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  Citation statistics : Table of Contents
   2014| July-December  | Volume 2 | Issue 2  
    Online since November 11, 2014

 
 
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SPECIAL ARTICLES
Moving toward competency-based education: Challenges and the way forward
Thomas V Chacko
July-December 2014, 2(2):247-253
DOI:10.4103/2321-4848.144365  
This article aims at giving a broad overview on competency-based education to those who are currently in the predominantly knowledge focused discipline-based curriculum and so are uninitiated to the competency-based educational paradigm. This is done by taking them through the curricular trends in medical education that have happened elsewhere in the world and providing them with a gist of what is competency-based medical education, how it is different from the earlier paradigms of instruction, the advantages that this paradigm of mastery learning presents to help the learner acquire competencies needed for doing the professional tasks and duties that are in alignment with health needs of the country, the framework and the broad steps involved in its implementation, the challenges that its implementation presents particularly with regard to benchmarking for assessment as revealed by the experiences in the Western world that resulted in a three-decade lag between intention to change and actual change and the way forward to overcome these challenges particularly through faculty capacity-building using longitudinal faculty development programs or series of faculty retreats to ensure that it can be successfully implemented and sustained to serve the purpose of producing job-ready professionals.
  6 12,484 1,598
ORIGINAL ARTICLES
Distribution of microorganisms in neonatal sepsis and antimicrobial susceptibility patterns in a tertiary care hospital
Sweetha Nayak, Rekha Rai, Vimal K Kumar, H Sanjeev, Asha Pai, HR Ganesh
July-December 2014, 2(2):136-139
DOI:10.4103/2321-4848.144304  
Introduction: Neonatal sepsis is one of the leading causes of neonatal deaths in developing countries. The organisms responsible for early onset and late onset sepsis are different. Infections with multidrug-resistant organisms are also increasing in incidence. Objective: To identify the organisms causing septicemia in neonates and to determine the antimicrobial susceptibility pattern of the isolates. Materials and Methods: This prospective study was conducted by analyzing the blood cultures and the sensitivity reports of 195 newborns who were admitted to the NICU between June 2011 and May 2012 with sepsis. Results: A total number of 75 patients (38.46%) had positive blood cultures. Klebsiella pneumoniae (30.66%) was the most common organism isolated. Majority of organisms isolated were resistant to commonly used antibiotics. Maximum sensitivity was seen for Carbapenems in gram-negative bacilli, Vancomycin for gram-positive cocci. Conclusion: Multi-drug-resistant organisms were isolated from neonatal septicemia. Therefore, great caution is required in selection of antibiotics.
  3 2,717 386
Knowledge on management of anemia during pregnancy: A descriptive study
Ashly Baby, Jeevan Venugopal, Renita D'silva, Shantia Chacko, PV Vineesha, T Vinaya Kumary
July-December 2014, 2(2):140-144
DOI:10.4103/2321-4848.144308  
Background of the study: The growing fetus depends entirely on its mother's healthy body for all needs. However, sometimes it can be a time of fear of suffering and death, in case women begin pregnancy with low or absent stores of iron because of previous pregnancy, poor iron intake, substance abuse; increased fetal demands of iron leads to iron deficiency anemia. Iron deficiency anemia is the most common form of malnutrition in the world and is the eighth leading cause of death in pregnant women in developing countries leading to the low birth weight, which is in turn an important risk factor for infant mortality. Objectives: To determine the knowledge of antenatal mothers regarding management of anemia during pregnancy. Materials and Methods: Non-experimental descriptive study was conducted to assess the knowledge of antenatal mothers from Yenepoya Medical College Hospital. A sample size consists of 50 antenatal mothers were selected through non-probability purposive sampling. The data was collected by using pretested structured knowledge questionnaire. Data was analyzed using SPSS version 16 and the results expressed as proportions. Results: The majority of the antenatal mothers (54%) had satisfactory knowledge, 38% had poor knowledge, and 8% had good knowledge regarding anemia during pregnancy. Conclusion: The overall knowledge in the study population was 29.9%. Hence, the researcher emphasizes the need for more research to improve the knowledge of antenatal mothers on anemia during pregnancy.
