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   Table of Contents - Current issue
Coverpage
May-August 2019
Volume 6 | Issue 2
Page Nos. 37-88

Online since Tuesday, July 23, 2019

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REVIEW ARTICLES  

The role of school in the management of children with epilepsy p. 37
Aminu Taura Abdullahi, Umar Abdullahi Taura, Zubaida Ladan Farouk
DOI:10.4103/jhrr.jhrr_27_19  
Worldwide, epilepsy affects about 0.7% of children of school age. It is associated with educational difficulties in addition to psychological, social, and other comorbidities. It is important for children with medical conditions such as epilepsy to receive education. The trend is to provide this at mainstream schools. However, there is poor perception and lack of support for children with epilepsy from schoolteachers and the school environment, especially in low and middle-income countries. Teachers, healthcare providers, and policymakers need to have a good understanding of the various issues involved in providing education to these children. We therefore carry out a review of the literature with the aim of highlighting the keys issues pertaining to the education of children with epilepsy. We conclude that the school environment has a role in the management of children with epilepsy from the diagnosis, psychosocial support, and control of stigma to seizure treatment. In particular, there is a need for teachers to be involved in the management of these children in the school environment. Specifically, the involvement of teachers in the provision of rescue medication and safety measures needs to be emphasized.
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Neuropsychiatric sequelae in childhood brain tumor survivors p. 42
Mohammad Abu-Hegazy, Hend Ahmed El-Hadaad, Abdulkhaleq Saeed Alghamdi
DOI:10.4103/jhrr.jhrr_25_19  
Childhood brain tumor (BT) survivors have increased. Physical, cognitive, social functions, and overall quality of life (QOL), may be diminished in response to tumors or their treatments in children. The tumor itself, surgery, chemotherapy, and radiotherapy can contribute to neurocognitive sequelae to debilitating levels. Short-term memory, attention, processing speed, visual-motor processing, and spatial relations deficits may occur months to years after treatment. BT survivors may develop motor, intellectual, visual, and psychoemotional dysfunctions, with moderate-to-severe disabilities. Among survivors of the central nervous system tumors, ocular deficits are common. Platinum-based chemotherapy and posterior and middle cranial fossa radiotherapy have contributed to ototoxicity. Survivors of treated temporal lobe cyst suffered from incapacitating depression and psychosis in one study; however, it is not clear if psychiatric and somatic symptoms are caused by BTs or as a response to psychological stresses after diagnosis or treatment. Childhood (BT) survivors experienced significant lower Health-Related QOL scores than in the normal population. It is a major challenge, for the medical team to prevent these late effects. The article will address the following items: neurological; including cognitive impairment and psychiatric sequelae; QOL in childhood (BT) survivors and how to minimize, prevent, and treat them. The neurological, cognitive, psychiatric, and social problems that develop early in childhood BT survivors may extend into adulthood. Life-long support and follow-up care are recommended for childhood BT survivors. Treatment protocols should be placed considering the reduction of neurocognitive and late neurological deficits.
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Current understanding of diabetes mellitus-induced lower urinary tract dysfunction p. 50
Sasanka Kumar Barua, Somor Jyoti Borah, TP Rajeev
DOI:10.4103/jhrr.jhrr_9_19  
Diabetes mellitus (DM) is slowly emerging as an epidemic in India, afflicting majority of the population, thus having serious public health consequences. DM usually inflicts major insult to almost all organ systems of the body, including the urinary tract. However, there is a dearth of literature on potential hazardous effects of DM on the urinary tract in a particular population. Considering its negative impact on the quality of life, particularly among the growing elderly population in India, we performed literature search through PubMed and unbound Medline database using the terms “diabetic cystopathy,” “diabetic complication urinary tract,” “diabetic urethropathy,” and “diabetic bladder dysfunction” to study the current understanding on the pathophysiology of diabetes induced on the lower urinary tract dysfunction. All the literature based on DM relevant to lower urinary tract dysfunction were studied, and a comprehensive overview of the current understanding of the pathophysiology of diabetes induced on the lower urinary tract dysfunction is provided. These results will facilitate the future directions for research and clinical care of patients with DM-induced lower urinary tract dysfunction. In conclusion, the long-term hyperglycemic state may result in structural and functional changes in urinary bladder and urethra, contributing to deterioration of lower urinary tract coordinated function.
