International Journal of Clinical and Biomedical Research <p style="text-align: center;"><strong>ISSN: 2395-0471 (Online),&nbsp;</strong><strong>ISSN: 2521-0394 (Print).</strong></p> <p style="text-align: center;"><strong>Journal indexed in following major databases; Logos are embedded with respective links. Go to Indexed in page for more indexing information</strong></p> <hr> <p><a href=";journalId=32442" target="_blank" rel="noopener"><img src="/public/site/images/admin/copernicus.jpg" alt="" width="115" height="32"></a> <a href=";refid=dcrecen" target="_blank" rel="noopener"><img src="/public/site/images/admin/base.png" alt="" width="74" height="35"></a> &nbsp;<a href=";q=2395-0471&amp;hl=en&amp;as_sdt=0,5" target="_blank" rel="noopener"><img src="/public/site/images/admin/GoogleScholar1.png" alt="" width="74" height="28"></a> <a href=";qt=results_page" target="_blank" rel="noopener"><img src="/public/site/images/admin/logo_wcmasthead_en1.png" alt="" width="102" height="32"></a> <a href="" target="_blank" rel="noopener"><img src="/public/site/images/admin/pkp-index-301.png" alt=""></a> <a href=";sourceid=30542&amp;la=en&amp;fIDnum=|&amp;mode=simple" target="_blank" rel="noopener"><img src="/public/site/images/admin/sherparomeo-home.jpg" alt=""></a> <a href="" target="_blank" rel="noopener"><img src="/public/site/images/admin/rsz_21rsz_1rsz_imsear.png" alt="" width="141" height="30"></a></p> <hr> <p>International Journal of Clinical and Biomedical Research provides an outlet for research scientists in areas of Health Sciences. IJCBR is open access, online &amp; print, peer-reviewed international journal with a primary objective to provide research and applications related to all the health sciences:</p> <p>All branches of Biomedical Sciences,</p> <ul> <li class="show">Biology,</li> <li class="show">Dentistry,</li> <li class="show">Medical Education,</li> <li class="show">Physiotherapy,</li> <li class="show">Pharmacy, and Nursing.</li> </ul> <p>Submitted papers must be in technical English, suitable for scientific publication. All articles have to be original articles that have not been published elsewhere or are being considered for publication in other journals. All articles submitted will be peer-reviewed by experts. Receipt of the manuscript will be acknowledged by email. Every effort will be made to complete the review process within 3 weeks and communicated to the corresponding author. Papers should be submitted electronically on the journal's website. 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If any further information is required please mail to:</p> <p><a href="" target="_blank" rel="noopener"></a>,&nbsp;</p> <p><a href="" target="_blank" rel="noopener">;</a>or&nbsp;</p> <p><a href="" target="_blank" rel="noopener"></a>.</p> <p>The journal accepts manuscripts in the following forms:</p> <ul> <li class="show">Original research articles</li> <li class="show">Reviews</li> <li class="show">Case reports</li> <li class="show">Short communications</li> <li class="show">Letters to editor</li> <li class="show">Discussion papers</li> <li class="show">Clinical Experience</li> <li class="show">Clinicopathological correlation Book reviews and</li> <li class="show">"How to do it" type articles describing new methods or procedures.</li> </ul> <p>Kind regards,</p> <p>IJCBR Editorial Team.</p> en-US <p>The journal <strong>allows the author(s) to hold the copyright without restrictions and will retain publishing rights without restrictions</strong>.</p> <p>The submitted papers are assumed to contain no proprietary material unprotected by patent or patent application; responsibility for technical content and for protection of proprietary material rests solely with the author(s) and their organizations and is not the responsibility of the journal. 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Journal's standard policies allow the following re-use rights:</p> <ul> <li class="show">The journal allows the author(s) to hold the copyright without restrictions.</li> <li class="show">The journal allows the author(s) to obtain publishing rights without restrictions.</li> <li class="show">You may do whatever you wish with the version of the article you submitted to the journal.</li> <li class="show">Once the article has been accepted for publication, you may post the accepted version of the article on your own personal website, your department's website or the repository of your institution without any restrictions.