  3 21,183 1,404
MEDICAL EDUCATION
Psychiatry as a career choice: Perception of students at a private medical college in South India
Animesh Jain, M Shashidhar Kotian, Rashmi Jain, Nitin Joseph
July-December 2014, 2(2):238-242
DOI:10.4103/2321-4848.144362  
Background and Aim: People with mental illness are often subjected to stigma and discrimination. The poor popularity of Psychiatry as a field of specialty has been a global concern. Any preconceived notions, perceptions and formative influences among medical students could have strong influence on their future choice of career. This study aimed to determine the students' perception of Psychiatry as career choice and the factors influencing their perception and career choice. Subjects and Methods: Following approval from Institutional Ethics Committee and necessary permissions, consenting medical students at a private medical college in Mangalore, India were surveyed using a pilot-tested questionnaire. The responses were compiled and data analyzed using Statistical Package for the Social Sciences (SPSS) version 10. Chi-square test was performed and P < 0.05 was considered significant. Results: Of the 250 participants, 152 (60.8%) were males while 96 (38.4%) were females aged 17-25 years. Only 28 (11.2%) wanted to pursue Psychiatry as a career while 97 (38.8%) considered it as an option although not their first choice. There was no association between gender and completion of Psychiatry postings on the decision regarding Psychiatry as a career. However, an exposure to a mentally ill person had a statistically significant association with Psychiatry as career choice (P < 0.001). Conclusion: Very few students aspire for Psychiatry. Targeted interventions including focused approach and creating an interest during undergraduate posting may inspire more students to take up Psychiatry.
  2 2,179 202
SPECIAL ARTICLES
Problem-based learning in health professions education: An overview
Ajay Telang
July-December 2014, 2(2):243-246
DOI:10.4103/2321-4848.144363  
Problem-based learning (PBL) has been discussed and deliberated at various levels in health professions education in the last few decades. It has been accepted as a student-centered pedagogy that helps learners understand the core concepts, as well as helping them develop adult learning skills, communication skills, team working skills among other skills, which are considered as essential soft skills for future professional practice and employment. This article presents a description of the origin of PBL, the principles of learning that it is based on and a detailed description of the type of PBL process that can be used to introduce PBL. The research evidence in favor of PBL from the perspective of the faculty and the students has also been discussed with suggestions for future research based on literature.
  2 2,321 329
CASE REPORTS
Sclerosing stromal tumor of the ovary: A case report
Navjot Kaur, Neelam Sharma, Vijay Kaushal, Sarita Asotra, Jagjit Singh Chahal
July-December 2014, 2(2):231-233
DOI:10.4103/2321-4848.144355  
Sclerosing stromal tumors are benign ovarian neoplasms of the sex cord-stromal category, occurring predominantly in the second and third decades of life. Herein, we report a 23-year-old female who presented with pelvic pain, irregular menses but normal hormonal status and was diagnosed as having a right ovarian tumor. A right oophorectomy was performed, and microscopic examination revealed a sclerosing stromal tumor of the right ovary. We stress the importance of being familiar with sclerosing stromal tumors when evaluating ovarian neoplasms in young women, in order to contribute to the appropriate clinical management, preventing extensive and unnecessary surgery, and preserving fertility.
  1 1,876 151
MEDICAL HISTORY
Changing concept of disease prevention: From primordial to quaternary
Harshal Tukaram Pandve
July-December 2014, 2(2):254-256
DOI:10.4103/2321-4848.144366  
  1 10,383 1,111
ORIGINAL ARTICLES
A randomized two-way crossover comparative pharmacokinetic study of two different tablet formulations containing ilaprazole in healthy human Indian volunteers
Shubhasis Dan, Hira Choudhury, Pradipta Sarkar, Bapi Gorain, Anwesha Barik, Balaram Ghosh, Tapan Kumar Pal
July-December 2014, 2(2):160-164
DOI:10.4103/2321-4848.144324  
Background: Proton Pump Inhibitors (PPI) are observed to be great healer in gastroesophageal reflux disorder (GERD) and duodenal ulcer. Quantification of the drugs in human plasma by validated bioanalytical method are very important to determine pharmacokinetic parameters for undergoing comparative study with standard available formulations to make the newer one commercially available. Objective: The objective of this study was to determine the relative bioavailability of Ilaprazole, a novel PPI comparing the test formulation to the reference one according to standard regulatory guidelines. Materials and Methods: The bioequivalence of two tablet formulations, one as reference and other as test containing 10 mg of ilaprazole [CAS No. 172152-36-2] was studied in 12 healthy Indian volunteers. This was a single dose, twoperiod and randomized crossover study separated with a washout period of one week. Plasma samples for pharmacokinetic analysis were collected before dosing and at pre-specified time points after dosing. The concentration of ilaprazole in plasma was determined by a validated HPLC-UV method using theophylline as internal standard. The formulations were compared using the parameters Area under the plasma concentration-time curve (AUC 0-t ), Area under the plasma concentration-time curve from zero to infinity (AUC 0-͵), Peak plasma concentration (C max ), and time to reach peak plasma concentration (t max ). Results: Mean AUC 0-t of test and reference product were calculated to be 2627.793 ± 154.989 ng h ml−1 and 2555.905 ± 225.916 ng h ml−1 , with a C max of 347.459 ± 48.175 ng h ml−1 . While mean AUC 0-͵ of test and reference product were calculated to be 2733.334 ± 242.438 ng h ml−1 and 2728.716 ± 284.408 ng h ml−1 . Conclusion: The results of this investigation indicated no statistically significant differences between the logarithmic transformed AUC 0-͵ and C max values of the two preparations. The 90% confidence interval for the ratio of the logarithmic transformed AUC 0-t , AUC 0-͵ and C max were 2 within the bioequivalence limit of 80-125% and the relative bioavailability of test formulation was 102.81% to that of reference formulation. The results of this study in healthy human volunteers of 27.92 ± 5.12 yrs (average age), 171.28 ± 6.85 cm (average height) and 66.43 ± 5.21 kg (average weight) support the use of the 10 mg dose tablet newly formulated.
