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   Table of Contents - Current issue
Coverpage
January-June 2018
Volume 3 | Issue 1
Page Nos. 1-66

Online since Tuesday, June 19, 2018

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EDITORIAL  

Cyclosporine in Stevens–Johnson syndrome and toxic epidermal necrolysis: Current scenario Highly accessed article p. 1
Keshavmurthy A Adya
DOI:10.4103/bjhs.bjhs_15_18  
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REVIEW ARTICLES Top

Noncommunicable disease modeling and simulation as means of understanding childhood obesity and intervention effectiveness p. 3
Meghana Aruru, Saumyadipta Pyne
DOI:10.4103/bjhs.bjhs_8_18  
Lifestyle and dietary changes have led to rise in noncommunicable diseases such as diabetes, obesity, and cardiovascular disorders, accounting for increased mortality and morbidity in many parts of the world including developing countries. Obesity has doubled since 1980s and continues to be a growing problem of our times. Public health policies to address obesity are evolving in connection with dynamically changing human behaviors and complex interactions with the environment. However, designing and testing of new interventions are expensive and time-consuming. Computational simulations to model interventions offer useful tools to compare the effectiveness of potential interventions. In this article, we discuss a popular computational approach, agent-based modeling (ABM), to address the global challenge of childhood obesity through modeling of different interventions as described in the literature.
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Integration of yoga in modern healthcare system: A dream to reality p. 9
Satadru Palbag
DOI:10.4103/bjhs.bjhs_14_17  
Yoga means union of the soul of the individual with the supreme consciousness. It is a 5000-year-old Indian source of wisdom whose importance is accepted by the whole world. India has taken several important steps to amalgamate the tradition of yoga with everyday life through implementation in student's physical training program to inclusion in modern healthcare system. This minireview will throw light over the development of integration of yoga in several diversified fields and its positive outcome.
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ORIGINAL ARTICLES Top