</li> <li class="show">You may not post the accepted version of the article in any repository other than those listed above (i.e. you may not deposit in the repository of another institution or a subject-matter repository) until 12 months after publication of the article in the journal.</li> <li class="show">You may use the published article for your own teaching needs or to supply on an individual basis to research colleagues, provided that such supply is not for commercial purposes.</li> </ul> (Sumathi Publications) (Admin) Sun, 28 Apr 2019 00:00:00 +0000 OJS 60 Medically Important Coagulase Negative Staphylococci <p>In recent years, coagulase negative <em>Staphylococci</em> (CONS) are increasingly recognized as one of the major causes of health care associated infections (HCAI). CONS infections are one of the major causes of morbidity and mortality in hospitalized patients. As CONS colonize various parts of the skin and mucous membranes, most of infections are endogenous in origin. However, they are also transmitted exogenously via various medical/ surgical procedures. The aim of present review article is to update and summarize the information available on medically important CONS with special reference to epidemiology, laboratory diagnosis and antibiotic resistance.</p> Nagaraju Vanaparthi, Kalpana Sadawarte ##submission.copyrightStatement## Sat, 27 Apr 2019 00:00:00 +0000 Knee Osteoarthritis Revisited; But Only After KL Grading Is Tested: A Retrospective Analysis <p><strong>Background</strong>: Osteoarthritis (OA) of the knee is one of the major causes in musculoskeletal condition leading to functional loss in patients. Determining the progression of the disease is a useful tool which will help in the planning of the exercise programme to slow or halt the disease progression. Measuring the joint space width of the tibiofemoral joint is one of the best options for knowing the disease progression and helps in designing an exercise programme. <strong>Aim:</strong> Retrospective measurement of joint space width in patients with bilateral tibiofemoral osteoarthritis of the knee joint. <strong>Methodology: </strong>Data was retrieved from the picture archiving and communication system (PACS) from 1<sup>st</sup> of February to 22<sup>nd</sup> of June 2018. Radiographs that were showing OA knee features by using Kellegren Lawrence (KL) grading system were considered and the joint space between the tibial and femoral compartment was measured. <strong>Result</strong>: The joint space width showed more reduction in the medial compartment of the joint as compared to the lateral compartment. <strong>Conclusion: </strong>In the rural population of Maharashtra the medial joint space is markedly decreased as compared to the lateral compartment of the tibiofemoral joint and as the KL grade increases the joint space width decreased.</p> <p><strong>Keywords: </strong>Osteoarthritis; Knee; Joint space width; Rural Maharashtra.</p> Victoria David Kuttan, Deepak Anap, Sushil Kachewar ##submission.copyrightStatement## Sat, 27 Apr 2019 00:00:00 +0000 A study of the Oxidative stress and Antioxidant status in diabetic subjects who are on treatment with Metformin <p><strong>Background:</strong> Oxidative stress plays an important role in the pathogenesis of DM and its complications. However, antioxidant status and its contribution to type 2 DM are less explored in South Indian population. Metformin, is a biguanide anti hyperglycemic agent used for the management of type 2 diabetes. <strong>Aim:</strong>Â&nbsp; To study the alteration in oxidant and antioxidant status in type 2 diabetic subjects on treatment with Metformin and to evaluate the effect of metformin in improving the total antioxidant status. <strong>Methodology:</strong> In this cross sectional study, all subjects were T2DM patients, on metformin monotherapy (500 mg, bd) and were grouped into two - Group 1 and Group 2 for the study purpose, based on their HbA1c values. Baseline parameters (B.P, Waist Hip ratio, BMI, family history), glycemic status, lipid profile, FRAP, TBARS and serum Metformin levels were assayed. Fasting and postprandial blood specimens were collected and plasma glucose concentrations were measured by standard methods. Fasting plasma total antioxidant capacity (TAC) was measured by ferric reducing ability of plasma (FRAP) assay. Oxidative stress was evaluated and measured as TBARS and the values were compared among the two groups. <strong>Results:</strong> TBARS levels were higher and FRAP levels were significantly lower in Group I subjects compared to Group II subjects and can be explained due to increased superoxide ions and reduced activity of S. O. D. <strong>Conclusion:</strong> It may be concluded that total antioxidant status is lower in type 2 diabetic subjects of Group 1 category compared to diabetic subjects in the Group 2 and it may be related to the beneficial effects of the biguanide, Metformin.