  1 2,591 302
SHORT COMMUNICATION
Formulating a comprehensive strategy to counter the menace of malnutrition in developing countries
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava, Jegadeesh Ramasamy
July-December 2014, 2(2):266-268
DOI:10.4103/2321-4848.144393  
The indispensable role of optimal nutrition in ensuring absolute health status and holistic development of a society is well acknowledged. Malnutrition is considered as a disease of human society that can begin in the womb and eventually lasts till the death. A wide range of socio-cultural and infectious parameters have been determined that can ultimately precipitate malnutrition. Considering the multi-factorial origin of the disease, the strategy to combat malnutrition should also be comprehensive and multi-pronged comprising measures to combat the condition at every level concurrently in the entire nation. The corrective policy essentially requires the coordinated approach of different stakeholders and should be targeted at four different levels - family, community, national, and international. To conclude, diet is a crucial element in the natural history of many public health-related diseases, and owing to the multiple factors that eventually determine the dietary habits, a comprehensive approach is the need of the hour.
  1 1,551 187
TEACHING IMAGES
Maffucci syndrome revisited
Sandhya K Hemraj, Devdas K Acharya, G Ravichandra
July-December 2014, 2(2):263-263
DOI:10.4103/2321-4848.144369  
  1 1,236 108
CASE REPORTS
Pathogenesis and prevention of residual gall bladder: Report of three cases and review of literature
Usha Dalal, Ashwani Kumar Dalal, Rikki Singal, Ashok Kumar Attri, Gautam Mendiratta
July-December 2014, 2(2):195-198
DOI:10.4103/2321-4848.144337  
Cholecystectomy is a common surgery performed for uncomplicated symptomatic gall stones as a definitive procedure. For complicated cases, partial or modified subtotal cholecystectomy has been described as an easy, safe, and definitive option. But, insufficient cholecystectomy leaving behind gall bladder may lead to persistence or recurrence of the biliary symptoms. We are presenting three cases, in which open partial cholecystectomy had been performed at a peripheral hospital on patients admitted with agonizing biliary type of pain. All the patients underwent re-exploration and successful removal of residual gall bladder tissues, leading to complete resolution of symptoms. The patients were doing well at one year of follow-up.
  - 3,602 228
An unusual finding in a subcutaneous cyst: A case of phaeohyphomycotic cyst
Prema C Saldanha, Vidya Pai
July-December 2014, 2(2):199-201
DOI:10.4103/2321-4848.144338  
Phaeohyphomycosis is a mycotic infection, which can be caused by different fungal organisms commonly presenting as cutaneous and subcutaneous cysts. The diagnosis can only be made by histopathological examination, and the entity should be considered in the clinical differential diagnosis of every cystic lesion of the skin.
  - 2,198 183
Male breast carcinoma and review of the literature
Sunder Goyal, Snigdha Goyal, Gulshan Kumar Garg
July-December 2014, 2(2):202-205
DOI:10.4103/2321-4848.144339  
Male breast cancer is a rare disease with unclear etiology. Its incidence is about 0.5-1%. Usually, these male patients present in advance stages due to non-specific clinical features and due to lack of awareness. Treatment scheduling is similar to female breast cancer.
  - 1,637 170
Case of recurrent cervical polyp-unusual presentation of leiomyosarcoma
Archana Vikram, S Ajith, Rajagopal , S Vikram
July-December 2014, 2(2):206-208
DOI:10.4103/2321-4848.144340  
Leiomyosarcomas are relatively rare tumors of mesodermal origin. These tumors constitute 2-6% of uterine malignancies. Lieomyosarcoma is common in age group of 43-53 yrs; only 15% is usually seen in younger than 40 yrs. Symptoms are usually non-specific include vaginal bleeding, pelvic pain or pressure, and an abdominopelvic mass. Here, we describe a rare case of recurrent cervical polyp in a 32-year-old parous woman.
  - 2,423 122
Root resection: Apropos of 6 cases
H Rajesh, Anand Dharamsi, KS Rajesh, Shashikanth A Hegde
July-December 2014, 2(2):209-213
DOI:10.4103/2321-4848.144342  
Root resection procedures are indicated in the treatment of advanced Grade II and Grade III furcation involvement. Their long-term prognosis is comparable to that of implants. The objective of this article is to present case reports of hemisection in mandibular first molar and root amputation in maxillary second molar, employed successfully as a part of the oral rehabilitation procedure.
