iosr-JDMS   Volume-18 ~ Issue-11 ~ November-2019

Abstract: Introduction: Eclampsia is defined as the development of convulsions and/or coma unrelated to other cerebral conditions during pregnancy or in the post-partum period in patients with signs and symptoms of pre-eclampsia after 20weeks of gestation. Materials and Methods: This study was done on "Maternal and Perinatal outcomeof eclampsia in a tertiary care centre" (KMC & GGH) fromJanuary 2018 to December 2018. The study was conductedin Obstetrics and Gynecology Department, Kurnool MedicalCollege Kurnool, AP, India. The present study aims todetermine the factors affecting the maternal and perinataloutcome of eclamptic mothers. Women with other causesof convulsions were excluded.It was an observational study. Patients with eclampsia wereadmitted through emergency. Inclusion criteria.....

Keywords: Eclampsia, Maternal and Perinatal outcome, preeclampsia

[1]. Iozza I, Cianci S, Di Natale A, et al. Update on systemic lupus erythematosus pregnancy.Journal of Prenatal Medicine. 2010;4(4):67-73.
[2]. Sibai B M.Eclampsia .VI. Maternal-perinatal outcome in 254 consecutive cases. AmJ Obstet Gynecol 1990; 163: 1049–55.
[3]. Hosley CM, McCullough LD. Acute Neurological Issues in Pregnancy and the Peripartum.The Neurohospitalist. 2011;1(2):104-116.
[4]. Zhang J, Meikle S, Trumble A. Severe maternal morbidity associated with hypertensive disorders in pregnancy in United States, Hypertension in Pregnancy 2003; 22:203-127.
[5]. MacKay A P, Berg C J, Atrash H K. Pregnancy-related mortality from preeclampsia and eclampsia. Obstet Gynecol 2001; 97:533–8..

Abstract: Introduction: A hernia is defined as an area of weakness or complete disruption of the fibro muscular tissues of the body wall. Hernias are among the oldest known afflictions of humankind. The word "hernia" is derived from a Latin term meaning "a rupture". The earliest reports of abdominal wall hernias date back to 1500 BC. During this early era, abdominal wall hernias were treated with trusses or bandage dressings. Despite the high incidence, the technical aspects of hernia repair continue to evolve. Materials and methods: All patients attending at Osmania General Hospital OPD with ventral hernia were approached and counseled for laparoscopic IPOM hernioplasty, but only those who agreed were included in this study. Fifty consecutive patients underwent IPOM hernioplasty, over a time period of 20 months (January 2018- December 2018)..........

Key Words: hernia, Laparoscopic intraperitoneal onlay mesh, Abdominal ultrasonogram

[1]. Bauer JJ, Harris MT, Kreel I, Gelernt IM, Twelve year experience with expanded poly tetra fluoro ethylene in the repair of abdominal wall defects. Mt Sinai J Med 1999; 66:20-25.
[2]. Koller R, Miholic J, Jalk RJ, Repair of incisional hernias with expanded polytetrafluoroethylene. Eur J Surg 1997; 163: 261-66.
[3]. Leber GE, Garb JL, Albert AI, Reed WP. Long-term complications associated with prosthetic repair of incisional hernia. Arch Surg 1998; 132: 1141-44.
[4]. Park A, Gagner M, Pomp A, Laparoscopic repair of large incisional hernias. Surg Laparosc Endosc 1996; 6: 123-28.
[5]. White TJ, Santos MC, Thompson JS, Factors affecting wound complications in repair of ventral hernias. Am Surg 1998;64: 276-80.
[6]. Bencini L, Sanchez J, Bo B, Farsi M, Moretti R, Incisional hernia repair: retrospective comparison of laparoscopic and open techniques. Surg Endosc (2003) 17: 1546-51

Abstract: Introduction: An enterostomy is either a surgical procedure to create a durable opening (called a stoma) through the abdominal wall into an intestine (small intestine or large intestine) or the stoma thus created. The various types of enterostomy are named according to which intestinal segment is involved. Indications for surgery and complications are dependent on the site of the enterostomy. Gastrostomies and enterostomies can be used to provide nutrition in digestive disorders. Hernia development at both permanent and temporary enterostomy sites in a common complication. Materials and methods: This is a cross sectional observational study conducted at Department of General Surgery, Osmania Medical College and Osmania......

