveda Hospital from January to December 2017. After obtaining written informed consent, the data on demographic details, duration of PCOD, prognosis of disease, and rasa dushti lakshanas were collected in a pretested structured questionnaire by interview technique. RESULTS: Among the fifty patients with PCOD included in the present study, majority belonging to 21–25 years' (44%) age group and majority 15 (30%) were obese Category II. It was observed that, as the Rasa dusti nidana scores increase, there was also increase in the Rasa dusti lakshanas among patients with PCOD. This correlation was found to be strong and statistically significant (r = 0.764, P < 0.05). As the Rasa dusti lakshana scores increase, there was also increase in the clinical signs and symptoms of PCOD among the study patients. This correlation was found to be strong and statistically significant (r = 0.631, P < 0.05). CONCLUSION: The present study has revealed that Rasa dusti nidana was seen evidently in the manifestation of PCOD.
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Asymptomatic respiratory dysfunction in patients with gastroesophageal reflux disease p. 103
K A Sudarshan Murthy, M Bhanukumar, CM Tejamani, Aparna R Menon
DOI:10.4103/ijhas.IJHAS_20_18  
BACKGROUND: Gastroesophageal reflux disease is the primary cause for many conditions affecting extraesophageal structures. OBJECTIVE: The objective of the study is to investigate the relation between reflux disease and asymptomatic respiratory dysfunction and examine correlation between the respiratory dysfunction with severity of gastroesophageal reflux disease (GERD) spectrum. METHODOLOGY: A total of 242 patients were subjected to pulmonary function test (PFT) using spirometer-G procedures. Forced expiratory volume 1 s (FEV1), forced vital capacity (FVC), FEV1/FV C ratio, and peak expiratory flow rate (PEFR) were measured. Patients in test group were treated with proton-pump inhibitor (PPI) and esomeprazole 40 mg twice daily for 3 months. They were subjected to PEFR at the end of the study. Analysis was performed using SPSS version. RESULTS: Age and PFT parameters FEV1, forced expiratory flow (FEF) 25–75, PEF, and PEFR were compared groupwise and were found to be statistically significant except FEV. As the severity of GERD increases, severity of pulmonary disorder also increases. In Group 1A, 56.5% patients had normal PEFR and 43.4% PEFR was reduced showing statistically significant. In patients with abnormal PFT, 74.2% had mild esophagitis, 15.1% had moderate esophagitis, and 10.6% had severe esophagitis showing statistically significant. Mean PEFR before treatment showed 344.1 ± 79.22. After 3 months of esomeprazole 40 mg, twice daily mean increased 409.08 ± 100.00. In Group 1B, PEFR before treatment noted 342.0 ± 53.77. Significant improvement was seen in PEFR with mean of 506.00 ± 52.64 with PPIs. CONCLUSIONS: GERD is associated with asymptomatic respiratory dysfunction. There is strong and direct relationship between the severity of respiratory disorders, detected by FEV1 and FEV1/FVC, FEF25–75, PEF, PEFR, and severity of GERD. This study demonstrated significant improvement in PEFR values, with adequate treatment of GERD.