A comparative study of acute nonemphysematous pyelonephritis in diabetics and nondiabetics from a tertiary care hospital in South India p. 12
Mahesh Eswarappa, Sarita Suryadevara, Manns Manohar John, Gurudev Chennabasappa
DOI:10.4103/bjhs.bjhs_2_18  
AIM: The aim of this study is to analyze the clinical, biochemical, and microbiological characteristics of patients with acute nonemphysematous pyelonephritis in diabetics and nondiabetics from Indian subcontinent. MATERIALS AND METHODS: It is a retrospective study conducted at a tertiary care hospital from January 2012 to August 2016. The hospital medical records were searched electronically for clinical, biochemical, and microbiologic data. RESULTS: A total of 177 patients were enrolled for the study. in the diabetic group (51.9 years) was slightly higher than the nondiabetic patients (45.7 years). Nondiabetic patients presented late when compared to diabetics (6.38 days against 4.7 days). About 11.5% in diabetics against 5.8% in nondiabetics had recurrent urinary tract infection. The urine culture in the diabetics and nondiabetics showed positive growth in 43.8% and 43.2% of cases, respectively, with Escherichia coli, extended-spectrum β-lactamase, and Klebsiella being commonly identified organisms. Blood culture specimens in both the groups had high negative results with 86.5% in diabetics and 98.8% in nondiabetics. Over 90% of patients in either group responded to treatment with either antibiotic alone or in combination with double-J stenting. Temporary hemodialysis was required in 8% in diabetic group and 6% in nondiabetic group. Maintenance hemodialysis was required in approximately 3% of diabetic patients. CONCLUSION: In our study, the incidence of acute pyelonephritis was found to be higher in patients in their fifth decade of life. Diabetics had more severe infection at presentation and consequently had poorer outcomes in terms of residual renal function and need for dialysis.
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Awareness and usage of sports and energy drinks among university students: A pilot study in Turkey p. 18
Indrani Kalkan, Merve Pehlivan, Serap Anda, Serap Andaç Öztürk, Gülgün Ersoy
DOI:10.4103/bjhs.bjhs_4_18  
BACKGROUND: Sports and energy drinks are progressively gaining popularity among the young population for variable reasons such as improving performance and boosting energy and alertness, owing to the presence of stimulants such as caffeine and guarana. In spite of its increased consumption, lack of adequate knowledge exists regarding the intended use of these drinks. Recent studies have reported negative health outcomes of some of the sports and energy drink components. OBJECTIVE: This pilot study investigated the intentions of a group of university students regarding sports and energy drink usage, their consumption status, and awareness regarding effects of these drinks on health. MATERIALS AND METHODS: This study was conducted on 194 university students aged 20.52 ± 1.76 years, between September 2016 and February 2017. A questionnaire was administered enquiring physical activity level and knowledge of energy and sports drinks. RESULTS: Of the participants, 5.2% were found to be regular users of sports beverage and 6.7% of energy drinks. Most of the participants (90.2%) were confused between concepts of sports and energy drinks. Health problems such as insomnia, dizziness, nausea, blurred vision, abdominal pain, and diarrhea were reported by energy drink users, in particular. CONCLUSION: Young people need to be informed about sports and energy drinks and their potential damages.
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Role of endometrial cytokines of the female genital tract tuberculosis in the context of infertility p. 24
Abira Datta, Anjana Ray Chaudhuri, Siddhartha Chatterjee, Rajib Gon Chowdhury, Basudev Bhattacharya
DOI:10.4103/bjhs.bjhs_1_18  
BACKGROUND: Nowadays, one of the most common vulnerable sites of extrapulmonary tuberculosis is female genital tract tuberculosis (FGTB) leading to infertility. As FGTB produce clinical symptom quite late, its detection is very difficult to the health-care providers and according to some experts in this field; FGTB has no confirmatory investigation procedure. FGTB can cause other form of reproductive failure through ectopic pregnancy, tubal block, and implantation failure. Their presence may alter the cytokines level in endometrium. METHODS: A total of 300 cases in our clinic had undergone polymerase chain reaction (PCR) for detection of tubercle bacillus (TB-PCR). Among of them, 91 individuals fulfilling all inclusion and exclusion criteria were included in this study. In our study, we measured cytokines, two from pro-inflammatory group (interleukin-6 [IL-6] and IL-10) and three from inflammatory group (IL-2, interferon gamma [IFNγ], and tumor necrosis factor alpha [TNFα]). RESULTS: Out of 91 participants, 45 (49.46%) cases were TB-PCR positive, and 46 (50.55%) cases were TB-PCR negative. It has been observed that the value of IL-10 and TNFα did not fit any statistical parameter. The result showed that pro-inflammatory indicators IL-6 and inflammatory indicators IL-2 and IFNγ had significant different values between TB-PCR- positive and TB-PCR-negative groups. P value of this cytokines has statistically significant. CONCLUSION: From our study, we conclude that cytokine study was undertaken, of which IFNγ showed a possibility to become an important clinical indicator of endometrial hostility followed by IL-2.
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Comparison of efficacy of Kabat rehabilitation and facial exercises along with nerve stimulation in patients with Bell's palsy p. 31
Kanwal Khanzada, Muhammad Junaid Ijaz Gondal, Muhammad Mustafa Qamar, Ayesha Basharat, Waqas Ahmad, Sajid Ali
DOI:10.4103/bjhs.bjhs_35_17  