Key Words: enterostomy, QOL, Gastrostomies, Hernia.

[1]. The WHOQOL Group. The World Health Organisation Quality of Life Assessment (WHOQOL). Develop Psychometr Properties, Soc Sci Med. 1998;46:1569-85.
[2]. Centre for Disease Control and Prevention. Measuring Healthy Days: Population Assessment of Health Related Quality of Life. Centre for Disease Control and Prevention, Atlanta, Georgia; 2000.
[3]. McLeod RS, Cohen Z. Quality of Life with A Stoma. In: Anonymous Intestinal Stomas: Principles, Techniques and Management. New York: Marcel Dekker Inc; 2004: 91-109.
[4]. Chaudhary P, Nabi I, Ranjan G, Tiwari AK, Kumar S, Kapur A, et al. Prospective Analysis of Indications and Early Complications of Emergency Temporary Loop Ileostomies for Perforative Peritonitis. Ann Gastroenterol Q Publ Hell Soc Gastroenterol. 2013;28(1):135-40.
[5]. Arumugum PJ, Beven L, MacDonald L, Watkins AJ, Morgan AR, Beynon J, et al. A Prospective Audit of Stomas- Analysis of Risk Factors and Complications and Their Management. Colorectal Dis. 2003;5(1):49-52.

Abstract: To study the impact of DM on iPTH levels in CKD patients undergoing maintenance hemodialysis. 44 Diabetic CKD patients and 56 Non-Diabetic CKD patients were studied. Fasting Plasma Glucose was measured by Hexokinase method and Serum iPTH levels were measured by Chemiluminescence immunoassay. The Mean of PTH in Diabetics is 239.6 pg/ml compared to the Mean of 306.7 pg/ml in Non-Diabetics. The decrease in PTH in Diabetics is highly significant (p< 0.001) when statistically analysed with Student t-test. This suppression of PTH secretion in Diabetics can be considered to be due to Hyperglycemia seen in DM, which causes inhibition of secretion of PTH by parathyroid cells. We conclude from our study that there is significant decrease in iPTH levels among Diabetic CKD patients on Maintenance Hemodialysis which is responsible for the development of Adynamic Bone Disease in these patients compared to Non-Diabetics. Careful management of Mineral Bone Disease in these patients is essential to avoid Low Turnover Bone Disease (LTBD).

Keywords: Chronic Kidney Disease, intact Parathormone, Diabetes Mellitus, Secondary Hyperparathyroidism, Chronic Kidney Disease-Mineral Bone Disorder

[1]. Levey, A. S., Atkins, R., Coresh, J., et al. (2007). Chronic kidney disease as a global public health problem: approaches and initiatives—a position statement from Kidney Disease Improving Global Outcomes. Kidney Int, 72, 247–59.
[2]. Eknoyan G, Lameire N, Barsoum R et al. The burden of kidney disease: improving global outcomes. Kidney Int 2004; 66: 1310–1314.
[3]. Agarwal SK. Chronic Kidney Disease and its prevention in India. Kidney Int. 2005:68 (Suppl 98):S41-S45.
[4]. Yamamoto M, Yamaguchi T, Nawata K, Yamauchi M, Sugimoto T, H. PT. Decreased Accompanied by Low Bone Formation Are Associated with Vertebral Fractures in Postmenopausal Women with Type 2 Diabetes. The Journal of Clinical Endocrinology Metabolism. 2012;97(4 SRC - BaiduScholar):1277-84.
[5]. Sugimoto T, Ritter C, Morrissey J, Hayes C, Slatopolsky E. Effects of high concentrations of glucose on PTH secretion in parathyroid cells. Kidney International. 1990;37(6):1522-7..