</p> Manju Koshy, Palocaren Jeeji, Sethupathy S ##submission.copyrightStatement## Sat, 27 Apr 2019 00:00:00 +0000 Body Mass Index, Blood Pressure and Serum Cortisol Level as Stress Index in Symptomatic HIV/AIDS Male Subjects on Antiretroviral Therapy Negative to Malaria Parasite in Nnewi, Anambra State, Nigeria <p><strong>Background: </strong>HIV infection is a risk factor for a variety of endocrine problems. <strong>Objectives:</strong> This study investigated the body mass index (BMI), Systolic blood pressure (SBP), Diastolic blood pressure (DBP) and serum cortisol level as stress factor/index symptomatic HIV/AIDS male subjects on ART who are negative to malaria parasite in Nnewi, Anambra State, Nigeria. <strong>Methods</strong>: A total of 274 adult male participants aged between 18 and 60 (42 ±13) years were randomly recruited at the Voluntary Counseling and Testing (VCT) Centre in Nnamdi Azikiwe University Teaching Hospital and grouped based on WHO criteria for staging HIV into symptomatic HIV (stage 11) infected male participants on ART (A: n=69), Symptomatic HIV subjects not on ART (B: n= 69), Asymptomatic HIV positive subjects (C: n= 68) and HIV seronegative subjects (D: n= 68). Blood samples were collected from the participants for the determination of HIV status by immunochromatography and HIV confirmation by Western Blot. Enzyme-Linked Immunosorbent Assay (ELISA) was used to assay for cortisol level. <strong>Results: </strong>The results showed a significantly increased BMI and decreased mean serum cortisol level in HIV/AIDS seropositive participants on ART than in those, not on ART (p&lt;0.05). Also, the BMI and mean serum cortisol level were significantly decreased and increased respectively in&nbsp; HIV/AIDS seropositive participants not on ART than in Asymptomatic HIV positive subjects and control respectively (p&lt;0.05). However, the mean SBP and DBP did not differ significantly between the groups studied (p&gt;0.05). <strong>Conclusion: </strong>This study revealed a decreased stress index in HIV/AIDS subjects on ART with hypercortisolism and lower BMI in symptomatic HIV participants, not on ART.</p> <p><strong>Keywords: </strong>HIV; AIDS; Malaria uninfected male subjects; Cortisol; Blood pressure; Antiretroviral therapy.</p> Ezeugwunne I P, Ogbodo E C, Analike R A, Onuora I J, Obi-Ezeani C N, Ugwu M C, Amah U K, Okezie A O, Onyenkwe C C, Ahaneku J E ##submission.copyrightStatement## Sat, 27 Apr 2019 00:00:00 +0000 Correlation between Age, IPSS, Prostate size with histopathological findings and management of patients of prostatism <p><strong>Introduction:</strong> Benign prostatic obstruction/enlargement (BPO/BPE) is one of the important aetiology for Bladder outlet obstruction (BOO) in men. Study has been planned to measure various parameters of bladder dysfunction by using Cystometry in patients of Prostatism and to find out correlation between various parameters like age, prostate size, IPSS, management of patients with Prostatism, choice of operative procedure performed and various histopathological findings. <strong>Methods: </strong>This was observational study. Total 75 patients with age&gt; 50 year and IPSS &gt; 19 having symptoms of Prostatism were included in the study. Patient detailed history was taken and demographic parameters with IPSS, histopathological findings, management plan, Ultrasonography findings were recorded in structured proforma. <strong>Results: </strong>It is seen that the maximum i.e. 39 (52%) cases of prostatism are observed in the age group of 60 to 70 years. The average age was 67.29 years. Maximum i.e. 31 (41.33%) cases of prostatism had prostate size in 50-70 gms.36 patients were managed by catheterisation while surgery was performed in remaining 39 patients. Transurethral resection of prostate (TURP) was performed in 36 of 39 patients. IPSS was decreased significantly from average of 26 to average of 22 after 2 weeks of operation/catheterisation. <strong>Conclusion: </strong>Prevalence of BPE increases with age as there found to be positive correlation between age and Prostate size. TURP was preferred procedure in our tertiary centre for the treatment of BPE. Significant decrease in IPPS suggests improvement in symptoms of BPE after operation/catheterisation.