OBJECTIVES: The aim of this study is to compare the role of Kabat rehabilitation and facial exercise techniques with nerve stimulation common in both for Bell's palsy treatment and its effectiveness in improving physical and social function. MATERIALS AND METHODS: A randomized control trial conducted at the Department of Physiotherapy, Mayo Hospital, Lahore. Two equal Groups (A and B) consist of 26 patients each. Patients were employed Kabat rehabilitation technique in GroupA and with facial exercise in Group-B. Patients in both treatment groups were followed until 3 weeks and improvement in Sunnybrook facial grading scale (SFGS) and facial disability index (FDI) scale were recorded at the end of treatment. RESULTS: In this study, 52 patients were enrolled into the study. At the end of 3 weeks, more improvement was seen in SFGS in Group-A (81.58 + 11.321) versus Group-B (63.77 + 21.645). Similarly, the improvement in physical and social function on FDI in Group-A was more than Group-B (>0.05). CONCLUSION: Kabat technique is more effective as compared to facial exercise technique in improving physical and social function.
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Correlation between transcutaneous bilirubin estimation and total serum bilirubin estimation in neonatal hyperbilirubinemia Highly accessed article p. 36
Avijit Mandal, Rohit Bannerji, Jaydeb Ray, Monjori Mitra, Syed Md Azad, Surupa Basu
DOI:10.4103/bjhs.bjhs_6_17  
AIMS: To determine the efficacy of measuring the transcutaneous bilirubin as a screening tool for clinically significant hyperbilirubinaemia in Indian infants. MATERIALS AND METHODS: A cohort of 100 neonates who have clinical jaundice, admitted in NICU of Institute of Child Health, Kolkata from March 2014 to Jan 2015, were included in the study. Both the total serum bilirubin and transcutaneous bilirubin were measured for the above group. Inclusion criteria was neonates who had clinical jaundice and required extimation of serum bilirubin. Exclusion criteria was neonates who would receive phototherapy and/or exchange transfusion. STATISTICAL ANALYSIS: Software used was SPSS. RESULTS: 59 male and 41 female neonates were enrolled. A strong agreement was found between Total serum bilirubin and Transcutaneous bilirubin values. Mean gestational age was 34.91 weeks with a mean birth weight of 2492.2 gms.Mean age at the time of measurement was 86.13 hours. CONCLUSION: The above strong agreement between TSB and TCB was same in the term population as well as the whole population. The results of this study supports Transcutaneous bilirubin as an effective screening tool for estimation of neonatal hyperbilirubinaemia in Indian infants.
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Hand hygiene practices among doctors in health facility in a semi-urban setting p. 43
Ibrahim Aliyu, Teslim O Lawal, Wasiu Olawale, Kehinde Fasasi Monsudi, Bashir Mariat Zubayr
DOI:10.4103/bjhs.bjhs_26_17  
INTRODUCTION: Hand hygiene is an integral part of personal hygiene; poor hand hygiene practice may result not only in self-hurt but also may serve as a vehicle for transmission of infection among patients. Hence, knowledge of proper hand hygiene practice will significantly reduce the burden of infectious diseases. MATERIALS AND METHODS: This was a cross-sectional study involving doctors at Federal Medical Centre Birnin Kebbi; it was conducted from September 2015 to November 2015. Convenience sampling method was adopted. Pretested self-administered questionnaire based was used; relevant information such as age, sex, profession, years of working experience, awareness of Global HandWashing Day, hand-washing technique, steps in hand washing, ability to list the five moments in hand washing, and principles of hand washing were obtained. RESULTS: There were 33 males and 12 females with a male to female ratio of 2.8:1. All respondents believed hand washing reduces the risk of transmitting or contracting infections. Soap and water was the most common agent for hand cleansing, majority of the respondents (86.7%) had been taught on the technique of hand washing; however, only 19 (42.2%) of them wash their hands before examining patients; but all the respondents (100%) wash their hands after examining patient or handling their secretions; similarly, they all reported washing their hands after using the restroom. Almost all of the respondents (97.8%) use water and soap for hand washing. Furthermore, only 44.4% of the respondents had their personal hand rub. CONCLUSION: Soap and water was the most common agent for hand cleansing, and there was poor utilization of hand rub; and most respondents did not wash their hands before patient contact.
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Correlation of lipid profile among patients with hypothyroidism and type 2 diabetes mellitus p. 48
Amrita Ghosh, Dipankar Kundu, Faizur Rahman, Md Ezaz Zafar, KR Prasad, HK Baruah, Tapan Mukhopadhyay
DOI:10.4103/bjhs.bjhs_36_17  
BACKGROUND: Dyslipidemia is common metabolic abnormality in thyroid disorders overt or subclinical and diabetes mellitus (DM) with a marked increase in circulating low-density lipoprotein (LDL-C). OBJECTIVES: This study was carried out to find variations in dyslipidemic patterns in type 2 DM (T2DM) with hypothyroidism (HY). METHODS: Total cholesterol (TC), triglycerides (TG), very low-density cholesterol (VLDL), low-density cholesterol (LDL), and high-density cholesterol (HDL) were compared among the three study groups at a tertiary care teaching hospital of Bihar in eastern India. Group A: T2DM. Group B HY, and Group C: having both T2DM and HY and control group. RESULTS: The lipid profile of patients with diabetes showed TC (316.18 ± 4.299 mg/dl), TG (358.36 ± 5.544 mg/dl), LDL (214.70 ± 4.192 mg/dl), VLDL (71.67 ± 1.109 mg/dl), and HDL (29.80 ± 0.348 mg/dl). Mean lipid profile values in HYs were TC (314.38 ± 1.739 mg/dl), TG (322.46 ± 2.429 mg/dl), LDL (208.69 ± 1.665 mg/dl), VLDL (64.29 ± 0.5591 mg/dl), and HDL (41.20 ± 0.3647 mg/dl). Patients suffering from both diabetes and HY had TC (337.92 ± 4.793 mg/dl), TG (350.02 ± 5.127 mg/dl), LDL (236.17 ± 4.093 mg/dl), VLDL (70.01 ± 1.026 mg/dl), and HDL (31.74 ± 0.285 mg/dl). LDL value was markedly high in diabetic HY patients. All the lipid profile parameters were significantly increased except HDL among the patients with diabetes and HY patients. Increase was more in cholesterol and LDL values among patients suffering from both diabetes and HY. HDL levels were lowest among the patients with diabetes and also decreased among the diabetic HYs. CONCLUSIONS: In this study, on patients with diabetes and HY, dyslipidemia was more in two variables, namely, cholesterol and LDL; there was a distinct difference in lipid profile patterns between single and dual morbidities.
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MEDICAL EDUCATION TEACHING NOTE Top