Abstract: Tuberculosis is very common in developing countries like India, be it pulmonary or extrapulmonary. Abdomen is sixth commonest site of involvement in extrapulmonary TB. Abdominal TB may manifest as Tuberculous peritonitis, tuberculous mesenteric lymphadenitis, gastrointestinal tuberculosis and TB of solid abdominal viscera. Here we report a case of TB of inguinal hernia sac in a young male who was posted for elective inguinal mesh hernioplasty for B/L indirect inguinal hernia

Keywords: Abdominal Tuberculosis, Miliary Tubercles.

[1]. Marshall JB. Tuberculosis of the gastrointestinal tract and peritoneum. Am J Gastroenterol. 1993;88:989-99.
[2]. Narasimharaw KL, Pradeep R, Mitra SK, Pathak IC. Abdominal tuberculosis presenting as inguinal hernia. Indian Pediatr. 1983;20:790-1.
[3]. Rao BJ, Kabir MJ, Varshney S: Richter's hernia: A rare presentation of abdominal tuberculosis. Indian J Gastroenterol. 1999;18(1):33.
[4]. Vashist M, Singhal N, Verma M, Deswal S, Mathur S. Abdominal Tuberculosis In A Hernia Sac: A Rare Presentation. The Internet Journal Of Surgery. 2012;28(2).
[5]. Basrur GB, Naik RP, Doctor NH. Primary presentation of abdominal tuberculosis in an inguinal hernia. Indian Journal of Surgery. 2006;68(3):174..

Abstract: Structured Abstract Aim: This study was conducted to evaluate the neoplastic and non-neoplastic conditions encountered in nephrectomy specimens that were received in our department over a 2 year period. Methods: A hospital based two year retrospective study of all nephrectomy specimens received in the department of pathology. Result: A total of 32 nephrectomy specimens were studied. Mean age at which nephrectomy was done was 40.6 years with a female preponderance. 62.5% cases were non neoplastic lesions and 37.5% neoplastic lesions. Wilm's tumor in pediatric age group and renal cell carcinoma in adult age group were commonly seen in the malignant category.....

Keywords: Nephrectomy, Chronic Pyelonephritis, Renal Cell Carcinoma, Wilms tumor,PNET

[1]. Monalisa Hui et al. Histopathological spectrum of pediatric nephrectomies. Indian Journal of Pathology and Microbiology, 2010; 53(1):101-102.
[2]. Kumar MU, Yelikar BR, Patil G, Karigoudar MH, Pande P, Patil SB. Spectrum of histopathological lesions in Nephrectomy specimens- A two year study in a tertiary care hospital. International Journal of Research in Pharmaceutical and Biomedical Sciences. 2012; 3:1787-89.
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[4]. Figlin RA. Renal cell carcinoma: Management of advanced disease. J Urol 1999;161:381-7... [5]. Ordonez NG, Rosai J. Urinary tract. In: Rosai J, editor. Ackerman‟s Surgical Pathology. 9th ed. Missouri: Mosby; 2005. p. 1251-63

Abstract: Hypothyroidism can present with a wide spectrum of presenting symptoms. Patients can have symptoms like fatigue/ lethargy, weight gain, cold intolerance, constipation, menstrual abnormalities in women which are commonly seen and also rare modes of presentation like cerebrovascular accident, isolated effusion (ascites, pleural effusion, pericardial effusion) or in combination of multiple body cavity effusions along with tissue oedema. They can also present with no symptoms at all. According to the literature, the association of hypothyroidism with minor bleeding events (gum bleeding, bruises, and menorrhagia) is widely known, but only a few reports of hypothyroidism as a risk factor for intracerebral bleeding are published. Very few cases have been reported in the literature about the presence of ascites, pericardial effusion and pleural effusion as a separate entity in hypothyroidism or a combination......