</p> <p><strong>Keywords: </strong>&nbsp;Bladder outlet obstruction; Prostatism; International Prostate Symptom Score; Transurethral resection.</p> Tushar Chandrakant Baheti, Shelke C V, Amar Deshmukh ##submission.copyrightStatement## Sat, 27 Apr 2019 00:00:00 +0000 Biomarkers to Assess Liver Function in Various Types of Liver Diseases <p><strong>Background: </strong>It is estimated that liver diseases are among the top ten killer diseases in India, causing deaths every year. Besides, there are those who suffered from chronic liver problems needing recurrent hospitalization and prolonged medical attention, which leaves them physically, mentally, emotionally and financially devastated. <strong>Methodology:</strong> The study included (n=80) various liver disease patients admitted to the General Medicine department and controls (n=20) subjects were having normal health within the age group of 30-55 years. Serum levels of bilirubin, Aspartate Transaminase, Alanine Amino Transferase, Alkaline Phosphatase and Gamma Glutamyl Transferase parameters were studied among the subjects suffering from cirrhosis, alcoholic liver disease, viral hepatitis, obstructive jaundice type of liver diseases. <strong>Result:</strong> The results of this study showed that the increase in serum levels of Bilirubin, AST, ALT, ALP and GGT in various types of liver diseases i.e Obstructive jaundice, Cirrhosis of the liver, Viral hepatitis, Alcoholic Liver disease when compared with controls. <strong>Conclusion:</strong> Biochemistry laboratory investigations i.e. Liver Function Test (LFT) are a simple, easy measure of tools which can early diagnose the various types of liver diseases.</p> <p><strong>Keywords: </strong>Liver diseases; Liver Bio-markers;&nbsp; Liver Function Test.</p> Pradeep G, Vikram B, Sharma DVHS ##submission.copyrightStatement## Sat, 27 Apr 2019 00:00:00 +0000 Effect of Various Concentrations of Lignocaine & Adrenaline Combination as Local Anesthetic on ECG Parameters of Patients Undergoing Dental Procedures <p><strong>Background:</strong> Systemic absorption of local anesthetics occurs due to its local vasodilator effects. This leads to inhibitory action on the heart which is represented in the form of a decrease in conduction rate, the excitability of myocardium and force of contraction. The aim of the present study was to evaluate the effects of Lignocaine and adrenaline combinations on electrocardiogram undergoing dental procedures. <strong>Methods:</strong> This was a prospective, observational clinical study done in collaboration with the Department of Oral &amp; Maxillofacial Surgery. All patients scheduled for oral surgeries under local anesthesia with Lignocaine 2% and adrenaline (1:80000 or 1:200000) combination of age 18 years or above 150 patients were included in the study. Patients with a history of hepatic, renal, cardiovascular and thyroid disorders were excluded from the study. A standard 12-lead ECG (25 mm/s) was recorded for each patient before administration of drugs (Basal), during the dental procedure (Intraoperative) and immediately after completion of surgical procedure. <strong>Results:</strong> There was no statistically significant difference seen between the Group A (Lignocaine 2% with 1:80000 adrenaline) and B (Lignocaine 2% with 1:200000 adrenaline) when the age, gender, PR interval, RR interval, mean QT &amp; QTc dispersion, and heart rate were compared. Statistically significant difference was seen in comparing the mean QT &amp; QTc interval, which was higher in Group A. ECG parameters in Group A and B showed a statistically significant decrease in PR interval, RR interval, QT interval, QTc interval, QT dispersion and QTc dispersion, with the basal, was compared with intraoperative and postoperative findings. The increase in heart rate although was statistically significant in both the groups, it was always within normal limits suggestive of no clinical significance. There was a statistically significant decrease in QT and QTc interval, QT and QTc dispersion. The change in all these parameters was within the physiologic range. All