Students lose balance over the yin-yang of sodium physiology p. 54
Hwee-Ming Cheng, See-Ziau Hoe
DOI:10.4103/bjhs.bjhs_9_18  
One of the major areas that students studying physiology stumble over is sodium homeostasis. In particular, there is often an unclear separation in their understanding to differentiate between sodium balance and sodium concentration (NaC) control. Functionally, students need to understand that NaC control involves the osmoreceptors that monitor changes in NaC in the extracellular fluid (ECF) since NaC is the dominant determinant of ECF osmolarity. This teaching note aims to address the common misconception regarding sodium physiology, specifically that ECF NaC is not regulated by the renin-angiotensin-aldosterone (RAAS) family of hormones. The RAAS is instead directed toward total body sodium or sodium balance. Different scenarios of ECF changes that alter sodium balance and/or NaC will be illustrated with a summary of “Tables of Salt.” Hopefully, both students and teachers will find this teaching note useful in their appreciation of the wonderful Yin Yang of sodium physiology.
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CASE REPORT Top

Microfilaria in fine-needle aspiration cytology of renal mass – an unusual site: A rare case report p. 58
Majed Momin, Abhijeet Ingle, S Sandeep
DOI:10.4103/bjhs.bjhs_7_18  
In tropical countries like India, filariasis is one among the major public health problems. Most commonly (90%) cases of lymphatic filariasis caused by wuchereria bancrofti, and rest (10%) cases by Brugia malayi. In India, filariasis is transmitted by the bite of culex or mansonia mosquito species. The diagnostic method of choice in filariasis is the detection of microfilaria in peripheral blood film examinations. Microfilaria was incidentally detected in fine-needle aspiration cytology (FNAC) smears from different tissues, organs, and serous cavities. However, the presence of a filarial worm in renal mass aspirate is unusual, and no literature has been published with best of our knowledge. We report a case in which ultrasound-guided FNAC renal mass revealed the presence of microfilaria in the background of renal cell carcinoma cells.
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LETTERS TO EDITOR Top

Severe ankyloglossia with failure to thrive p. 61
Ibrahim Aliyu
DOI:10.4103/bjhs.bjhs_22_17  
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Critical comment on knowledge and attitude regarding swine flu among dental house surgeons in Belagavi city: A cross-sectional study p. 63
Radha Saini
DOI:10.4103/bjhs.bjhs_39_17  
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Dear editor, please reject my letter Highly accessed article p. 65
Sarika Mondal, Himel Mondal
DOI:10.4103/bjhs.bjhs_3_18  
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