  - 3,003 328
Benefits of early treatment with intravenous methylprednisolone in recurrent posterior scleritis
Anupama Bappal, Neelam Puthran, Vidya Hegde
July-December 2014, 2(2):214-216
DOI:10.4103/2321-4848.144343  
The rarity and posterior location of posterior scleritis eludes diagnosis. Similarly, etiological factors of posterior scleritis could be identified in less than half of the cases. We report a case of recurrent posterior scleritis due to presumed ocular tuberculosis (TB) in an elderly lady. Complete resolution of the disease, with the combination of oral steroids, intravenous methylprednisolone, and antitubercular treatment is presented. The role of antitubercular treatment in areas where TB is endemic, even in the absence of its clear-cut evidence is emphasized.
  - 1,812 150
Bilateral communication between the mylohyoid and lingual nerves: Clinical implications
Har Simarjit Kaur, Upasana , Sukhminder Jit Singh Bajwa, Gurdeep Singh Kalyan, Manjit Singh
July-December 2014, 2(2):217-219
DOI:10.4103/2321-4848.144345  
Although variations in the course of the mylohyoid nerve (MHN) in relation to the mandible are frequently found on dissection but these anatomical variations have not been conclusively described in the anatomical or surgical literature. However, it is a well-known fact that variations in the branching pattern of the mandibular nerve frequently account for the failure to obtain adequate anesthetic effect in routine oral and dental procedures and also for the unexpected injury to the branches of the nerves during surgery. Furthermore, anatomical variations might be responsible for unexpected and unexplained symptoms after a certain surgical procedures and in some cases of refractory neuralgias. We describe the presence of a rare bilateral communicating branch between the MHN and lingual nerves (LN) in an adult male cadaver, with a brief discussion of its anatomical, clinical and surgical implications as well as its possible role in the sensory innervations of the tongue. The present case reinforces the idea of a communicating branch between the MHN and LN, indicating that some of the sensory components of the MHN, instead of innervating the teeth or chin skin, might also innervate the tongue. This anatomical variation mandates to update the knowledge and awareness among surgeons and anesthesiologists who are frequently involved in oro-surgical procedures and nerve blocks of the face for various neuralgias so as to avoid any un-anticipated nerve injury.
  - 1,672 161
Acinic cell carcinoma of the nasal cavity
K.S. Gangadhara Somayaji, Zainab Sunu Ali, Mohammad Nalapad Abdulla, Vijin Ravindran Nambiar, Tom Koshy Johns
July-December 2014, 2(2):220-222
DOI:10.4103/2321-4848.144347  
Acinic cell carcinoma presenting in the nasal cavity is a rare entity. Here we report a case of a 65-year-old female patient who presented with a history of epistaxis and nasal obstruction. The case was diagnosed as acinic cell carcinoma. The tumor was found to be arising from the lateral wall of the right nasal cavity and it was treated by surgical excision and regular follow-up. This tumor is usually found in the major salivary glands and has a low grade behavior with the best survival rate of any salivary malignancy. We present a rare case presenting in the lateral wall of the nasal cavity. The clinical, histopathological features, and the management of this tumor is described with a review of the relevant literature.
  - 1,663 146
A case of ruptured liver abscess manifesting with intestinal obstruction
P Sudarshan, Arunabha Sinha, Harinatha Sreekar, B Arunchandra
July-December 2014, 2(2):223-224
DOI:10.4103/2321-4848.144349  
Liver abscess manifests with various clinical features. Features include vague abdominal pain, bowel disturbances, jaundice, and rarely abdominal swelling. The sheer plethora of the manifestations can confuse an unwary surgeon. Liver abscess manifesting with intestinal obstruction is rarely reported. This is one such case of liver abscess which manifested with intestinal obstruction which highlights a different mode of presentation of liver abscess.
  - 1,626 147
Subcutaneous panniculitis-like T-cell lymphoma
Atul Jain, Banyameen Iqbal, Tushar Kambale
July-December 2014, 2(2):225-227
DOI:10.4103/2321-4848.144350  
Panniculitis like T-cell lymphoma is a rare, aggressive variant of cutaneous T-cell lymphoma. The main dilemma lies in differentiating these lesions from simple panniculitis which is a benign lesion. We present the case of a 73 -year-old female patient, who presented with complaints of swelling in left axilla since 15 days, associated with throbbing pain and swelling of one arm. The initial diagnosis was paniculitis, but no clinical improvement was seen despite systemic antibiotic therapy. After two skin biopsies, the patient was diagnosed with panniculitis cutaneous T-cell lymphoma (PTCL). SPTCL can be a challenge to diagnose and can be misdiagnosed as benign panniculitis due to similarities in clinical and histological features between the two entities and for which immunohistochemical stains are required for confirmation of diagnosis.