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A review on iron-refractory iron-deficiency anemia p. 57
Sangeetha Thangavelu, T Varsha, Vignesh Mariappan, Vijaya Anand Arumugam, Preethi Basavaraju
DOI:10.4103/0028-3886.263237  
Anemia is a common and predominant blood disorder globally, in which the level of hemoglobin or healthy red blood cells are abnormally lower. The most common type of anemia is iron-deficiency anemia (IDA), and the treatment is iron supplementation to the individuals. In some conditions, the iron supplementation does not alter the hemoglobin range, which means the iron given is not taken up by the body of the individual. This condition is found to be iron-refractory IDA (IRIDA). It is the genetic condition, in which the hepcidin, an iron regulatory hormone expression is altered. IRIDA is a rare genetic disorder, which is autosomal recessive in inheritance pattern. Hepcidin alteration blocks the iron absorption, which in turn causes anemic condition. The transmembrane protease serine 6 (TMPRSS6) gene is involved in negative regulation of hepcidin along with the encoding of matriptase-2 enzyme, which is crucial for iron balance in the human body. Matriptase-2 regulates the iron homeostasis by balancing the hepcidin hormone. The genetic polymorphisms in the TMPRSS6 gene result in this a rare type of anemic condition. Therefore, this review particularly focuses on the IRIDA and TMPRSS6 gene, hepcidin, and matriptase-2 enzyme. The review on IRIDA is being found to be important since the clear metabolism of hepcidin and matriptase-2 in iron metabolism are still unclear.
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ORIGINAL ARTICLES Top

Prevalance of correlation between temporomandibular dysfunction and occupational stress in white collar professionals p. 62
Krutika D Gawade, G Vardharajulu
DOI:10.4103/jhrr.jhrr_21_19  
Aims: Occupational stress (OS) is regarded as associated factor for causing temporomandibular joint temporomandibular dysfunction (TMD). However, there is little knowledge on the relationship between incremental OS and its role in causing TMD. The purpose of the study is to determine the relationship between OS and TMD. This study will help to provide the basic data to improve the conditions at the worksite and enhance the quality of life. Materials and Methods: A cross-sectional study was conducted among 100 white-collar professionals (WCPs) in Karad. To determine the prevalence of TMD, the scaled named Anamnestic Index by Fonseca was used. OS was assessed by the OS Index Scale. Data obtained from the outcome measures were analyzed using InStat, adopting a 5% significance level. Brief analysis was made, and the Pearson correlation test was used to find the correlation between TMD and OS. Results: The results obtained by OSI stated that majority of WCP experienced moderate stress (67%) highest among teachers. Fifty-three percent prevalence of TMD was noted, highest among teachers. The major correlation noted in moderate OS group (38%) majorly affecting teachers. The gender-wise findings noted females (53%) were more prone. Age-wise findings stated more prevalence among 31–40 years (56%). Conclusion: The results of this study show that a significant percentage of population had signs of TMDs, and there are high chances they may develop symptoms in the future. It is necessary to prevent the OS in WCP by improving working conditions, emotional stability, and frequent postural changes. Further studies are necessary for documentation of these preventive measures.
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Comparative effect of chair calisthenics, Yoga, and chest physiotherapy on exercise tolerance, quality of life, and duration of hospital stay in hospitalized chronic obstructive pulmonary disease patients p. 67
Peeyoosha Gurudut, Sakshi Ozha, Risia Passanha, Shivani Patel
DOI:10.4103/0028-3886.263248  
Aims: Previous studies have inferred that calisthenics, yoga, and chest physiotherapy (CPT) are effective in managing chronic obstructive pulmonary disease (COPD) patients. However, there are no studies done to compare calisthenics, yoga, and CPT. The aim of this study was to compare the effect of calisthenics exercises, yoga, and CPT on exercise tolerance, fatigue level, quality of life (QOL), and duration of hospital stay in COPD patients. Subjects and Methods: This study was an assessor-blinded, randomized, controlled trial. Data were collected from the inpatient department of a tertiary care hospital in Belagavi. Thirty-three patients diagnosed with COPD were divided randomly into calisthenics, yoga, and CPT groups. Outcomes were assessed for exercise tolerance, breathlessness, lung capacity, and QOL. Within-group analysis was done using the Wilcoxon signed-rank test/paired t-test. Between-group comparison was done using the ANOVA/Kruskal–Wallis test. Post hoc test was used to find which specific group was better than the others. Results: Between-group analyses showed that calisthenics was better than CPT (P < 0.001) to improve lung capacity, whereas calisthenics and yoga showed equal effect in improving lung capacity. Conclusions: Calisthenics, yoga, and CPT are equally effective in improving exercise tolerance, QOL, and perceived exertion. Calisthenics and yoga are equally effective and better than CPT in improving lung capacity of patients with COPD.