these relevant parameters for cardiac arrhythmias did not show any arrhythmogenic potential of lignocaine-adrenaline combination in both the groups. Both the combinations are comparable with each other in terms of ECG parameters with changes more with group A suggesting the effect of increased concentration of adrenaline. The change in the heart rate and ECG parameters in both the study group might be attributed to the presence of adrenaline in the combination. No cardiovascular morbidities were observed except palpitation. <strong>Conclusion:</strong> Thus it can be very well concluded that the effects of lignocaine-adrenaline combinations on electrocardiographic parameters are minimal and clinically irrelevant. Both the combination appears to be safe to use in healthy individuals.</p> <p><strong>Keywords: </strong>Adrenaline; Lignocaine; ECG parameters; Dental procedures.</p> Sinare B R, Annasaheb Gagare, Chinmaye Batwal, Liz Thaliath, Prashant Patel, Kunkulol R R, Narwane Sandeep ##submission.copyrightStatement## Sun, 28 Apr 2019 00:08:54 +0000 Prevalence of Musculoskeletal Disorders in Workers In An Industry in Ahmednagar District, Maharashtra. <p><strong>Introduction:</strong> Musculoskeletal disorders are a major public health problem in industrialized and developing countries. The present study was aimed to find out the prevalence of acute and chronic WMSD’s in Industrial workers. <strong>Methodology: </strong>This cross-sectional observational study was carried out in 60 workers of the Adon Block department workers of the electrical &amp; automation industry, Ahmednagar. Pre-structured occupational Performa was filled by asking questions in the worker’s local language. The Nordic pain Questionnaire was filled by asking the subjects to mark the sites of pain on body chart paper. The risk factors for work-related musculoskeletal problems were assessed by the working posture of workers and repetitive movements in industrial set up. The data collected were interpreted and analyzed. <strong>Results:</strong> In the present study, 60 workers were selected, of which a number of females were 39 (65%) while males were 21 (35%). The Neck (20.2%) followed by the shoulder (14.9%), elbow (14.4%) and knee (14.4%) were most commonly involved. There was a statistically significant variation in the number of workers involved according to the posture (sitting vs standing) and part of the MSK system involved. <strong>Conclusion: </strong>The WMSD’s are common in Adon block department workers. The involvement of neck, shoulder, lower back and arm was common in sitting position, while the involvement of upper back, elbow and knee were common in standing position. The disorders are commonly seen in workers irrespective of their duration of work and gender.</p> <p><strong>Keywords: </strong>Musculoskeletal disorders; Industry Workers; Nordic pain Questionnaire; Ahmednagar.</p> Sneha Chordiya, Nitin Nikhade ##submission.copyrightStatement## Sun, 28 Apr 2019 00:00:00 +0000 Study of serum high sensitivity C- reactive protein and lipid profile in ischemic and hemorrhagic stroke <p><strong>Introduction: </strong>Stroke is the neurological deficit of abrupt onset attributable to focal vascular cause and makes a considerable contribution to morbidity and mortality. High sensitivity C reactive protein (hsCRP) is an acute-phase reactant tends to increase at the onset of inflammation. Atherosclerosis, a major risk factor for cerebrovascular diseases involves inflammation which is triggered by dyslipidaemia. <strong>Objective:</strong> To estimate and compare levels of serum hs-CRP and lipid profile in patients with ischemic and haemorrhagic stroke. <strong>Methods:</strong> Present study comprised of 90 subjects, 30 ischemic stroke, 30 haemorrhagic stroke and 30 as apparently healthy control. Blood samples obtained within 24 hours of presentation were analysed for serum hsCRP and lipid profile. <strong>Results:</strong> In the present study Median age was 52 years, 52.5 years and 54 years in control, ischemic stroke and haemorrhagic stroke respectively. Hs-CRP levels were raised in ischemic and haemorrhagic stroke compared to normal control (F-value=96.78; p&lt;0.0001). Total cholesterol, triglyceride and LDL- cholesterol levels were significantly raised while HDL- cholesterol levels were low in ischemic stroke and haemorrhagic stroke than control (p&lt;0.05). <strong>Conclusion:</strong> Increased serum hs-CRP levels and dyslipidemia were observed in ischemic and haemorrhagic stroke. But serum hs-CRP cannot differentiate type of stroke.