IMJ Health : December 2015

Dermatitis Artefacta : Case Report and Review of Literature

AbstractDermatitis artefacta is a self-inflicted dermatologic injury with underlying primary psychiatric condition. Precipitating factors ranges from simple anxiety to interpersonal conflicts and several personality disorders including obsessive compulsive disorder, depression and psychotic disturbances. The diagnosis of this entity is often missed. Herein, we are reporting a case of dermatitis artefacta with description of its various manifestations.

Key words: Psychodermatology, Dermatitis Artefacta, Factitious Disorders, Liaison Psychiatry

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The Rapeutic Priority for Developing Communication in Children with Special Educational Needs: Speech Therapy Intervention

Abstract The verbal behaviour of persons with special educational needs features delayed speech evolution compared to normally developed persons. In the speech therapy process for children with SEN, it is necessary to delimit strictly the objectives proposed, the responsibilities for each factor involved, and the corresponding priorities. The paper focuses on the importance and necessity of speech therapy activities, conducted for students with special educational needs. Speech therapy activities are based on a systematic process of learning or re-learning correct language structures, of gradually consolidating these structures in current speech. There is no typical model in the education of disabled children, because any proposition is first defined by a team, in an attempt to understand the child’s needs, the family’s availability, and the assistance service functioning. In conclusion, disability can always be compensated by the child’s capacities within his psychophysical potential.

Keywords : Disability, Special Educational Needs, Speech Therapy, Speech Communication

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Social Activities of Patients with Oncological Diseases

Abstract— Aim of the research is to determine the specific character of the social-behavioral functioning of patients with oncological diseases by focusing and analyzing the results of patients with carcinoma of the cervix. Methods: A sociological survey among 150 patients with malignant neoplasms has been done, in which the principles of confidentiality and informed consent were strictly followed. In accordance with the topic, the results of 41 women with carcinoma of the cervix have been commented. Results: According to the limitation of the diagnosis most of the women are registered with a disease up to 6 months (19/46%) and up to 1 year (14/34%). 23 (56%) are not working at the moment of the survey, 18 (4%) – are working. There is a positive correlation between the active contacts of the patients with their families (59% of the surveyed mentioned this) and the statement that the communication with the others is meaningful when it enriches them (S=0.25, p=0.01) and a negative one with the statement that the number of people is important in the communication (S=-0.55, p=0.001). Age has a significant relation to the presence of a preferred activity/hobby, connected with movement and physical efforts (S=0.38, p=0.03). Patients who are in close contact with their relatives are certain that it is absolutely important to be active today and tomorrow (S=0.73, p=0.000). Conclusions: Psycho-therapeutic interventions must be addressed to those topics which can improve the quality of life, decrease the distress level and lengthen the patient’s life.

Key words: Oncological Diseases,Social Activities

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A Descriptive study of Expression of p16ink4a in Different Types of Lesions in Uterine Cervix

AbstractHuman papilloma virus (HPV) is the main reason for cervical carcinoma. The viral E7 oncogene induces increasing expression of the cyclin dependent kinase inhibitor p16 INK4a in dysplastic cells. This can be used to identify dysplastic cells in histological slides. The aim of this study was to determine the presence of p16INK4a expression and to evaluate the diagnostic value of p16 immunohistochemical (IHC) investigation in different types of lesions in the uterine cervix. The study was performed on 112 samples of cervical biopsy. All samples were selected from the records of Pathology services in University Hospital-Pleven, Bulgaria. The samples were collected in four separate groups: reactive non dysplastic changes (n=26); different degrees of intraepithelial dysplasia (n=38); invasive squamous cell carcinoma (n=32); endocervical lesions with glandular origin – microglandular hyperplasia, Adenocarcinoma in situ and invasive endocervical adenocarcinoma (n=16). In all samples immunohistochemical analysis using antibodies to p16INK4a was performed. Results. In the cases with dysplastic lesions and invasive carcinomas was found strong correlation between the level of expression of p16INK4a and the level of cervical neoplasia (p<0.01). All 26 cases (100%) of non-dysplastic cervical lesions are negative for p16INK4a. The most cases of CIN III group (14cases-87.5%) showed strong cytoplasmic and nuclear expression of p16INK4a in the whole depth of the epithelium. Strong mainly nuclear overexpression was found in all invasive cervical adenocarcinomas. Conclusions. P16INK4a overexpression is associated to high-grade precancerous lesions and cervical carcinomas. Immunohistochemical evaluation can be useful biomarker in identifying HR-HPV- infected low-grade lesions.