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Intestinal carriage of drug-resistant Gram-negative bacteria belonging to family Enterobacteriaceae in children aged 3–14 years: An emerging threat p. 108
Raminder Sandhu, Aditi Aggarwal, Pallavi Sayal, Surinder Kumar
DOI:10.4103/ijhas.IJHAS_74_18  
BACKGROUND: Intestinal colonization by the members of family Enterobacteriaceae represents a major step in the development of systemic infection. MATERIALS AND METHODS: A total of 100 stool samples were taken from healthy children aged between 3 and 14 years. A structured questionnaire concerning child's lifestyle, predisposing factors as well as risk factors was illustrated. Detection of microorganisms was done by standard laboratory procedures which included microscopy, culture identification, and antibiotic susceptibility testing. RESULTS: Thirty-three of 100 participants (33%) carried Escherichia coli (66.7%), Klebsiella spp. (27.3%), and Citrobacter freundii (6.1%). Underweight children showed the highest colonization rate (84.8%). Previous exposure to antimicrobial agents (60.6%), rural housing (60.6%), maternal education (57.6%), and nonimmunized status (51.5%) were significantly associated with high carriage among children. The pathogens revealed high resistance to ampicillin (E. coli, 90.9%; Klebsiella spp., 100%; and C. freundii, 100%), co-trimoxazole (E. coli, 81.8%; Klebsiella spp., 88.9%; and C. freundii, 100%), cefuroxime and cefotaxime (E. coli, 81.8% and 63.6%; Klebsiella spp., 100% and 88.9%; and C. freundii, 100% and 100%). Aminoglycoside depicted good susceptibility (gentamicin and amikacin) with resistance rates of 27.3% and 13.6% in E. coli, 33.3% and 44.4% in Klebsiella spp., and no resistance in C. freundii. Carbapenems (imipenem and meropenem) looked promising with low resistance levels (E. coli, 27.3% and 13.6%; Klebsiella spp., 33.3% and 22.2%; and C. freundii, 50% and 00%). CONCLUSION: High rate of colonization in healthy children with drug-resistant members of family Enterobacteriaceae was observed. The fecal flora of children in the community represents a huge potential reservoir of strains resistant to multiple antimicrobial agents and can be challenging to treat, as their therapeutic options are few.
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Relevance and interrelationship of progesterone receptor, Ki67, and p53 in meningiomas: An immunohistochemical analysis in 273 cases p. 116
Ishita Pant, Sujata Chaturvedi, Chandra Bhushan Tripathi, Gurbachan Singh
DOI:10.4103/ijhas.IJHAS_82_18  
BACKGROUND: Meningiomas are among the most common of central nervous system neoplasms. These are classified into meningiomas with low risk of recurrence and aggressive behavior (World Health Organization [WHO] Grade I) and meningiomas with greater likelihood of recurrence and aggressive behavior (WHO Grade II and Grade III) according to the WHO 2016 criteria. A host of markers are implicated in the genesis, progression, and recurrence of meningiomas. This study was undertaken with the aim to analyze the sociodemographic profile of various grades of meningiomas and to assess the relevance and correlation between progesterone receptor (PR), Ki67, and p53 among these. MATERIALS AND METHODS: Retrospective analysis was performed for 273 cases of intracranial and intraspinal meningiomas. All intracranial and intraspinal meningiomas were graded according to the WHO 2016 criteria. Immunohistochemistry was performed using PR, Ki67, and p53 in 273 cases. Statistical analysis was performed. RESULTS: According to the WHO 2016 grading system, 254 were Grade I (93.04%), 14 were Grade II (5.13%), and 5 were Grade III (1.83%) meningiomas. According to the histological type, among Grade I, 207 meningiomas were transitional (75.82%), 11 meningothelial (4.03%), 11 angiomatous (4.03%), 8 psammomatous (2.93%), 6 fibroblastic (2.19%), 5 microcystic (1.83%), 4 metaplastic (1.47%), and 2 secretory (0.73%). Among Grade II, there were 13 cases of atypical meningiomas (4.76%) and 1 case of clear-cell meningioma (0.37%). Among Grade III, 3 meningiomas were rhabdoid variant (1.09%) and 2 cases were anaplastic meningiomas (0.37%). In all the cases, correlation with PR, p53, and Ki67 was assessed. CONCLUSION: Immunohistochemical evaluation of PR status, p53 expression, and Ki67 labeling index do add information to the routine histopathological evaluation of meningiomas. In addition, these markers do help in assessing the biological behavior of meningiomas.