</p> <p><strong>Keywords: </strong>Ischemic stroke; Haemorrhagic stroke; hs-CRP; Lipid profile.</p> Dr. Sarika Argade, Dr. Reshakiran J Shendye ##submission.copyrightStatement## Sun, 28 Apr 2019 00:00:00 +0000 Evaluation of Effect of Melatonin on Hematological Parameters in Patients of Periodontitis <p><strong>Introduction:</strong> Considering the immunity enhancing property of melatonin, a study on the evaluation of the effect of melatonin on the hematological parameters in patients suffering from Periodontitis.&nbsp; <strong>Methods:</strong> This study was conducted in the Department of Periodontics, Rural Dental College, Loni. Patients of chronic Periodontitis, of age between 18 to 65 years of either gender ready to give informed consent to participate in the study were included. Postoperative patients, patients having night duties, drivers and those using heavy machinery, pregnant women, lactating mothers, patients with any clinically significant systemic disease and patients on any other drugs were excluded from the study. Patients were divided into two Groups. Group B received scaling and root planning (SRP) and melatonin 3 mg per day were compared to Group A which received SRP only. The Total Leukocyte count, Differential Leukocyte count and Erythrocyte sedimentation rate of each patient was studied at a baseline, 1<sup>st</sup> (30 days) visit, 2<sup>nd</sup> (60 days) visit and 3<sup>rd</sup> (90 days) visit. <strong>Results:</strong> Both the groups consisted of 80 subjects each. Group A consisted of 71.25% male and 28.75% female patients. There were 56.25% male and 43.75% female patients in Group B. With respect to visit 3, the TLC was statistically lower in Group B. The neutrophil count of Group B was significantly lower during visit 3 as compared to Group A. The lymphocyte count of Group B was significantly lower than that of Group A during the visit 1, and also significantly higher during visit 3 on comparison with Group A. There was no statistically significant difference in the groups with respect to eosinophil and basophil count. The Monocyte count of Group B was statistically lower when compared to that of Group A. There was no statistically significant difference between ESR of Group A &amp; Group B.&nbsp; <strong>Conclusions: </strong>It can be concluded that melatonin has a positive effect on TLC and differential count of patients of periodontitis, conferring a new facet to the management of periodontitis and an attempt to impede the disease progression.</p> <p><strong>Keywords: </strong>Melatonin; Hematological parameters; Periodontitis; Total Leukocyte count; Differential Leukocyte count; Erythrocyte sedimentation rate; Scaling and Root Planning.</p> Anagha Marawar, Pramod Marawar, Nandal D H, Rahul Kunkulol, Sandeep Narwane ##submission.copyrightStatement## Sun, 28 Apr 2019 00:00:00 +0000 Effectiveness of Balance Exercise Program in Total Knee Arthroplasty: Meta-Analysis <p><strong>Background: </strong>Balance is essential for maintaining postural stability while performing functional activities and for falls avoidance in patients with TKA.&nbsp; There are very few RCTs done to assess functional improvement after TKA. Hence, this study was undertaken to find out evidence on physiotherapy treatment in TKA and analyze it.&nbsp; <strong>Methods: </strong>We searched Medline, CINAHL, PEDro from the year 2001 to 2015 for RCT involving evaluations of physiotherapy exercise in adults with a knee replacement. Search criteria’s were pain, stiffness, adherence and attrition. The inclusion criteria were studies which included physiotherapy exercise for balance specific exercises which compared various functional training and functional training with balance exercise in TKA. <strong>Result: </strong>Searches identified 20 randomized trials related to TKA and physiotherapy. Only three were fulfilled the inclusion criteria. Functional training with balance exercises found to be effective in patients with total knee arthroplasty. <strong>Conclusion: </strong>After total knee replacement, interventions including physiotherapy along with balance exercises showed improvement in pain, stiffness and functional performance in mobility.</p> <p><strong>Keywords: </strong>Osteoarthritis; Balance; Total knee arthroplasty physiotherapy.