  - 1,754 165
Xanthogranulomatous osteomyelitis
Monika Rathi, Jyotsana Khattri, Satish Kumar Budania, Jaskirat Singh, Seema Awasthi, Sushmit Verma
July-December 2014, 2(2):228-230
DOI:10.4103/2321-4848.144352  
Xanthogranulomatous inflammation in bone is a very rare entity. We came across this rare case of xanthogranulomatous osteomyelitis. We present a rare case of 50-year-old male who presented to the hospital with the chief complaint of pain and swelling in left ankle for 5 months and fever for 2 days. Total leukocyte count and differential leucocyte count was normal. Renal function tests and liver function tests were normal. Montoux test was negative. Chest X-ray was normal. Pus culture was negative for acid-fast bacilli but showed heavy growth of Pseudomonas. X-ray imaging revealed soft tissue mass, periosteal reaction and cortical disruption in the lower end of left tibia. Sensitivity to Amikacin and Imipenem was found on pus culture. So patient was started with these antibiotics. However, pain was not relieved. So arthrodesis was done, and curetted material was sent to histopathology lab where it was diagnosed xanthogranulomatous osteomyelitis. The patient was followed-up for 1 month. He did not have any complaints. All the previously existing complaints subsided. Xanthogranulomatous inflammation can be seen in bones also, though rarely reported.
  - 1,678 152
EDITORIAL
Quest for medical professionalism in uncertain times
Bhaskara P Shelley
July-December 2014, 2(2):119-122
DOI:10.4103/2321-4848.144275  
  - 2,875 3,472
INVITED EDITORIAL
Performance-based assessment: Innovation in medical education
Balakrishnan R Nair, Kimberley Parsons
July-December 2014, 2(2):123-125
DOI:10.4103/2321-4848.144292  
  - 2,840 1,586
LETTER TO EDITOR
Cone beam computed tomography for mandibular tori
Treville Pereira, Subraj Shetty, Svylvy Pereira
July-December 2014, 2(2):264-265
DOI:10.4103/2321-4848.144370  
  - 2,341 161
MEDICAL EDUCATION
Low awareness of clinical research in India amongst final year medical students and physicians: Need for increased emphasis on clinical research in medical curriculum
Kamal H Sharma, Anchal Jindal
July-December 2014, 2(2):234-237
DOI:10.4103/2321-4848.144359  
Background: There is an increasing trend to undertake clinical trials in India, but its awareness among the health care professional remain far from satisfactory. Aim: To assess the level of knowledge regarding clinical research training amongst a group of Indian medical students and postdoctoral physicians who had already completed training in subject of pharmacology. Materials and Methods: A cross-sectional descriptive questionnaire based study was conducted among university undergraduate medical students and postdoctoral physicians. Questionnaire was administered to 155 final year medical students and 33 postdoctoral physicians. Results: Out of 155 undergraduate students, for the statement regarding the concept of clinical trials, around 20.2% fell in the good category, 61.4% in the average category and 18.4% in the poor category. Regarding the statement about International Conference of Harmonization (ICH), 58.8% were poor responders, 28.7% were average, and 12.5% were good. The statements regarding the participation in the clinical research study showed that a majority was in the poor response category (89.2%) as compared to 9.8% in the good category. Conclusion: Boom in clinical research opens a door for job opportunities and advanced research. Teaching good clinical practice (GCP) guidelines at the most formative years shall go a long way in development of ethical and healthy learning environment for clinical research in the country.
  - 1,989 269
MEDICAL HISTORY
The rise of physical therapy: A history in footsteps
Abdul Rahim Shaik, Arakkal Maniyat Shemjaz
July-December 2014, 2(2):257-260
DOI:10.4103/2321-4848.144367  
  - 13,250 658
ORIGINAL ARTICLES
Anatomical study of diaphyseal nutrient foramina in human adult humerus
Vijayalakshmi S Bhojaraja, Sneha Guruprasad Kalthur, Antony S Dsouza
July-December 2014, 2(2):165-169
DOI:10.4103/2321-4848.144325  
Purpose: The objective of the following study is to determine the variation in diaphyseal nutrient foramen (NF) of humerus with respect to their number, location, direction and size. Materials and Methods: The present study was conducted on 100 humeri. The number and direction of diaphyseal NF were observed in all bones with the help of a hand lens. Position was described into horizontal and vertical zones; caliber was determined using hypodermic needles. Foraminal index was also calculated. Results: The mean length of humerus observed in the present study was 30.7 cm. The NF was situated at 17.8 cm from the proximal end, 12.4 cm from the distal end and ~2.9 cm below the mid length of humerus. The mean foramina index and circumference of NF was 57.7 and 6.2 cm respectively. Majority of the humeri (77%) had single NF while in 3% of humeri NF was absent. Middle one-third and on the antero-medial surface of the humerus was the most common location of the foramen. Majority of the dominant foramen was large in size and all were directing toward the distal end. Conclusion: The results of the present investigation indicate that there is variation in the number, location and size of NF in humeri among Indian population. An accurate knowledge of the location of the NF in long bones can be useful in certain surgical procedures such as bone grafting, microsurgical vascularized bone transplantation and in fractures.