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A comparative study of central and peripheral arterial parameters in hypertensive patients on angiotensin receptor blockers and calcium channel blockers p. 76
Kailas Laxman Rao, Mohammed Abdul Hannan Hazari, Bachi Tazneem, Ahmed Abdul Aziz, Asiya Mohtesham, A Afreen, Kethavath Priyanka
DOI:10.4103/0028-3886.263243  
Aims: Untreated or inappropriately managed hypertension (HTN) is a significant risk factor for all-cause morbidity and mortality due to its complications. For proper management of HTN, timely diagnosis and classification into appropriate category is crucial. According to hypertensive class category, pharmacological therapy can be initiated according to the national or international guidelines. Various antihypertensive medications have differential effects on peripheral and central arterial parameters. Our study was aimed at comparing the effects of two classes of antihypertensive drugs, i.e., angiotensin receptor blockers (ARBs) and calcium channel blockers (CCBs). Materials and Methods: Hypertensive patients on monotherapy – ARBs (Group 1, n = 35) and CCBs (Group 2, n = 35) – over the age of 18 years, belonging to both genders, were recruited. Results: Heart rate and peripheral and central arterial pressures were lower in Group 2 compared to Group 1; ankle brachial index and carotid-femoral pulse wave velocity were less in Group 1 in comparison with Group 2; but these differences were statistically not significant. Conclusions: We conclude that the two groups of drugs were equally effective in blood pressure reduction, both in central and peripheral arteries.
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Survival parametric models to estimate the factors of under-five child mortality p. 82
Rakesh Kumar Saroj, K H. H. V. S. S. Narasimha Murthy, Mukesh Kumar, Rajneesh Singh, Avadhesh Kumar
DOI:10.4103/jhrr.jhrr_22_19  
Aims: Child survival status is one of the major health-related concerns in all over the developing countries. There are various socioeconomic, demographic, environmental, and proximate and biological factors which are responsible for under-five child mortality. Our aim was to find the significant factors among various responsible factors under study using parametric and semi-parametric models. Materials and Methods: In this article, National Family Health Survey (NFHS)-IV data is used state of Uttar Pradesh in India after authentication and permission. Cox regression analysis (semi-parametric model) was performed to obtain the significant role of variables. Parametric models (Weibull, exponential, log-logistic, and log-normal) were performed to estimate the survival. Results: By using the Cox regression model, it was found that socioeconomic, demographic (education level, women's age, and religion), and proximate and biological factors (women's age in years, total number of children ever born, birth in the last 5 years, number of living children, currently breastfeeding, smokers, desire for more children, size of child, delivery by cesarean section, antenatal care visits, and birth order) play a significant role in the context of under-five child mortality. Based on the Akaike Information Criterion's (32985.3) minimum value, the Weibull model was found to be best fitted among all the other parametric models. Conclusions: There is used different parametric models. It is found that Weibull model is best fitted among all models. The study concludes that child mortality influences by the different factors. The study suggests that public health researcher, clinicians, health policy makers and other demographer need to implement more health programs related to child health especially for the under-five year children.
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Survival parametric models to estimate the factors of under-five child mortality p. 82
Rakesh Kumar Saroj, K H. H. V. S. S. Narasimha Murthy, Mukesh Kumar, Rajneesh Singh, Avadhesh Kumar
DOI:10.4103/jhrr.jhrr_22_19  
Aims: Child survival status is one of the major health-related concerns in all over the developing countries. There are various socioeconomic, demographic, environmental, and proximate and biological factors which are responsible for under-five child mortality. Our aim was to find the significant factors among various responsible factors under study using parametric and semi-parametric models. Materials and Methods: In this article, National Family Health Survey (NFHS)-IV data is used state of Uttar Pradesh in India after authentication and permission. Cox regression analysis (semi-parametric model) was performed to obtain the significant role of variables. Parametric models (Weibull, exponential, log-logistic, and log-normal) were performed to estimate the survival. Results: By using the Cox regression model, it was found that socioeconomic, demographic (education level, women's age, and religion), and proximate and biological factors (women's age in years, total number of children ever born, birth in the last 5 years, number of living children, currently breastfeeding, smokers, desire for more children, size of child, delivery by cesarean section, antenatal care visits, and birth order) play a significant role in the context of under-five child mortality. Based on the Akaike Information Criterion's (32985.3) minimum value, the Weibull model was found to be best fitted among all the other parametric models. Conclusions: There is used different parametric models. It is found that Weibull model is best fitted among all models. The study concludes that child mortality influences by the different factors. The study suggests that public health researcher, clinicians, health policy makers and other demographer need to implement more health programs related to child health especially for the under-five year children.
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