</p> Priyanka H Jadhav, Deepak Anap ##submission.copyrightStatement## Sun, 28 Apr 2019 00:00:00 +0000 Fetal Umblical Artery Doppler Indices in Healthy Pregnant Women in Yenagoa, Nigeria. <p><strong>Introduction: </strong>The measurement of fetal umbilical blood flow using Doppler ultrasound is a well-established tool in the management of high-risk pregnancies and has resulted in improved outcome. However, there is paucity of data concerning the normal parameters in Nigeria. This study is aimed at assessing the fetal umbilical artery indices in pregnant Nigerian women. M<strong>ethods: </strong>This was a cross sectional prospective study carried out at the Niger delta university teaching hospital, silhouette radio diagnostic consultants Yenagoa and federal medical centre. A total of 400 pregnant women between the gestational ages of 20 – 40 weeks were evaluated within a one-year period using a 2014 Philips HD 11 ultrasound machine equipped with a 3.5Mhz curvilinear probe having colour, pulsed wave and power Doppler facilities. <strong>Results: </strong>The mean age and BMI were 30 ± 6 years and 29.9±5.76 kg/m<sup>2</sup> respectively while the mean umbilical artery systolic velocity and end diastolic velocities were 40.07± 8.99m/s and 17.44±6.37m respectively. The mean resistivity index (RI) is 0.57. There was a negative correlation of RI with Gestational age (P&lt;0.05). <strong>Conclusion: </strong>Fetal umbilical artery Doppler parameters are essential tool in management of high-risk pregnancies and has resulted in an improved outcome. This study is to serve as a baseline for further studies with a larger sample size.</p> <p><strong>Keywords: </strong>Fetal; Umbilical; Artery; Doppler; Pregnancies.</p> Kiridi Enefia Kelvin, Kiridi Emily Gabriel, Dappa Victor Datonye ##submission.copyrightStatement## Sun, 28 Apr 2019 00:00:00 +0000 Variations in Blood Pressures Amongst Day School Children and Boarding School Children in Western Maharashtra <p><strong>Introduction: </strong>School children majorly face stress due to the pressure and expectations from their parents besides academics, athletics, etc. It is known that depression, stress increases blood pressure. Such wide variations in blood pressure at such a young age can increase the incidence of cerebrovascular accidents, ischemic heart diseases, renal failure and preterm death in the adulthood of such children. This survey will guide the parents and teachers to the various problems student face and how can they help the student cope with it. <strong>Method</strong>: The blood pressure of each student was taken three times to reduce them to minimise the possibility of errors and the blood pressures of all the students were compared according to their age (13-16 years) and the schooling type (boarders and day scholars). <strong>Results:</strong>&nbsp; On comparing the prehypertensive stage, the numbers of pre-hypertensives are found to be greater in the age group of 15 years in both day scholars and boarders i.e. 14% and 8% respectively. The on comparing the schooling type the day scholars have a greater number of prehypertensive i.e. 25% than boarders which is 17%. Though pre-hypertensives are higher in the age group of 15 years, but the numbers of hypertensives are more in 14 years of age which is 7% (6% in hypertension stage I and 1% in hypertension stage II) in day scholars and 4% (3% in hypertension stage I and 1% in hypertension stage II) in boarders. In schooling type, a similar trend as that of prehypertension is seen i.e. in day scholars 14% students are in hypertension stage I and 3% students are in hypertension stage II making a total of 17% of hypertensive in day scholars. Similarly, in boarders there are 6% in hypertension stage I and 1% in hypertension stage II making 7% hypertensive in boarders, thereby showing a higher percentage of hypertensive in day scholars. <strong>Conclusion: </strong>The study revealed Percentage of students in hypertension stage I and hypertension stage II were found more in day scholars (14% HT STAGE I and 3% HT STAGE II) than boarders (6%HT STAGE I and 1% HT STAGE II) respectively. Thus, it can be very well concluded that 17% of day school children and 7% boarders were found to be in hypertensive.</p> <p><strong>Keywords: </strong>Variations in blood pressures, Day school; Boarding school Children; Western Maharashtra.