[1]. DeCastro F, Bonacini M, Walden JM, Schubert TT. Myxedema ascites. Report of two cases and review of literature. J ClinGastroenterol 1991; 13: 411-4
[2]. Kabadi UM, Kumar SP. Pericardial effusion in primary hypothyroidism. Am Heart J 1990; 120 : 1393-5
[3]. Zondek H. Das myxodemherz (Article in German). Munch Med Wschr 1918;65:1180–3
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[5]. Alevizaki M, Synetou M, Xynos K, Alevizaki CC, Vemmos KN. Hypothyroidism as a protective factor in acute stroke patients. ClinEndocrinol (Oxf) 2006;65:369-72

Abstract: Hypothyroidism, also known as underactive thyroid disease, is a condition in which the thyroid gland does not produce sufficient levels of the thyroid hormones, Triiodothyronine (T3) and Thyroxin (T4). The body's metabolism is affected by thyroid hormone. Hypothyroid patients despite being on adequate replacement doses of thyroxin often present with symptoms of weakness, numbness, paresthesia, and poor memory. Vitamin B12 deficiency could be the reason for these symptoms, so patients with hypothyroidism have vitamin B12 deficiency also, hence undertook to evaluate vitamin B12 levels in patients with hypothyroidism. Hypothyroidism gets worse by the deficiency of vitamin B12. The real problem is that sometime it is difficult to diagnose as both deficiencies can go unnoticed. There are many other causes which may cause vitamin B12 deficiency: - altered intestinal absorption due to sluggish bowel motility, bacterial overgrowth and bowel wall edema.

Keywords: hypothyroidism, subclinical hypothyroidism, vitamin B12

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Abstract: Placenta previa is a rare but leading cause of III trimester bleeding which causes significant maternal and fetal morbidity and mortality. Timely diagnosis of placenta previa is of utmost importance This was a prospective observational study aimed at placental localization in 5424 patients referred for II trimester targeted scan from May 2018 to April 2019 for a period of 12 months. Potential placenta previa defined as placenta with lower egde < 2cm from the os or touching or covering the os was identified in 108(2%) of the cases. These patients were followed up to evaluate the placental migration. Placenta previa was diagnosed in 20 cases(18% of the potential placenta previa......

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[3]. Mustafa SA, Brizot ML, Carvalho MH, Watanabe L, Kahhale S, Zugaib M. Transvaginal ultrasonography in predicting placenta previa at delivery: a longitudinal study. Ultrasound Obstet Gynecol 2002;20:356–9
[4]. Taipale P, Hiilesmaa V, Ylostalo P. Transvaginal ultrasonography at 18-23 weeks in predicting placenta previa at delivery. Ultrasound Obstet Gynecol 1998;12:422–5.
[5]. Lauria MR, Smith RS, Treadwell MC, Comstock CH, Kirk JS, Lee W, et al. The use of second-trimester transvaginal sonography to predict placenta previa. Ultrasound Obstet Gynecol 1996;8:337–40.

Abstract: BACKGROUND-spinal anaesthesia using local anaesthetics is a coomon procedure for surgeries below the umbilical level and some time adding additives to get some additional effects is also common in spinal anaesthesia. AIMS&OBJECTIVES-Our aim is to assess the analgesic effect, sedation and to note the enhancement of postoperative analgesia by the use of a benzodiazepine like Midazolam as an adjuvant to local anaesthetic – 0.5% hyperbaric Bupivacaine and also to assess any another benefits and adverse effects ov intrathecal Midazolam. METHODOLOGY-It is a randomized prospective study ,done in hundred patients ,where fifty patients were given 0.5% heavy Bupivicaine....

Keywords: SA-Spinal Anaesthesia ,PONV-Postoperative nausea &vomiting,GABA-Gamma Amino Butyric Acid. CSF -Cerebrospinal fluid

[1]. Brown DL. Spinal block in Atlas of Regional Anesthesia, 2nd Edition, Philadelphia, WB Saunders Company, 1999
[2]. Larson MD. History of anaesthetic practice, Chapter 1 in Millers' Anesthesia, Sixth Edition, Elsevier Churchill Livingstone, 2004; 3-54
[3]. Hocking G, Wildsmith JAW. Intrathecal Drug Spread. Br J Anaesth 2004;93(4) : 568-78.83
[4]. Batra YK, Jain K, Chari P, Dhillon MS Shaheen B, Reddy GM. Addition of intrathecal midazolam to bupivacaine produces better postoperative analgesia without prolonging recovery. Int J Clin PharmacolTher 1999; 37(10): 519-523.
[5]. N Agarwal, AUsmani, R Sehgal, R Kumar, P Bhadoria. Effect of intrathecal midazolam bupivacaine combination on postoperative analgesia. Ind J Anaesth 2005; 49(1): 39-39.