Key words: Cervical dysplasia, Cervical cancer, HPV,p16INK4a

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Relation between Changing Lifestyle and Adolescent Obesity in India: A Community Based Study among School Children

Abstract—Obesity is the major global nutrition concern. Modernisation and urbanisation have led to changes in dietary and lifestyle factors which are contributing to the increased prevalence of overweight and obesity.
Objective: To find out various life style risk factors for obesity among school children of affluent families aged 10-18 years in Jaipur city.
Methods: A cross-sectional study in ten randomly selected schools of Jaipur city with tuition fee > 18000 ₹/year was conducted from July 2012 to April 2013. 1610 students of class V to XII were included and their detailed life style history with anthropometric measurements was recorded after their informed written consent. Indian Academy of Pediatrics’ growth Monitoring Guidelines for children from birth to 18 years was followed for defining and classifying obesity.
Result: 364 (22.61%) participants were found obese/overweight. Watching television during meals, frequency of main meals outside home per month, frequency of snacks outside home per week and duration of television/ computer watching per day were found significant predictors of overweight/ obesity on binary multivariate logistic regression method.
Conclusion: The present study highlights childhood overweight/obesity is an emerging health problem (22.61%) and lifestyle factors are important risk for it.

Key words: Obesity/overweight, Affluent families, Adolescents, Life- style factors.

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Measuring job satisfaction and impact of demographic characteristics among Doctors of Teaching Hospitals

Abstract If job satisfaction is there in employees, work done by these employees is usually of better quality in comparison where the employees are not satisfied with their jobe. So this study to assess job satisfaction and influence of demographic variables on job satisfaction, this study was carried out on 105 doctors of teaching hospitals. Questionnaire method of data collection was adopted. Job satisfaction was measured by six domains: Organizational functioning, Interpersonal relationship, Financial incentives, Non-financial incentives, Physical facilities and Working conditions. Study observed that over all, doctors were moderately satisfied with their job. Domains such as Interpersonal relationship and Working conditions, doctors were highly satisfied, whereas rest of the domains: Organizational functioning, Financial incentives, Non-financial incentives, and Physical facilities doctors were moderately satisfied. It is important to note that even though overall satisfaction is moderate, there were few components, where doctors were highly satisfied were – Communication system between patients and doctors, Involvement in decision making in the department, Rules and regulations of the institution, relationship between the department colleagues and other department colleagues, Provision for leave encashment, reward given for research work, workload of clinical aspect and workload of teaching aspect. Age and sex both shown significant association on level of satisfaction where as experience, designation and marital status of the doctors have not shown significant association.

Key words: Job satisfaction, Doctors, Patient care

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Klippel Trenaunay Weber (KTW) Syndrome with solid organ involvement: Case Report of a rare case

AbstractKlippel-Trenaunay syndrome (KTW) is a rare, sporadic syndrome characterized by a triad of port-wine stain, varicose veins with or without venous malformations, and bony and soft tissue hypertrophy. It usually affects only one extremity, organ involvement is uncommon. A case of 17-year-old boy with this syndrome having solid viscous organ involvement was observed at surgery Outdoor. This case is rare so it was reported. Splenic lymphangiomatosis is also observed in this KTW syndrome case as association of AVM and lymphangioma together in spleen is rarest which was observed in this case. So it is a very rare case.

Keywords: Arterio-Venous Malformations, Limb Hypertrophy, Port-Wine Stain, Splenic Lymphangiomatosis

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Effects of Cigarette and Shisha Smoking on Hematological Parameters: An analytic case-control study

Abstract Cigarette smoking is one of the major causes of cancer and cardiovascular diseases leading to millions of premature deaths each year all over the world. Scientists have identified about 4,000 different substances in tobacco all of which have certain degree of toxic effects. At least 43 of them known carcinogens.

Objective: The aim of this study is to assess the extent of adverse effect of cigarette and shisha on haematological parameters in male population of Khartoum State – Sudan.

Subject and Methods: One hundred and fifty male subjects participated in this study, cigarette smoker (n= 50), shisha smoker (n= 50) and non-smoker (n= 50). The smokers were regularly smoking at least for 10 years. Fresh peripheral blood samples from healthy adult non-smokers and smokers (males) were collected and analysed for Red Blood Cells (RBC) count, haemoglobin (Hb) content, packed cell volume (PCV), MCV, MCH and MCHC, total and differential leucocytes (WBC) counts and total platelets count by using fully automatic haematological analyser.

Results: The smokers of cigarette and shisha had significantly higher level of Hb, HCT, RBCs, TWBC count and MCHC. However, platelets counts were significantly lower in cigarette smokers than that of non-smokers. Study shows that the duration of smoking had no significant effect on haematological parameters except Hb.

Conclusion: It concluded that smoking alters haematological parameter that is injurious to health.

Key words: Cigarette, Shisha, Smoking, Haematology

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