</p> <p>&nbsp;</p> Kulkarni N B, Dimple Manoj Tarwani, Kunkulol R R, Liz Thaliath, Chinmaye Batwal ##submission.copyrightStatement## Sun, 28 Apr 2019 00:00:00 +0000 Effectiveness of Surgical Management of Ankle Fractures in Attaining the Stability of Ankle <p><strong>Introduction:</strong> Ankle injuries comprise a major group of lower limb trauma. Many of these injuries can be treated by manipulative reduction and conservative treatment and some of these yield satisfactory results, so present study was undertaken to know the effectiveness of surgical management of ankle fractures. <strong>Method:</strong> 42 surgically treated displaced fractures are included and studied in detail of age, sex, occupation, type of fracture, mode of injury, type of treatment, Clinical evidence of fracture union, Radiological evidence of fracture union, Relation of talus in the ankle mortise, Range of mobility of the ankle, Residual disability and pain, Ability to walk and time of return to duty and complications were noted. <strong>Result:</strong>&nbsp; 42 cases were surgically treated, most of the patients were operated on an emergency basis within 24 hours of injury. Based on the mechanism of injury Pronation- External Rotation (30.9%) and Based on Ao Classification Type B - B2 (53.3%) were the major type of fractures. In the majority of cases, Malleolar screws type of implants used.&nbsp; In overall the final status of patients is good (ability to walk).&nbsp; <strong>Conclusion:</strong> Displaced ankle fractures need accurate open reduction and internal fixation and postoperative immobilization for 6 weeks. This will suffice to get good results. Post-operative rigid immobilization and protected weight bearing for 12 weeks is minimal to achieve good union followed by physiotherapy to restore the maximum range of movements</p> <p><strong>Keywords: </strong>Ankle Fractures; Surgical management, Stability; Effectiveness.</p> Ramesh L, Kiran Kumar L, Rakesh Chandra M ##submission.copyrightStatement## Sun, 28 Apr 2019 01:46:32 +0000 Number of Hours of Sleep with Changes in Blood Pressure Amongst Medical Students in Western Maharashtra <p><strong>Introduction: </strong>Sleep has become one of the most ignored factors today. More sleep or less sleep does not matter it is just compensated the next day. Importance of regular and timely sleep amongst the students and their correlation with blood pressure is necessary to be found out so that the students can be made aware of and can be provided treatment to prevent further complications. <strong>&nbsp;Method: </strong>Demographic profile was noted it includes name, age, gender, professional year of MBBS and residence. History of sleeping was noted and other factors which influences sleeping pattern (i.e, alcohol, smoking, an association of dreams with sleep, midnight awakenings with sleep, caffeine intake before bed and average stress levels) through a well-structured questionnaire. Blood pressures of all eligible students were recorded 3 times in a week at the same time by the principal investigator with the same instrument according to the JNC 7 classification for hypertension. <strong>Results: </strong>Amongst all the medical students, 6% had systolic hypertension and 22.50% had diastolic hypertension. Comparing blood pressures according to sleeping patterns, amongst cases (less than 5 hours of sleep) 20.8% had systolic hypertension and 56.30% had diastolic hypertension. Whereas in controls (more than 5 hours of sleep) 1.40% had systolic hypertension and 11.90% had diastolic hypertension. Factors such as alcohol consumption, smoking, caffeine consumption before sleep, dreams, midnight awakenings and stress were found to be associated with sleeping patterns and the results were found to be extremely significant (p&lt;0.0001) statistically. <strong>Conclusion:</strong> Sleep duration of less than 5 hours was noted in 24% of the total population. The subjects with lesser number of sleeping hours had increased levels of blood pressure and a higher prevalence of hypertension. The average systolic blood pressure in subjects with less than 5 hours of sleep (cases) showed 48.50% pre-hypertensives and 20.80% hypertensives whereas in case of average diastolic blood pressure 18.50% were prehypertensive and 56.30% were hypertensive.</p> <p><strong>Keywords: </strong>Blood pressures; Sleeping hours; Medical Students.</p> Dimple Manoj Tarwani, Kunkulol R R, Sohan Chaudhari, Chinmaye Batwal, Liz Thaliath ##submission.copyrightStatement## Sun, 28 Apr 2019 00:00:00 +0000