Abstract: Many studies have shown that the prevalence of diabetes is increasing rapidly in urban as well as in rural India. But there is scarcity of significant data on prevalence of diabetes in the rural population especially among women.Objective: 1.To find out the prevalence of diabetes among adult rural women. 2. To determine the risk factors of diabetes among the study population. Methods:It was a cross-sectional, community based study conducted on 183 adult rural women of 20 years and more of Dearah village of West Bengal. The study was conducted for a period of 3 months. A predesigned, pre tested, semi-structured schedule was used for data collection. Diabetes was assessedby measuring fasting blood sugar with diagnostic kits. Statistical Analysis: Data were analysed by using SPSS.....

Keywords: Diabetes, Rural women, BMI

[1]. Huizinga MM, Rothman RL. Addressing the diabetes pandemic: A comprehensive approach. Indian J Med Res 2006; 124:481-4.
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[3]. Sicree R, Shaw J, Zimmet P. Diabetes and impaired glucose tolerance. In: Gan D, editor. Diabetes Atlas. International Diabetes Federation. 3rd ed. International Diabetes Federation; Belgium: 2006: 15-103.
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Abstract: The purpose of this study was to evaluate the clinical presentations, demographic data and outcome of laparoscopic management of Cholelithiasis in a new medical college hospital of North Eastern state of India. Methods: The study comprised of 100 patients with cholelithiasis who had undergone Laparoscopic Cholecystectomy in a single unit of General Surgery of Zoram Medical College Hospital, Mizoram, India, during the period of November 2017 to October 2019. Patients with Choledocholithiasis, Empyema and Carcinoma of Gallbladder were excluded. Results: The most common clinical presentation in our study was abdominal pain/colic which occurs in 90 % of the cases, other associated complaints were nausea, bloating, belching, fever and jaundice. Age group of forties to fifties constituted majority of case. Few post-operative complications like port site infections,......

Keywords: Abdominal pain, Cholelithiasis, Laparoscopic Cholecystectomy, Bile leakage, bile duct injury Source of support: Nil

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Abstract: Introduction – Multiple bilateral long bone fractures are relatively rare injuries.This study aims to present a case of a patient, a known smoker who sustained ipsilateral humerus and patella and bilateral shaft of femur, tibia and fibula fractures, the functional and clinical outcomes of fixation witha two-year follow-up.Presentation of case: A 26 -year-old man presented to the emergency department after a motor vehicle accident. Radiographs and clinical examination determined a right shaft of humerus fracture, Bilateral shaft of femur fractures and right Patella fracture, right bimalleolar ankle fracture, and left segmental tibia fracture with a grade 3b compound injury. Right Humerus and Right Bimalleolar ankle fractures are treated with open reduction and plating. Tension Band Wiring is done for the right Patella fracture. The bilateralshaft of femur fractures are treated........

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Abstract: Background: Traditional policy is to discharge preterm infants from NICU when a predetermined weight has been achieved which makes their stay in NICU prolonged. Prolonged NICU stay is associated with many adverse effects. So, there must be ways out to discharge these infants early though there are many controversies and concern among health care professionals and parents. Objectives: This study was designed to evaluate the outcome of early transfer of preterm babies from NICU. Materials and Methods: This prospective observational study included stable preterm babies of <34 weeks, tolerating tube feeding, with 1-2 L/min oxygen by nasal canula and whose parents wanted early transfer from NICU. Mothers of the included babies were being trained to provide......

Keywords: Early transfer, NICU, Outcome, Preterm, VLBW.