  - 1,695 182
Effectiveness of teaching programme on knowledge of mothers regarding the effect of family conflicts on school children
GS Shilpa, Jovita Mathias, Libi Babu, Likhila Abraham, Lintu Susan Mathew, Loolu A George, Loveleen Jenifer, NP Lubaiba, Madhura B, Manu Mathew, Mareena Varghese, Meenu Xaviour
July-December 2014, 2(2):170-172
DOI:10.4103/2321-4848.144328  
Background: Conflict within home has been found to have a negative effect on many aspects of children's functioning. The incident rate of abnormal behavior and poor scholastic performance is high among the children with conflict in their family. Objectives: To determine the effectiveness of planned teaching program in terms of gain in knowledge of mothers regarding effects of family conflicts on children. Materials and Methods: This study involved pre-experimental one group pretest and post-test design. A sample of 50 mothers was selected by non-probability purposive sampling technique in the Talapady area. Structured knowledge questionnaire was used to assess the pretest and post-test knowledge. Results: Regarding effectiveness of teaching program, the overall mean percentage of knowledge score was 46.25% in the pre-test and 80% in the post-test. The enhancement in the mean percentage knowledge score was found to be significant. Discussion: Research conducted in this area suggested that conflict between parents is a consistent predictor for increasing anxiety in children, which needs to be prevented by educating the parents.
  - 1,650 120
Age estimation of an individual by using Olze's method in South Indian population
Nikhil Raj, Prashanth Shenai, Laxmikanth Chatra, KM Veena, Prasanna Kumar Rao, Rachana V Prabhu, KA Shahin, Prathima Shetty
July-December 2014, 2(2):173-177
DOI:10.4103/2321-4848.144330  
Background: The present study was conducted to assess age of adults by using Olze's method and also to estimate the efficacy of Olze's method in south Indian population. Materials and Methods: The present study comprised of 25 subjects ranging from 12 to 26 years from Mangalore. Dental age was assessed by using the Olze's method based on upper and lower third molar. Panoramic radiographs were taken for the same. The obtained data were analyzed by using paired t-test, intraclass correlation coefficient, and regression analysis using Statistical Package for Social Sciences (SPSS) 13 software for statistical analysis. Results: Average chronological age was 16.11. Average age estimated by Olze's method was 16.05. The intraclass correlation coefficient between the two methods showed excellent agreement between the two. Statistical analysis indicated that there is no significant difference between chronological age and age obtained by Olze's method. Conclusion: Olze's method has been experimented by many authors. An attempt was made to apply original method in our population and check its reliability. The present study indicated that, Olze's method was reliable for age estimation in our sample. This method of age estimation was accurate in both males and females.
  - 1,777 191
Evaluation of mechanical properties of recasted dental base metal alloys for considering their reusability in dentistry and engineering field
Nandish Bantarahalli Thopegowda, Kamalakanth Shenoy, Ravishankar Kiaakkar Shankaranarayana, Kukkila Jayaprakash, Kishore Gingipalli, Shama Bhat Vaddya, Sudeendra Prabhu
July-December 2014, 2(2):178-183
DOI:10.4103/2321-4848.144332  
Background: Base metal casting alloys are extensively used in dentistry to fabricate many oral appliances and a huge amount is wasted in the form of sprues and buttons during the casting procedure. Recycling and reusing these alloys by clean technologies may save our natural resources from being depleted and as well reduce the cost of the treatment of the patients. Objectives: To study the mechanical properties of recasted dental base metal alloys, and explore possible ways to recycle and reuse in dentistry and other fields of science and technology. Materials and Methods: Two beryllium-free Cobalt-Chromium (Co-Cr) dental casting alloys, Wironit and Wirobond-C, were used for this study. Six groups of specimen (melted once, twice, five, ten, fifteen and twenty times) per each alloy were casted. The tensile strength and hardness of these samples were measured by using universal testing machine and Vickers hardness number (VHN) tester. Results: Tensile strength decreased from 850 MPa to 777 MPa after 5 th recasting and to 674 MPa at the end of 20 th recasting procedure for the Wironit samples. For Wirobond-C samples, tensile strength decreased from 720 MPa to 678 MPa after 5 th recasting and further reduced to 534 MPa at the end of 20 th recasting procedure. Hardness decreased from 380VHN to 335VHN at the end of 20 th recasting for Wironit samples and 328VHN to 247VHN for Wirobond-C samples after 20 th recasting procedure. The slight decrease in their mechanical properties will not have any impact on the clinical performance for dental applications. Conclusion: There is no major degradation in the mechanical properties after recycling, and hence, the left over alloys after casting procedures can be reused in dentistry with a condition to satisfy cytotoxicity tests.