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Attitude of future doctors toward psychiatry: A cross-sectional study at a medical college in Eastern India p. 123
Snehanshu Dey, Soumya Swaroop Sahoo, Udit Kumar Panda, Jigyansa Ipsita Pattnaik, Subhankar Swain
DOI:10.4103/ijhas.IJHAS_102_18  
INTRODUCTION: Psychiatry is one of the emerging branches in medicine which has made rapid strides of late. However, the attitude of students toward psychiatry has not been favorable and it is one of the less popular subjects in the medical curriculum. In the present study, we explore the attitudes toward psychiatry (ATP) among the final-year students of a medical college of eastern India. MATERIALS AND METHODS: In this cross-sectional descriptive study, 147 final-year students were approached, of which 104 students consented for the study. They were assessed regarding their ATP as a subject, psychiatric patients, and illness and the treatment under the respective domains of ATP-30 scale. The analysis involved descriptive analysis of the data. RESULTS: A neutral to negative attitude was observed toward psychiatry as a subject in the students. The mean ATP score among the female students was slightly higher than the male students. The most neutral responses were received in the items such as “psychiatric illness deserves at least as much attention as physical illness,” “psychiatric hospitals have a specific contribution to make,” and “if we listen to them, psychiatric patients are just as human as other people.” CONCLUSION: The finding in our study is an indication of lacunae in the present undergraduate curricula and training in relation to psychiatry as subject of medical science. There is a need to reevaluate this aspect of undergraduate psychiatry teaching and look for potential solutions.
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Laser-assisted root coverage procedure in gingival recessions: A randomized controlled clinical study p. 128
R Divakaran, Joann Pauline George, Ankita Jha, Smiti Bhardwaj, Divya Khanna
DOI:10.4103/ijhas.IJHAS_103_17  
BACKGROUND: Laser de-epithelialization (LD) facilitates periodontal wound healing. This clinical trial aims to evaluate the clinical outcome of coronally advanced flap with subepithelial connective tissue graft and LD (CAF + SCTG + LD) and compare it with CAF + SCTG in the treatment of gingival recession. MATERIALS AND METHODS: Fifteen patients presenting with one pair of bilaterally symmetrical Miller's Class I/Class II buccal gingival recessions were enrolled for the study. De-epithelialization of the test sites was performed with diode laser (810 m), whereas control sites received sham laser application followed by CAF and SCTG. RESULTS: Six months postsurgically, comparable complete root coverage was observed in sites treated with CAF and SCTG with LD and CAF and SCTG alone. Mean root coverage (MRC) in the control group and the test group was similar (P > 0.05). Photogrammetric analysis showed similar MRC in the control group and the test group (P > 0.05). CONCLUSION: The clinical outcomes of recession coverage with CAF and SCTG and LD are comparable to CAF and SCTG. LD did not show any added clinical advantage over CAF and CTG in the management of gingival recessions.
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Incidental findings in the prostate above 50 years in an autopsy study in a tertiary care center from North India p. 135
Ramesh Kumar, Navjot Kaur, Jagjit Singh Chahal, Manjit Singh Bal, Ramesh Kundal
DOI:10.4103/ijhas.IJHAS_7_18  
BACKGROUND: Autopsy study of the prostate is one of the vital subjects since diseases of the prostate are common among adults with some clinically asymptomatic during life. AIMS: The purpose of our study was to find out the histological patterns, their frequency, and age distribution of prostatic lesions in the South-Eastern part of Punjab by analyzing prostate biopsies in persons above 50 years in routine medicolegal autopsy specimens. MATERIALS AND METHODS: The present study was conducted on prostate glands removed from autopsies in 100 men aged 50 years and above who died of causes other than clinically diagnosed prostate disease. After removal, the prostate glands were fixed in 10% formalin, weighed, sectioned, and processed. Paraffin-embedded sections were stained with hematoxylin and eosin and systematically examined. RESULTS: Age of the subjects ranged from 51 to 83 years. The distribution of prostatic lesions showed 76% of cases having benign prostatic hyperplasia (BPH) including 28% of cases with concomitant chronic prostatitis, followed by acute prostatitis (4%), adenocarcinoma (7%), transitional cell carcinoma (2%), prostatic intra-epithelial neoplasia (2%), prostatic infarction (2%), leiomyoma (1%) and 6% of cases having normal prostatic histology respectively. CONCLUSION: BPH emerged as the most common lesion with fibroglandular hyperplasia as the commonest variant. Amongst the malignant lesions, adenocarcinoma was the frequently detected type.