[1] Eichenwald EC, Stark AR. Management and outcomes of very low birth weight. The New England Journal of Medicine. 2008; 358(16):1700-11.
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[4] Park J, Knafl G, Thoyre S, Brandon D. Factors associated with feeding progression in extremely preterm infants. Nurs Res. 2015; 64(3):159-67.
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Abstract : Pyogenic granuloma is a very common, non‑neoplastic reactive growth of the oral cavity. Conservative surgical excision is the main line of treatment. Other treatment modalitie is cryosurgery, or lasersurgery. Scar formation and recurrence are the main post treatment complications. MATERIALS AND METHODS:500 patients were included in this study in which 325 patients weremale and 175 patients were female.Patients with 18 to 65 years of age were included in this study. Patients with severe reduced mouth opening were excluded from the study. Collected data was analyzed by using software SPSS 16. RESULTS:Out of 325 male patients, 36 (11.08%) patients were diagnosed with pyogenic granuloma and out of 175 female patients, 22 (12.57%) patients were diagnosed with pyogenic granuloma. CONCLUSION: Pyogenic granuloma is more common in female than male......

Keywords : Pyogenic Granuloma; Cryosurgery.

[1]. Samatha Y, Reddy TH, Jyothirrmai, Ravikiran A, Sankar AJ. Management of oral pyogenic granuloma with sodium tetra decyl sulphate. A case series.N Y State Dent J 2013;79:55‑7.
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[4]. Jafarzadeh H, Sanatkhani M, Mohtasham N. Oral pyogenic granuloma: A review. J Oral Sci 2006;48:167-75.
[5]. Kamal R, Dahiya P, Puri A. Oral pyogenic granuloma: Various concepts of etiopathogenesis. J Oral MaxillofacPathol 2012;16:79-82..

Abstract: La localisation colique d'un carcinome épidermoïde primitif est exceptionnelle. Seulement quelques rares cas ont été rapportés dans la littérature. 150 cas ont été publiés entre 1927 et 2014. Nous rapportons le cas d'une patiente de 62 ans sans antécédants pathologiques notables, dont la symptomatologie révélée par une douleur de l'hypochondre droit avec des mélénas et des vomissements postprandiaux. Le diagnostic a été confirmé par une TDMTAP qui a objectivé une tumeur de l'angle colique droite localement avancé avec envahissement de D1 et D2, l'endoscopie oesogastro duodénale a montré un énorme processus duodénal. Les biopsies ont conclu à un carcinome épidermoïde. La prise en charge proposée étant une chimiothérapie palliative

[1]. Santosh K. Mondal, Primary squamous cell carcinoma of the caecum: a case report. Jcancer res ther. 2011 Oct-Dec;5(4):5.
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Abstract: Background: Health care workers are at increasing risk to occupational exposure to blood borne infections. Although avoiding contact with blood is the optimum way to prevent these exposures, still appropriate post-exposure management is an important element in work place safety. Objectives: To evaluate level of knowledge, attitude and practice toward post exposure prophylaxis (PEP) among Sudanese dental practitioners. Materials and methods: A cross sectional study was carried out among 161 dental practitioners from Khartoum dental teaching hospital (KDTH) and Academy Dental Teaching hospital (ADTH) self-administered questionnaire including demographic data and questions regarding knowledge, attitude and practice of post-exposure prophylaxis. Comparison between......

Keywords: HIV/HBV, Needle Stick Injury, Post-exposure prophylaxis, Sudanese Dentists

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Abstract: Adolescence is a susceptible phase in Indian population for the development of nutritional anemia. In addition to physical health, iron and B vitamins also affect adversely the mental health and cognitive performance in children and adolescents.1 Patra, et al.2 in his study on severely anemic adolescents in a tertiary care hospital, found that megaloblastic anemia was the most common type of anemia (42.5%) and iron-deficiency accounted for 15% of cases. Choudhary, et al.3 found two-thirds of the anemic adolescents in community were suffering from iron deficiency anemia. The objective.......

[1]. Swaminathan S, Edward BS, Kurpad AV. Micronutrient deficiency and cognitive and physical performance in Indian children. Eur J Clin Nutr.2013;67:467-474.
[2]. Patra S, Pemde HK, Singh V, Chandra J, Dutta A. Profile of adolescents with severe anemia admitted in a tertiary care hospital in northern India. Indian J Pediatr. 2011;78:863-5.
[3]. Choudhary A, Moses PD, Mony P, Mathai M. Prevalence of anemia among adolescent girls in the urban slums of vellore, south India. Trop Doct. 2006;36:167-9.
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