  - 1,788 233
Effect of surface spinal stimulation on autonomic nervous system in the patients with spinal cord injury
Bhavkiran Kaur, Narkeesh Arumugam
July-December 2014, 2(2):126-130
DOI:10.4103/2321-4848.144297  
Background: The Autonomic Nervous System (ANS) plays a key role in the regulation of many physiological processes, mediated by supraspinal control from centers in the central nervous system. Spinal cord injury (SCI) decreases the ability to sympathetically control blood pressure and to regulate body temperature. Bladder dysfunction has been reported as a serious medical complication following SCI. The purpose of study is to find the effect of surface spinal stimulation on autonomic nervous system i.e., bladder function, skin resistance, and skin temperature. Materials and Methods: Five traumatic spinal cord injury subjects were selected for experimental pilot study; surface spinal stimulation for 45 minute period applied to the skin in T11-L2 area, with a carrier frequency of 2500Hz and modulated to beats frequency of 20Hz. Stimulation amplitude was raised to cause sensory stimulation. The pre- and post-stimulation values using the values of urodynamics testing, galvanic skin response, and infra-red thermometer compared in same patients and results were obtained. Results: Result of the present study indicates that four of five subjects demonstrate a decrease in the infused fluid volume, improved bladder sensation, but shown no effect over the bladder capacity. The skin resistance of the right lower limb was increased post-stimulation, but the improvement was not significant, and skin temperature of thigh and foreleg improved significantly. Conclusion: According to our results, surface spinal stimulation was effective to improve non-reflexive bladder, skin resistance and skin temperature, but further research is needed.
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Scorpion envenomation in children and its management
RV Bharath, M Rajesh Kumar, BV Subrahmanyam, P Rammohan, Amit Agrawal
July-December 2014, 2(2):131-135
DOI:10.4103/2321-4848.144300  
Introduction: The present study was aimed to describe our experience with epidemiological characteristics, management options, and outcome of scorpion envenomation in children. Materials and Methods: The present retrospective study was conducted at Narayana Medical College and Hospital. The epidemiologic details including geographical locality of the event, age distribution, gender, and sting sites were noted in all hospitalized children with scorpion bite injury. Results: During the study period, a total 52 children were managed for scorpion sting. Mean age was 8.87 years. Male children were commoner victims of scorpion sting. Scorpion sting had bimodal pattern. Prazocin was used in 25 children. There was evidence of pulmonary edema in 23 cases. Seven patients required elective ventilation, and 5 of them could be weaned off within 72 hours. Mean hospital stay was 3.69 days. Two children expired in the present series. Conclusion: In present study, there was bimodal distribution of the scorpion sting cases, male children were more affected, and almost all of them improved with good outcome. We did not use anti-venin in the present study. The data from the study will serve not only to create heightened public awareness about scorpion envenomation but also to develop public awareness strategies and preventive measures.
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Association of serum uric acid level with estimated glomerular filtration rate in diabetic patients
Nithyananda K Chowta, Mukta N Chowta
July-December 2014, 2(2):145-149
DOI:10.4103/2321-4848.144318  
Background and Objective: Uric acid may be a novel and important player in the pathogenesis of microvascular complications in diabetes mellitus. The objective of this study was to investigate the association between eGFR and uric acid in patients with type 2 diabetes mellitus. Materials and Methods: A cross-sectional study was done in type 2 diabetic patients of both genders above the age of 18 years. Demographic characteristics collected include age, gender, body weight, height, and duration of diabetes. Laboratory investigations data collected included serum creatinine, blood urea nitrogen, serum uric acid, urine albumin, urine creatinine, urine albumin creatinine ratio, HbA1c, and blood glucose. GFR was calculated using the Modification of Diet in Renal Disease formula (4 variable formula). Results: A total of 63 patients were included in the study. Among them, 35 (55.6%) were males and 28 were females (44.4%). Mean age of the patients was 61.63 ± 10.37 years. Out of 63 patients, 52 had normal uric acid level and 11 patients had elevated uric acid level. eGFR was 81.32 ± 17.53 ml/min in patients with normal uric acid level, whereas it was 61.63 ± 26.18 ml/min in patients with elevated uric acid level. The difference is statistically significant (P = 0.03). Urine albumin creatinine ratio was 12.2 ± 40.92 μg/mg in patients with normal uric acid level and was 47.04 ± 76.58 μg/mg in patients with elevated uric acid level, the difference being statistically significant (P = 0.035). There was a significant negative correlation between uric acid and eGFR (r = -31, P = 0.014), whereas statistically significant correlation was not seen between uric acid level and urine albumin creatinine ratio. Uric acid level was 0.312 ± 0.072 mmol/L in normoalbuminuric patients (55 patients), whereas it was 0.343 ± 0.092 mmol/L in patients with microalbuminuria (8 patients). Conclusion: Serum uric acid is independently and negatively associated with GFR in patients with type 2 diabetes mellitus and thus supporting the concept that uric acid may be involved in the pathogenesis of diabetic nephropathy.