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Evaluation of acute physiology and chronic health evaluation II system in a rural critical care setting: Correlating mortality and length of stay p. 139
Harish Handyal, Gopi Kumar Gouni, Mohanraj Rathinavelu Mudaliar, Sowmya Veeraballi, Priyanka Pichala Tejashwani, Veerendra Uppara
DOI:10.4103/ijhas.IJHAS_28_18  
BACKGROUND: Severity scoring systems are needed to assess quality of care, treatment efficacy, and may facilitate auditing and optimization of departmental resource utilization, with the aim of reducing health-care cost, providing better care, and improving outcomes. MATERIALS AND METHODS: The current retrospective study of 6 months' duration was performed to correlate Acute Physiology and Chronic Health Evaluation II (APACHE II) score with mortality and length of stay (LOS) in a seven bedded rural critical care setting, with 242 medical records of patients, admitted for 1 year. Demographic data, indication of intensive care unit (ICU) admission, and presence and absence of any chronic illness were obtained retrospectively from the patient records and documented in data collection form. At the completion of the first 24 h after the admission into ICU, APACHE II score was calculated using 12 physiological variables. Final outcome of the patient (shift out or death) and total length of critical care unit stay were recorded. RESULTS: In our study, the mean age of the patient was 38.5 ± 1.05 ranging from 18 to 85 years, in whom 59.50% of patients had medical indications for ICU admission and increase in age was known to be associated with mortality (69.23%) in relation to APACHE II Score >34, and mean LOS in ICU was found to be 5.3 days ± 0.36. CONCLUSION: APACHE II system will be of more priority in determining risk population for whom optimum care to be delivered, by which mortality in ICU could be minimized in rural critical care settings.
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Anemia-related knowledge, attitude, and practices in adolescent schoolgirls of Delhi: A cross-sectional study p. 144
Monika Singh, Om Prakash Rajoura, Raghavendra A Honnakamble
DOI:10.4103/ijhas.IJHAS_97_18  
BACKGROUND: Anemia is a serious public health problem, especially in a developing country like India. Gap in nutritional knowledge is one of the major reasons for nutritional problems. Consequently, improper practices can lead to intergenerational impact. OBJECTIVES: To examine anemia-related knowledge, attitude, and practices (KAP) in adolescent schoolgirls and to find health-seeking behavior regarding anemia among adolescent schoolgirls. MATERIALS AND METHODS: This cross-sectional survey was conducted in a northwest district of Delhi. A total of 210 adolescent schoolgirls were included in this study. A predesigned, pretested, semi-structured questionnaire was used to asses KAP about anemia. RESULTS: The present study observed that adolescent schoolgirls had less knowledge about anemia. Out of 210 girls, only 60 (28.5%) had heard the term anemia and among them, 50 (83.3%) considered that anemia is a health problem. Very few girls correctly answered questions regarding the symptoms, prevention, and treatment of anemia. Most of the students (170 [80.9]) used soap for washing their hands and the rest (19%) cleaned with just water. Only 52% of girls cleaned their hands with soap before consuming food. Trimming of nails regularly was practiced by 160 (76.2%) girls, and there was a practice of barefoot walking outside the home in 28.5% of girls. CONCLUSION: Adolescent girls exhibited knowledge toward anemia but not adequate attitude and practice. Propagation of comprehensive nutritional knowledge regarding diet and supplements rich in iron should be made mandatory.
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Burkitt's lymphoma of intestine presenting as ileocolic intussusception: An atypical presentation p. 149
Mahmood Dhahir Al-Mendalawi
DOI:10.4103/ijhas.IJHAS_70_18  
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