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Screening of nutritional status of male undergraduates in Kolkata using anthropometric indices
Pallav Sengupta, Elzbieta Krajewska-Kulak
July-December 2014, 2(2):150-154
DOI:10.4103/2321-4848.144320  
Context and Aims: Anthropometric measurements can easily reflect the nutritional status of an individual. The purpose of this study is to investigate the magnitude of obesity and undernutrition based on body mass index (BMI) and direct, derived anthropometric variables, among college students of Kolkata. Subjects and Methods: Anthropometry is generally considered as the single most easily obtainable, inexpensive, and non-invasive method that reflects body composition. A total of 100 male students aged 18-22 years of different undergraduate colleges of Kolkata have participated in this study. Anthropometric profiles (a total of 24 direct and derived variables) including weight, height, waist, and hip circumferences were measured. Results: Results showed 14.68% of the studied population are underweight, 9.25% are overweight, and 0.89% is obese, as per BMI. The present report showed higher prevalence of normal BMI (75.16%) in male college students, whereas obesity was almost found to absent among participants. Conclusion: The findings of the present report indicated occurrence of almost normal nutritional status among male undergraduates of Kolkata based on BMI and anthropometric indices
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Is there any difference between Back Saver Sit-Reach Test and Modified Back Saver Sit-Reach Test in estimating hamstring flexibility among the primary school children?
Bhoomita Gadhiya, Watson Arulsingh, Pitchiah Arunachalam, Asir John Samuel
July-December 2014, 2(2):155-159
DOI:10.4103/2321-4848.144321  
Background: Modified back saver sit-and-reach test (MBSSRT) has more advantages over Back saver sit-and-reach test (BSSRT) in measuring hamstring flexibility among middle school children and adolescents. However, whether MBSSRT can be used instead of the other among the primary school going children is not yet clear. Objective : To estimate the association between BSSRT and MBSSRT for measuring hamstring flexibility. Procedure : One hundred and forty-one healthy children (5-12 years) were selected from the primary school identified by the cluster sampling method for this cross-sectional study. The subjects were asked to perform three trials of BSSRT and MBSSRT (both leg) in randomized order. Average was used for data analysis. The association between the two tests was established by Spearman Rank Correlation test. Results: The correlation between BSSRT and MBSSRT for right lower limb ranged from 0.43 to 0.77 with mean correlation of ρ = 0.66 (P < 0.01) and for left lower limb ranged from 0.46 to 0.78 with mean correlation of ρ = 0.68 (P < 0.01). Conclusion: MBSSRT can be used alternatively instead of BSSRT to measure hamstring flexibility among the primary school children.
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REVIEW ARTICLES
Electronic cigarette: A review
Vinay Mahishale
July-December 2014, 2(2):184-189
DOI:10.4103/2321-4848.144334  
The principal addictive component of tobacco smoke is nicotine. The mechanisms of nicotine addiction are highly complex and are responsible for maintenance of smoking behaviour. Use of electronic cigarettes (E-cigarettes), devices that deliver a nicotine containing vapor has increased rapidly across the world. They are marketed as a "healthier alternatives" to conventional cigarettes. There is extensive debate over long-term safety and efficacy of these devices on public health. Studies show that the vapor generated from the E-cigarettes has a variable amount of nicotine and potential harmful toxins. Until robust research demonstrates the safety of E-cigarettes and efficacy in the treatment of tobacco dependence, their role as safe smoking cessation tool is unclear. This review highlights the recent data regarding E-cigarettes toxicity, impact on lung function, and efficacy in smoking reduction and cessation.
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Xerostomia: Few dry facts about dry mouth
Prasanna Kumar J Rao, Laxmikanth Chatra, Prashanth Shenai, KM Veena, Rachana V Prabhu, Tashika Kushraj, Prathima Shetty, Shaul Hameed
July-December 2014, 2(2):190-194
DOI:10.4103/2321-4848.144335  
Xerostomia is the subjective feeling of oral dryness, which is often associated with hypofunction of the salivary gland. Xerostomia can also have a major impact on a patient's oral health and quality of life. Patients with xerostomia complaints of problems with mastication, phonetics, deglutition and wearing dentures. Treatment of this condition always depends on the cause. Oral physicians should be able to diagnose this condition and able to give proper treatment to provide comfort to their patients. This article reviews the causes of xerostomia and its management.
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TEACHING IMAGES
Dacryocystocele
KS Gangadhara Somayaji, Rajeshwary Aroor, A Mohammad Nalapad, K Tom Jones
July-December 2014, 2(2):261-262
DOI:10.4103/2321-4848.144368  
  - 1,185 120
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